Abstract EP44: Longer Retirement Time Is Associated With Lower Left Ventricular Mass In Retired National Football League Players

Abstract

Background: Increased left ventricular mass (LVM), a common structural phenomenon associated with athlete’s heart, has been reported to regress following cessation from systematic high-intensity training. However, information is limited on the interplay between length of retirement and LVM in former professional field-based athletes, a segment of the population in which both hypertension and obesity, factors generally associated with increased LVM, have been reported as highly prevalent. Thus, we aimed to explore this observation in a group of former National Football League (NFL) players. Methods: This complete-case analysis included 1,348 retired NFL players (aged 53.3 ± 12.8 years, 55.5% Black) that participated in the NFL’s Player Care Foundation comprehensive health screenings between 2015 and 2021. Years since retirement from professional American-style football (YrsRetired) was calculated as year of examination minus the last self-reported year playing for the NFL. Echocardiography was used to estimate LV mass, which was then indexed to height 2.7 (LVMI). LVMI was divided into quartiles and stepwise binary logistic regression models were fitted to assess the association of YrsRetired with the lowest quartile (Q1) of LVMI, after adjusting for traditional cardiometabolic risk factors, NFL career length, and playing position group (Model 1); cardiometabolic risk factors and playing position group (Model 2); or cardiometabolic risk factors only (Model 3). Results: The prevalence of hypertension and abdominal obesity in our sample was 75.1% and 57.1%, respectively. Mean retirement length was 24.8 ± 12.7 years (range: 1.0 - 59.0 years), and mean LVMI was 40.3 ± 9.7 g/m 2.7 . Increasing YrsRetired was independently associated with higher odds for LVMI Q1 (Model 2, odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.00-1.07, p= 0.04 ; Model 3, OR: 1.03, 95% CI: 1.00-1.07, p= 0.03). When adding NFL career length to the model, the association between YrsRetired and LVMI Q1 was attenuated (Model 1, p = 0.91). Conclusions: Longer retirement is associated with lower left ventricular mass in this group of retired NFL players. These findings suggest that regression of LVM following retirement from professional sport may be common in former NFL players, despite the high prevalence of hypertension and obesity reported in this population. Further, these findings imply that elite sports participation may have a potential buffering effect against hypertension and/or obesity-induced hemodynamic changes that increase LVM, which seem to particularly occur after retirement from professional sports. This potential instance may be impacted by professional career length.