Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes

Publication Date: May 1, 2020
Last Updated: March 14, 2022

Key Points


  1. Clinical imaging specialists performing and/or interpreting imaging studies in CA should possess a basic knowledge of fundamental exercise physiology and EICR.
  2. The magnitude (i.e., absolute wall thickness and chamber dimensions/volumes) and geometry (eccentric vs. concentric) of LV adaptation in CA is defined by the complex interplay between numerous factors, including sport type, sex, ethnicity, and duration of prior exercise exposure.
  3. When due to EICR, RV dilation, a common adaptation in CA engaging in endurance sports, should be accompanied by LV eccentric remodeling/hypertrophy and biatrial dilation.
  4. Mild aortic sinus or ascending aortic dilation may occur in young CA but absolute aortic measurements of ≥40 mm (men) and ≥34 mm (women) are uncommon. A finding of aortic sinus or ascending aortic dimensions in excess of these sex-specific cut-points should prompt clinical consideration of aortic pathology and subsequent imaging with either gated CTA or CMR.

CA, Competitive athlete(s); CMR, Cardiac magnetic resonance imaging; CTA, Computed tomography angiography; CVD, Cardiovascular disease; EICR, Exercise-induced cardiac remodeling; LA, Left atrium/left atrial; LV, Left ventricle/left ventricular; RA, Right atrium/right atrial; RV, Right ventricle/right ventricular; SCD, Sudden cardiac death; TTE, Transthoracic echocardiography/echocardiogram



Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes

Authoring Organizations