{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:36:40Z","timestamp":1790307400522,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Clinically relevant aortic dilatation (&gt;40\u2009mm) and increased cardiovascular risk are common among retired professional American\u2010style football athletes. Among younger athletes, the effect of American\u2010style football participation on aortic size is incompletely understood. We sought to determine changes in aortic root (AR) size and associated cardiovascular phenotypes across the collegiate career.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This was a multicenter, longitudinal repeated\u2010measures observational cohort study of athletes across 3\u2009years of elite collegiate American\u2010style football participation. A total of 247 athletes (119 [48%] Black, 126 [51%] White, 2 [1%] Latino; 91 [37%] linemen, 156 [63%] non\u2010linemen) were enrolled as freshmen and studied at pre\u2010 and postseason year 1, postseason year\u00a02 (N=140 athletes), and postseason year 3 (N=82 athletes). AR size was measured with transthoracic echocardiography. AR diameter increased over the study period from 31.7 (95% CI, 31.4\u201332.0) to 33.5\u2009mm (95% CI, 33.1\u201333.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). No athlete developed an AR \u226540\u2009mm. Athletes also demonstrated increased weight (cumulative mean \u0394, 5.0 [95% CI, 4.1\u20136.0] kg,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), systolic blood pressure (cumulative mean \u0394, 10.6 [95% CI, 8.0\u201313.2] mm\u2009Hg,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), pulse wave velocity (cumulative mean \u0394, 0.43 [95% CI, 0.31\u20130.56] m\/s,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and left ventricular mass index (cumulative mean \u0394, 21.2 [95% CI, 19.2\u201323.3] g\/m\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and decreased\n              <jats:italic>E<\/jats:italic>\n              \u2032 velocity (cumulative mean \u0394, \u22122.4 [95%CI, \u22122.9 to \u22121.9] cm\/s,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Adjusting for height, player position, systolic blood pressure, and diastolic blood pressure, higher weight (\n              <jats:italic>\u03b2<\/jats:italic>\n              =0.030,\n              <jats:italic>P<\/jats:italic>\n              =0.003), pulse wave velocity (\n              <jats:italic>\u03b2<\/jats:italic>\n              =0.215,\n              <jats:italic>P<\/jats:italic>\n              =0.02), and left ventricular mass index (\n              <jats:italic>\u03b2<\/jats:italic>\n              =0.032,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and lower\n              <jats:italic>E<\/jats:italic>\n              \u2032 (\n              <jats:italic>\u03b2<\/jats:italic>\n              =\u22120.082,\n              <jats:italic>P<\/jats:italic>\n              =0.001) were associated with increased AR diameter.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Over the collegiate American\u2010style football\u00a0career, athletes demonstrate progressive AR dilatation associated with cardiac and vascular functional impairment. Future studies delineating aortic outcomes are necessary to determine whether AR dilation is indicative of maladaptive vascular remodeling in this population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.030314","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T10:27:25Z","timestamp":1686824845000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Longitudinal Aortic Root Dilatation in Collegiate American\u2010Style Football Athletes"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-5362","authenticated-orcid":false,"given":"Jason V.","family":"Tso","sequence":"first","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8677-5912","authenticated-orcid":false,"given":"Casey G.","family":"Turner","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8918-7224","authenticated-orcid":false,"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Prabakaran","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1217-7037","authenticated-orcid":false,"given":"Mekensie","family":"Jackson","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Galante","sequence":"additional","affiliation":[{"name":"Sports Medicine Georgia Institute of Technology Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla R.","family":"Gilson","sequence":"additional","affiliation":[{"name":"Sports Medicine Georgia Institute of Technology Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Clark","sequence":"additional","affiliation":[{"name":"Sports Medicine Furman University Greenville SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"B. Robinson","family":"Williams","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8166-679X","authenticated-orcid":false,"given":"Arshed A.","family":"Quyyumi","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2042-1489","authenticated-orcid":false,"given":"Aaron L.","family":"Baggish","sequence":"additional","affiliation":[{"name":"Cardiovascular Performance Program Massachusetts General Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5885-0284","authenticated-orcid":false,"given":"Jonathan 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