It is not always easy to distinguish modifications occurring in the heart of athletes from the ones which are real heart diseases: for example, ventricular left remodeling can be taken for hypertrophy and the same difficulty is to be seen in the evaluation of aortic root diameter, normally considered a physiologic consequence of the increased heart output. On this topic, in athletes, a maximum normal limit has been established in 40 mm in males and in 34 mm in females, but the matter is not clear, yet. Using the data from the Italian National Olympic Committee, some researchers have identified 2317 athletes (1300 males) with no heart diseases, undergoing starting echocardiography and followed then for about 8 years. At the beginning, 17males and 10 females (no one affected by Marfan syndrome) presented an aortic root diameter higher than the above mentioned limit. Among males, this diameter has increased during follow-up from 41 to 43 mm and in three athletes it has gone beyond 48 mm. There have been, instead, no changes in females. With adjusted analyses, it was seen a significant association between aortic root diameter and body weight, height, left ventricle mass and age; from the point of view of sports, the strongest association has been found in cycling, swimming and basket.
The result of this Italian trial confirms the limits considered as normal for athletes (40 mm and 34 mm, in males and females), so considering exceeding values as not normal and worth of further investigations.
