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Risks to heart structure, function elevated in college football linemen
ORLANDO, Fla. — College football linemen have a greater risk for certain heart problems compared with players at other positions, according to data presented at the American Heart Association Scientific Sessions.
Researchers analyzed 87 college freshmen playing football, 30 of whom were linemen. They compared the players’ systolic BP, left ventricular mass and prevalence of LV hypertrophy before and after their freshman season and then stratified them by position.
Previous research indicated that college football players, particularly linemen, are at increased risk for developing LV hypertrophy. Jeffrey Lin, MD, and colleagues hypothesized that this elevated risk would be accompanied by relative impairment in systolic function as determined by LV global longitudinal strain.
Jeffrey Lin
At the end of their freshman season, players had an increase in systolic BP (baseline, 119 mm Hg; end of season, 124 mm Hg; P < .05), body surface area-indexed LV mass (baseline, 95 g/m2; end of season, 104 g/m2; P < .05) and prevalent LV hypertrophy (baseline, 8%; end of season, 25%; P < .05), according to results reported.
“The most dramatic change is the increase in the incidence of high [BP], particularly in the linemen who have an increased mass of muscle wall and a relative decrease in heart function compared to non-linemen,” Lin, a cardiac imaging fellow at Columbia University, said in a press release.
Most linemen with LV hypertrophy (82%) had concentric geometry while most non-linemen with LV hypertrophy (80%) had eccentric geometry, according to the researchers.
“In this context, linemen demonstrated a significant decrease in [global longitudinal strain] (P < .001), which was associated with changes in LV mass and [systolic] BP, while non-linemen demonstrated an increase in [global longitudinal strain] (P = .001) unrelated to either mass or [systolic] BP,” the researchers wrote in an abstract.
Ejection fraction did not differ between linemen and non-linemen in this study.
“There are physiologic differences between football linemen and non-linemen,” Lin said. “Linemen tend to be heavier, making them at higher risk for increased high [BP] and thickness of heart muscle, and potentially decreased heart function over time.” – by Erik Swain
Reference:
Lin J, et al. Abstract 14278. Presented at: American Heart Association Scientific Sessions; Nov. 7-11, 2015; Orlando, Fla.
Disclosure: Lin reports no relevant financial disclosures.
Perspective
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Changes in the heart with exercise, termed “athlete’s heart,” have been assumed to be healthy adaptions to increased demand. These data, an important extension of this group’s prior research on changes in the heart with high-intensity exercise, suggest we may need to think further about what’s adaptive and what may actually be maladaptive. Prior data from this unique research program, which collects meticulous data over time in college football players from their arrival on the team as freshman, has shown increases in BP and LV mass with college football training, but it was unclear whether these changes were adaptive or not. The current data show that markers of cardiac function may actually worsen in conjunction with these changes. This is a short-term study, and it will be important to determine whether these acute changes will carry any long-term prognostic import, a study this group is uniquely positioned to pursue and I hope they will.
There are a couple of immediate take-home points for cardiologists. First, we need to realize that not all athletes are the same. Here, even within one sport, there were differences between the linemen and the other positions. Second, we need to keep in mind that just because changes occur with sports does not mean they are necessarily to the good. Whether there are specific measures which may keep athletes healthy over time is another important avenue for future research.