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June 12, 2026European Journal of Preventive CardiologyOpen Access

Among athletes exceeding absolute thresholds for aortic dilatation, 10% exceeded +2 SD using LVEDV indexation, compared to 17.5% using BSA and 25% using height.

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Why the study?

Does indexing aortic dimensions to LVEDV improve the classification of aortic dilatation in elite athletes compared to BSA or height indexation?

Population

404 elite athletes, median age 28.0 years, 41% women, 46% endurance athletes.

Comparison

Indexation of aortic dimensions to left… vs Indexation of aortic dimensions to body surface…

Design

Cross-sectional

Authors

HHH El HriMDM A Van DiepenJDJ J N Daems

Discussion

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Overview

Indexing to LVEDV may normalize aortic dimensions in more athletes than BSA or height; leaves open impact on clinical outcomes.

Key Points

  • Investigate if indexing aortic dimensions to LVEDV reclassifies athletes with aortic dilatation.
  • Cross-sectional cardiac MRI study in elite athletes aged ≥16 years with no heart disease history.
  • Aortic root measured and indexed to BSA, height, and LVEDV; the study included 404 athletes and categorized by sex and sport type.
  • Adjusted correlation analysis between aortic root diameter and LVEDV across different sport categories.
  • Aortic dilatation found in 9.2% of athletes, with 54% being women and 46% endurance athletes.
  • Aortic root diameter significantly correlates with LVEDV; among those exceeding dilation thresholds, 10% reclassified using LVEDV compared to 17.5% using BSA.
  • Indexing to LVEDV placed more athletes within normal physiological range compared to indexation methods based on BSA and height.

Structured PICO

Does indexing aortic dimensions to LVEDV improve the classification of aortic dilatation in elite athletes compared to BSA or height indexation?

P
Population
404 elite athletes (Olympic, national or international; ≥16 years; ≥10h exercise/week without a history of heart disease and no para-athletes), median age 28.0 years, 41% women, 46% endurance athletes.
I
Intervention
Indexation of aortic dimensions to left ventricular end-diastolic volume (LVEDV) measured by cardiac MRI.
C
Comparator
Indexation of aortic dimensions to body surface area (BSA) and height.
O
Outcome
Reclassification of athletes exceeding absolute thresholds for aortic dilatation (>40 mm in men and >34 mm in women).surrogate

Indexing aortic root dimensions to LVEDV reclassifies more athletes with an absolute dilated aortic root to normal physiological ranges than BSA or height indexation, better reflecting exercise-induced remodeling.

Cite This Study

Hri et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe902https://doi.org/10.1093/eurjpc/zwag249.092
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Aallometric scaling of left ventricular structure in elite cyclists: development of sport-specific prediction equations2026
  2. 2LEFT ATRIAL VOLUME INDEXATION IN PREDIABETES AND TYPE 2 DIABETES: WHY HEIGHT MATTERS2025
  3. 3Aortic dilation in masters endurance athletes: prevalence and associations with cardiac physiology and training load2026
  4. 4Effects of Exercise Training on Left Ventricular Hypertrophy and Cardiac Regulation in Elite Athletes: Insight from a Composite Index Proxy of Autonomic Control2026 · 1 citations
  5. 5Cardiovascular magnetic resonance to differentiate veteran athlete’s heart with cavity dilatation and mild dilated cardiomyopathy2025 · 5 citations