The right heart of the elite senior rugby football league athlete

Background: Right heart enlargement is common in the athletes’ heart phenotype however few data exist regarding interpretation of normal athletic adaptation during Pre-participation Cardiac Screening (PCS) of Rugby Football League (RFL) athletes. Echocardiography is utilised during PCS and thus the primary aim of this study was to establish the normal right ventricular (RV) phenotype in elite RFL athletes using standard 2D echocardiography and myocardial mechanics. The secondary aim was to describe right atrial (RA) structure and function using 2D echocardiography. Methods: 139 male RFL athletes underwent echocardiographic evaluation of the right heart including RV strain (ɛ) and strain rate (SR) imaging using speckle tracking echocardiography (STE). Non-athletic males were used for comparison and allometric scaling was applied for conventional echocardiographic parameters. Results: Scaled RV dimensions were larger in athletes (P 0.05) in RV fractional area change (FAC) and RV longitudinal ɛ were observed between groups. Tissue Doppler imaging (TDI) indexed parameters and global strain rate (SR) were lower (P 0.05) observed by volume assessment. Conclusions: Reduction in SR and indexed TDI are partly associated with lower HR and increased body mass and are likely to represent normal physiological adaptation in RFL athletes. RA enlargement appears proportional to RV enlargement. These data may aid interpretation of normal athletic adaptation during PCS of RFL athletes.