Left atrial enlargement in competitive athletes and atrial electrophysiology

Rev Esp Cardiol (Engl Ed). 2022 May;75(5):421-428. doi: 10.1016/j.rec.2021.05.020. Epub 2021 Aug 7.
[Article in English, Spanish]

Abstract

Introduction and objectives: There are scarce data on left atrial (LA) enlargement and electrophysiological features in athletes.

Methods: Multicenter observational study in competitive athletes and controls. LA enlargement was defined as LA volume indexed to body surface area ≥ 34mL/m2. We analyzed its relationship with atrial electrocardiography parameters.

Results: We included 356 participants, 308 athletes (mean age: 36.4±11.6 years) and 48 controls (mean age: 49.3±16.1 years). Compared with controls, athletes had a higher mean LA volume index (29.8±8.6 vs 25.6±8.0mL/m2, P=.006) and a higher prevalence of LA enlargement (113 [36.7%] vs 5 [10.4%], P <.001), but there were no relevant differences in P-wave duration (106.3±12.5ms vs 108.2±7.7ms; P=.31), the prevalence of interatrial block (40 [13.0%] vs 4 [8.3%]; P=.36), or morphology-voltage-P-wave duration score (1.8±0.84 vs 1.5±0.8; P=.71). Competitive training was independently associated with LA enlargement (OR, 14.7; 95%CI, 4.7-44.0; P <.001) but not with P-wave duration (OR, 1.02; 95%CI, 0.99-1.04), IAB (OR, 1.4; 95%CI, 0.7-3.1), or with morphology-voltage-P-wave duration score (OR, 1.4; 95%CI, 0.9-2.2).

Conclusions: LA enlargement is common in adult competitive athletes but is not accompanied by a significant modification in electrocardiographic parameters.

Keywords: Athlete; Bloqueo interauricular; Deportista; Dilatación de la aurícula izquierda; Interatrial block; Left atrial enlargement; Onda P; P-wave.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Athletes
  • Atrial Fibrillation* / epidemiology
  • Cardiac Electrophysiology
  • Electrocardiography
  • Heart Atria / diagnostic imaging
  • Humans
  • Interatrial Block
  • Middle Aged
  • Young Adult