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Coronary artery z score values in adolescent elite male soccer players

Published online by Cambridge University Press:  24 November 2020

Stephan Gerling*
Affiliation:
Department of Pediatrics, University Children’s Hospital Regensburg (KUNO), Campus St. Hedwig, Regensburg, Germany
Tobias Pollinger
Affiliation:
Department of Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany
Markus Johann Dechant
Affiliation:
Department of Pediatrics, University Children’s Hospital Regensburg (KUNO), Campus St. Hedwig, Regensburg, Germany
Michael Melter
Affiliation:
Department of Pediatrics, University Children’s Hospital Regensburg (KUNO), Campus St. Hedwig, Regensburg, Germany
Werner Krutsch
Affiliation:
Department of Traumatology, University Hospital Regensburg, Regensburg, Germany
Holger Michel
Affiliation:
Department of Pediatrics, University Children’s Hospital Regensburg (KUNO), Campus St. Hedwig, Regensburg, Germany
*
Author for correspondence: Dr S. Gerling, MD, University Children’s Hospital Regensburg (KUNO), Campus St. Hedwig, Steinmetzstr 1-3, Regensburg93049, Germany. Tel: 0049 941/369-5409; Fax: 0049 941/369-5424. E-mail: [email protected]

Abstract

Background:

With the increased training loads at very early ages in European elite youth soccer, there is an interest to analyse coronary artery remodelling due to high-intensity exercise.

Design and methods:

Prospective echocardiographic study in 259 adolescent elite male soccer players and 48 matched controls.

Results:

The mean age was 12.7 ± 0.63 years in soccer players and 12.6 ± 0.7 years in controls (p > 0.05). Soccer players had significant greater indexed left ventricular mass (93 ± 13 g/m2 versus 79 ± 12 g/m2, p = 0.001). Both coronary arteries origin could be identified in every participant. In soccer players, the mean diameter of the left main coronary artery was 3.67 mm (SD ± 0.59) and 2.61 mm (SD ± 0.48) for right main coronary artery. Controls showed smaller mean luminal diameter (left main coronary artery, p = 0.01; right main coronary artery, p = 0.025). In soccer players, a total of 91% (n = 196) and in controls a total of 94% (n = 45) showed left main coronary artery z scores within the normal range: −2.0 to 2.0. In right main coronary artery, a pattern of z score values distribution was comparable (soccer players 94%, n = 202 vs. controls 84%, n = 40). A subgroup of soccer players had supernormal z score values (>2.0 to 2.5) for left main coronary artery (9%, n = 19, p = 0.01) and right main coronary artery (6%, n = 10, p = 0.025), respectively.

Conclusion:

