Aortic Abnormalities in Elite Rugby Players

There are many reports of cardiac abnormalities in athletes. By contrast, there is little known about cardiac abnormalities in Rugby. We observed the ascending aortic index (AoI) of elite rugby players compared to non-elite rugby players. A transthoracic echocardiogram was performed on 162 Rugby players. The AoI was measured and compared. Of the players, 89were former elite players aged 45± 8.4 years, engaged in >5 years of 1st grade Rugby (70% played for their Country/State of Origin). Height was 179.1± 11.1 cm and weight 93± 17 kg. The remaining 73 played Rugby at club grade >5 years and were well matched for height, weight and age. They were aged 43± 6.7 years. Height was 178.2± 5.8 cm and weight 92± 14.7 kg. In the elite group the AoI was 22± 0.6mm/m2. The AoI was enlarged >20mm/m2 in 69 players >23mm/m2 in 15 players. There was also notable effacement of the anterior sinotubular junction in 65% of the elite players. In the non-elite players the average AoI was smaller at 18.1± 0.8mm/m2. The AoI was enlarged >20mm/m2 in 8 players >23mm/m2 in one player. The incidence of AoI 20mm/m2 in elite Rugby players is significantly greater than a matched non elite population (p< 0.0001). The reason for this is unknown; it could be secondary to the training regime, the high aortic pressures developed during strength training in conjunction with explosive aerobic exercise, thoracic micro trauma, or the unique game playing tactics and tackling. It is unlikely to be an expression of a pathological condition but may have longer term clinical implications.