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Association between race and maladaptive concentric left ventricular hypertrophy in American-style football athletes
  1. Jason V Tso1,
  2. Casey G Turner1,
  3. Chang Liu1,
  4. Angelo Galante2,
  5. Carla R Gilson2,
  6. Craig Clark3,
  7. Herman A Taylor4,
  8. Arshed A Quyyumi1,
  9. Aaron L Baggish5,
  10. Jonathan H Kim1
  1. 1Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2Sports Medicine, Georgia Institute of Technology, Atlanta, Georgia, USA
  3. 3Sports Medicine, Furman University, Greenville, South Carolina, USA
  4. 4Department of Medicine, Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, USA
  5. 5Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Jonathan H Kim, Emory University School of Medicine, Atlanta, Georgia, USA; jonathan.kim{at}emory.edu

Abstract

Objectives American-style football (ASF) athletes are at risk for the development of concentric left ventricular hypertrophy (C-LVH), an established cardiovascular risk factor in the general population. We sought to address whether black race is associated with acquired C-LVH in collegiate ASF athletes.

Methods Collegiate ASF athletes from two National Collegiate Athletic Association Division-I programmes were recruited as freshmen between 2014 and 2019 and analysed over 3 years. Demographics (neighbourhood family income) and repeated clinical characteristics and echocardiography were recorded longitudinally at multiple timepoints. A mixed-modelling approach was performed to evaluate acquired C-LVH in black versus white athletes controlling for playing position (linemen (LM) and non-linemen (NLM)), family income, body weight and blood pressure.

Results At baseline, black athletes (N=124) were more often NLM (72% vs 54%, p=0.005) and had lower median neighbourhood family income ($54 119 vs $63 146, p=0.006) compared with white athletes (N=125). While both black and white LM demonstrated similar increases in C-LVH over time, among NLM acquired C-LVH was more common in black versus white athletes (postseason year-1: N=14/89 (16%) vs N=2/68 (3%); postseason year-2: N=9/50 (18%) vs N=2/32 (6%); postseason year-3: N=8/33 (24%) vs N=1/13 (8%), p=0.005 change over time). In stratified models, black race was associated with acquired C-LVH in NLM (OR: 3.70, 95% CI 1.12 to 12.21, p=0.03) and LM was associated with acquired C-LVH in white athletes (OR: 3.40, 95% CI 1.03 to 11.27, p=0.048).

Conclusions Independent of family income and changes in weight and blood pressure, black race was associated with acquired C-LVH among collegiate ASF NLM and LM was associated with acquired C-LVH in white athletes.

  • football
  • cardiology
  • cardiomegaly
  • exercise-induced
  • longitudinal studies

Data availability statement

No data are available. No data are available. The data are deidentified participant data and not available for public use.

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Data availability statement

No data are available. No data are available. The data are deidentified participant data and not available for public use.

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Footnotes

  • Twitter @jonathankimmd

  • Contributors JHK had access to all of the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. JVT, CL and JHK performed statistical analyses and drafted the manuscript. All authors contributed with acquisition of the data, conceptual design, analyses and interpretation of the results. All authors contributed to draft the article, critical revisions for intellectual content and gave final approval for the version submitted.

  • Funding This work was entirely supported by US National Institutes of Health/National Heart, Lung, and Blood Institute research grant K23 HL128795 (to JHK).

  • Competing interests JHK receives compensation serving in his role as team cardiologist for the Atlanta Falcons. AB receives compensation serving in his role as team cardiologist for the New England Patriots. HAT is an Advisory Board Member for Pfizer and Educational Consultant for Novartis.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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