Clinical InvestigationImaging and Diagnostic TestingCardiac magnetic resonance assessment of left and right ventricular morphologic and functional adaptations in professional soccer players

BackgroundProfessional, long-term physical training is associated with cardiac morphologic and functional changes that depend on the type of exercise performed. So far, the specific effect of soccer training on cardiac morphology has not been investigated with cardiac magnetic resonance imaging (CMRI). We sought to use CMRI to study left ventricular (LV) and right ventricular (RV) morphologic and functional adaptations in professional soccer players.MethodsTwenty-nine male professional soccer players (mean age 24.6 ± 3.9 years, range 18-31 years) in different playing positions and 29 nonathlete male controls (27.0 ± 3.7 years, 21-34 years) underwent CMRI. Electrocardiographic-gated steady-state free-precession cine CMRI was used to measure myocardial mass (MM), end-diastolic volume (EDV) and end-systolic volume, stroke volume (SV), ejection fraction, and cardiac index at rest. We calculated the ventricular remodeling index (RI) to describe the pattern of cardiac hypertrophy.ResultsVentricular volume and mass indices were significantly (P < .001) higher in athletes. LVEDV and RVEDV on MRI was above normal in 27/29 athletes. There was a strong positive correlation between EDV and myocardial mass (P < .01). The LVRI and RVRI were similar (0.73 ± 0.1 g/mL; 0.22 ± 0.01 g/mL) to that of controls (0.71 ± 0.1 g/mL; 0.22 ± 0.01 g/mL). No significant differences were observed for LV ejection fraction and cardiac index. Neither the comparison of athletes in different playing positions nor the comparison of younger and older players revealed statistically significant differences.ConclusionCardiac magnetic resonance imaging measurements enable studying the mechanisms of LV and RV adaptation in professional soccer players and reflect the ventricular response to combined endurance and strength based training.