Kandels Joscha, Metze Michael, Stöbe Stephan, Do Lisa, Möbius-Winkler Maximilian Nicolas, Antoniadis Marios, Hagendorff Andreas, Marshall Robert Percy
Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, 04103 Leipzig, Germany.
RasenBallsport Leipzig GmbH, Cottaweg 3, 04177 Leipzig, Germany.
Diagnostics (Basel). 2025 Jul 9;15(14):1745. doi: 10.3390/diagnostics15141745.
Transthoracic echocardiography (TTE) is the primary imaging modality to assess cardiac morphology and function. In athletes, distinguishing physiological adaptations from pathological changes is essential. This study aimed to evaluate long-term cardiac structural and functional changes in professional soccer players. This retrospective study included 20 healthy male professional soccer players (mean age 21.2 ± 3.4 years) from the German first division, examined annually from 2016 to 2024 (mean follow-up 5.6 ± 2.0 years). TTE parameters associated with the "athlete's heart" were assessed, including left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVSD), relative wall thickness (RWT), indexed LV mass (LVMi), and left atrial volume index (LAVi), along with 3D-derived LV and RV volumes. Advanced deformation imaging included global longitudinal strain (GLS), right ventricular strain (RVS), and left/right atrial reservoir strain (LASr and RASr, respectively). Baseline and final follow-up values were compared. No significant changes were observed over time in conventional or advanced echocardiographic parameters (e.g., LVEDD: 54.5 ± 3.1 mm vs. 54.6 ± 3.9 mm; = 0.868; GLS: -18.7% ± 2.2% vs. -18.4% ± 1.9%; = 0.670). Ventricular volumes and strain values also remained stable throughout follow-up. Over a mean follow-up of more than five years, professional soccer players showed stable cardiac morphology and function without evidence of pathological remodeling. These findings support the concept that long-term high-level training in mixed-discipline sports leads to balanced, physiological cardiac adaptation.
经胸超声心动图（TTE）是评估心脏形态和功能的主要成像方式。在运动员中，区分生理适应性变化与病理改变至关重要。本研究旨在评估职业足球运动员长期的心脏结构和功能变化。这项回顾性研究纳入了20名来自德国甲级联赛的健康男性职业足球运动员（平均年龄21.2±3.4岁），他们在2016年至2024年期间每年接受检查（平均随访5.6±2.0年）。评估了与“运动员心脏”相关的TTE参数，包括左心室舒张末期内径（LVEDD）、室间隔厚度（IVSD）、相对壁厚（RWT）、左心室质量指数（LVMi）和左心房容积指数（LAVi），以及三维测量的左心室和右心室容积。先进的形变成像包括整体纵向应变（GLS）、右心室应变（RVS）以及左/右心房储备应变（分别为LASr和RASr）。比较了基线值和最终随访值。在传统或先进的超声心动图参数方面，未观察到随时间的显著变化（例如，LVEDD：54.5±3.1mm对54.6±3.9mm；P = 0.868；GLS：-18.7%±2.2%对-18.4%±1.9%；P = 0.670）。在整个随访过程中，心室容积和应变值也保持稳定。在平均超过五年的随访中，职业足球运动员表现出稳定的心脏形态和功能，没有病理重塑的迹象。这些发现支持了这样一种观点，即混合项目运动中的长期高水平训练会导致心脏产生平衡的生理适应性变化。
