Abstract 11052: The Association Between Left Ventricular Mass and Coronary Artery Calcium Score in Retired National Football League Players

Abstract

Introduction: Literature suggests that increased left ventricular mass (LVM) is a predictor of coronary heart disease and mortality in the general population, and that increased LVM is associated with higher CAC. However, the association between LVM and subclinical atherosclerosis as indicated by absolute CAC has not been widely explored in retired elite athletes, who may have had or still have increased LVM as a result of exercise adaptation. Thus, we sought to investigate this association in a cohort of retired National Football League (NFL) players. Methods: This cross-sectional study included 632 retired NFL players aged 40 and older (mean age 56.4 ± 9.7 yrs; 51.3% Black) that participated in NFL Player Care Foundation health screenings. Two-dimensional echocardiogram was used to determine LVM according to American Society of Echocardiology guidelines and indexed to height to obtain left ventricular mass index (LVMI, g/m 2.7 ). LVH was considered as LVMI &gt 49.2 g/m 2.7 . Multi-variable logistic regression models were utilized to determine the association of LVM with the highest quintile of CAC (CAC = 264-6239) after adjusting for traditional cardiometabolic risk factors. Results: The mean LVM of study participants was 220.8 ± 56.6 g and the prevalence of LVH 16.9%. LVM was highest in the 2 nd quintile of CAC, with LVM in the highest quintile of CAC significantly lower than that of the first and second quintiles and not significantly different from that of the 3 rd or 4 th quintiles. Multi-variable logistic regression models revealed that increasing LVM was associated with decreased odds for the highest quintile of CAC (odds ratio [OR]: 0.99, 95% confidence interval [CI] 0.99 - 1.00, p = 0.0486), with no such association for LVH (OR: 0.72, 95% CI 0.37-1.41, p = 0.3429). Conclusion: Odds for increased atherosclerotic cardiovascular disease risk, as indicated by the highest quintile of CAC, are decreased by augmented LVM within physiological range in this cohort of retired NFL players, possibly reflective of a potential protective effect of high lifetime exercise dose. These results suggest that there may be lingering or carryover effect of early life cardiovascular fitness, even in middle-aged retired athletes.