Elite soccer training in early adolescence may be a stimulus strong enough to develop increased coronary arteries diameters. In soccer players, a coronary artery z score >2.0–2.5 might reflect a physiologic response induced by multiannual high-intensity training.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Mont, L, Pelliccia, A, Piepoli, M, et al. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: position paper from the EHRA and the EACPR, branches of the ESC. Eur J Prev Cardiol 2017; 24: 4169.CrossRefGoogle ScholarPubMed
Maron, BJ, Doerer, JJ, Haas, TS, Tierney, DM, Mueller, FO. Sudden deaths in young competitive athletes. Analysis of 1866 deaths in the United States, 1980–2006. Circulation 2009; 119: 1085.CrossRefGoogle ScholarPubMed
Gerling, S, Michel, H, Krutsch, W, et al. Echocardiographic diagnosis of congenital coronary artery abnormalities in a continuous series of adolescent football players. Eur J Prev Cardiol 2019; 26: 988994.CrossRefGoogle Scholar
Wrigley, R, Drust, B, Stratton, G, Scott, M, Gregson, W. Quantification of the typical weekly in-season training load in elite junior soccer players. J Sports Sci 2012; 30: 15731580.CrossRefGoogle ScholarPubMed
McClean, G, Riding, NR, Wilson, DG, et al. Electrical and structural adaptations of the paediatric athlete’s heart: a systematic review with meta-analysis. Br J Sports Med 2018; 52: 230.CrossRefGoogle ScholarPubMed
Gerling, S, Pollinger, T, Michel, H, Dechant, MJ, Melter, M, Krutsch, W. z-score values of left ventricular dimensions in adolescent elite male soccer players. Eur J of Ped, 2020 July 24. [Epub ahead of print].Google ScholarPubMed
Pelliccia, A, Spataro, A, Granata, M, Biffi, A, Caselli, G, Alabiso, A. Coronary arteries in physiological hypertrophy: echocardiographic evidence of increased proximal size in elite athletes. Int J Sports Med 1990; 11: 120126.CrossRefGoogle ScholarPubMed
Green, DJ, Spence, A, Rowley, N, Thijssen, DH, Naylor, LH. Vascular adaptation in athletes: is there an “athlete’s artery”? Exp Physiol 2012; 97: 295304.CrossRefGoogle Scholar
Lang, RM, Badano, LP, Voigt, JU, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16: 233270 CrossRefGoogle ScholarPubMed
Fuse, S, Kobayashi, T, Saji, T, et al. Standard method for ultrasound imaging of coronary artery in children. Pediatr Int 2010; 52: 876–82.CrossRefGoogle ScholarPubMed
Dallaire, F, Dahdah, N. New equations and a critical appraisal of coronary artery z scores in healthy children. J Am Soc Echocardiogr 2011; 24: 6074.CrossRefGoogle Scholar
Haycock, GB, Schwartz, GJ, Wisotsky, DH. Geometric method for measuring body surface area: a height–weight formula validated in infants, children and adults. J Pediatr 1978; 93: 6266.CrossRefGoogle ScholarPubMed
Epstein, ML, Goldberg, SJ, Allen, HD, Konecke, L, Wood, J. Great vessel, cardiac chamber, and wall growth patterns in normal children. Circulation 1975; 51: 11241129.CrossRefGoogle ScholarPubMed
Cheitlin, MD, MacGregor, J. Congenital anomalies of coronary arteries: role in the pathogenesis of sudden cardiac death. Herz 2009; 34: 268279.CrossRefGoogle ScholarPubMed
Davis, JA, Cecchin, F, Jones, TK, Portmann, MA. Major coronary artery anomalies in a pediatric population: incidence and clinical importance. J Am Coll Cardiol 2001; 37: 593597.CrossRefGoogle Scholar
Dahhan, A. Coronary artery ectasia in atherosclerotic coronary artery disease, inflamatory disorders, and sickle cell disease. Cardiovasc Ther 2015; 33: 7988.CrossRefGoogle Scholar
Schuler, G, Adams, V, Goto, Y. Role of exercise in the prevention of cardiovascular disease: results, mechanisms, and new perspectives. Eur Heart J 2013; 34: 17901799.CrossRefGoogle ScholarPubMed
Poliner, LR, Dehmer, GJ, Lewis, SE, Parkey, RW, Blomqvist, CG, Willerson, JT. Left ventricular performance in normal subjects: a comparison of the responses to exercise in the upright and supine positions. Circulation 1980; 62: 528534.CrossRefGoogle ScholarPubMed
Mitchell, JH, Haskell, W, Snell, P, Van Camp, SP. Task force 8: classification of sports. J Am Coll Cardiol 2005; 45: 13641367.CrossRefGoogle ScholarPubMed
Laughlin, MH, Joseph, B. Physical activity in prevention and treatment of coronary disease: the battle line is in exercise vascular cell biology. Med Sci Sports Exerc 2004; 36: 352362.CrossRefGoogle ScholarPubMed
Nelson, RR, Gobel, FL, Jorgensen, CR, Wang, K, Wang, Y, Taylor, HL. Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise. Circulation 1974; 50: 11791189.CrossRefGoogle ScholarPubMed
Hildick-Smith, D, Johnson, P, Cooper, KH, et al. Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study. Heart 2000; 84: 383389.CrossRefGoogle ScholarPubMed
Ho, JS, Cannaday, JJ, FitzGerald, SJ, et al. Relation of coronary artery diameters with cardiorespiratory fitness. Am J Cardiol 2018; 121: 10651071.CrossRefGoogle ScholarPubMed
Sharma, S, Merghani, A, Mont, L. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J 2015; 36: 14451453.CrossRefGoogle ScholarPubMed