Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, NSW, Australia.
Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Heart Lung Circ. 2020 Feb;29(2):196-201. doi: 10.1016/j.hlc.2019.06.714. Epub 2019 Jun 28.
Prompted by a cluster of observations concerning ascending aortic pathology in elite rugby players, we assessed over 150 asymptomatic predominantly retired players with echocardiography, aiming to document the prevalence and severity of ascending aortic dilatation and/or anterior aortic effacement, both 'risk factors' for potentially catastrophic aortic complications.
Rugby players (at least 5 years of high level competitive rugby) were classified as elite (national, state or first grade representatives) or non-elite. A total of 152 asymptomatic players with a mean age of 45 ± 13 years (range 21-65) underwent transthoracic echocardiography. Z-scores (number of standard deviations from a population mean) were calculated for aortic root and ascending aortic size.
Regarding the aortic root, a Z-score of >2 was seen in 24% (expected prevalence 2.3%, p < 0.001) and a Z-score >3 was seen in 4% (expected prevalence 0..1%, p < 0.001). Sixty-two (62) players (41%) had an aortic root greater than 40 mm diameter. Ascending aortic Z-scores were >2 in 53% of players and >3 in 22% (p < 0.001). Abnormal anterior aortic effacement at the sinotubular junction (STJ) was seen in 88 players (58%). Abnormal aortic dilatation and effacement were associated with a longer duration of competitive rugby participation and elite status, respectively.
Ascending aortic dilatation with abnormal anterior effacement is exceedingly common in asymptomatic retired elite rugby players. This warrants increased surveillance in retired players until the clinical significance of these findings can be further investigated.
由于观察到精英橄榄球运动员的升主动脉病变，我们对 150 多名无症状的、主要是已退休的运动员进行了超声心动图检查，旨在记录升主动脉扩张和/或主动脉前壁消失的发生率和严重程度，这两者都是潜在灾难性主动脉并发症的“危险因素”。
将橄榄球运动员（至少有 5 年高水平竞技橄榄球经历）分为精英（国家级、州级或一级代表）和非精英。共有 152 名无症状的、平均年龄 45±13 岁（21-65 岁）的运动员接受了经胸超声心动图检查。主动脉根部和升主动脉大小的 Z 评分（距人群平均值的标准差数）进行了计算。
主动脉根部 Z 评分>2 的发生率为 24%（预期发生率 2.3%，p<0.001），Z 评分>3 的发生率为 4%（预期发生率 0.1%，p<0.001）。62 名（41%）运动员的主动脉根部直径大于 40mm。53%的运动员升主动脉 Z 评分>2，22%的运动员升主动脉 Z 评分>3（p<0.001）。88 名运动员（58%）出现窦管交界区异常前壁消失。异常主动脉扩张和前壁消失与更长的竞技橄榄球参与时间和精英状态有关。
无症状的已退休精英橄榄球运动员升主动脉扩张伴异常前壁消失极为常见。这需要对退役运动员进行更密切的监测，直到进一步研究这些发现的临床意义。
