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Author Notes:

Dr Jonathan H Kim, Emory University School of Medicine, Atlanta, Georgia, USA. Email: jonathan.kim@emory.edu; Twitter Jonathan H Kim @jonathankimmd

We continue to thank the athletic departments and the student athletes at Georgia Institute of Technology and Furman University for their ongoing support of this research and participation in our athletic registry. We also acknowledge Digirad and Athletic Heart for providing all echocardiographic imaging services. Digirad and Athletic Heart were both compensated for providing the sonographers who performed all echocardiograms a part of this study.

JHK receives compensation serving in his role as team cardiologist for the Atlanta Falcons. AB receives compensation serving in his role as team cardiologist for the New England Patriots. HAT is an Advisory Board Member for Pfizer and Educational Consultant for Novartis.


Research Funding:

This work was entirely supported by US National Institutes of Health/National Heart, Lung, and Blood Institute research grant K23 HL128795 (to JHK).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Sport Sciences
  • football
  • cardiology
  • cardiomegaly
  • exercise-induced
  • longitudinal studies
  • MASS

Association between race and maladaptive concentric left ventricular hypertrophy in American-style football athletes


Journal Title:



Volume 56, Number 3


, Pages 151-+

Type of Work:

Article | Post-print: After Peer Review


OBJECTIVES: American-style football (ASF) athletes are at risk for the development of concentric left ventricular hypertrophy (C-LVH), an established cardiovascular risk factor in the general population. We sought to address whether black race is associated with acquired C-LVH in collegiate ASF athletes. METHODS: Collegiate ASF athletes from two National Collegiate Athletic Association Division-I programmes were recruited as freshmen between 2014 and 2019 and analysed over 3 years. Demographics (neighbourhood family income) and repeated clinical characteristics and echocardiography were recorded longitudinally at multiple timepoints. A mixed-modelling approach was performed to evaluate acquired C-LVH in black versus white athletes controlling for playing position (linemen (LM) and non-linemen (NLM)), family income, body weight and blood pressure. RESULTS: At baseline, black athletes (N=124) were more often NLM (72% vs 54%, p=0.005) and had lower median neighbourhood family income ($54 119 vs $63 146, p=0.006) compared with white athletes (N=125). While both black and white LM demonstrated similar increases in C-LVH over time, among NLM acquired C-LVH was more common in black versus white athletes (postseason year-1: N=14/89 (16%) vs N=2/68 (3%); postseason year-2: N=9/50 (18%) vs N=2/32 (6%); postseason year-3: N=8/33 (24%) vs N=1/13 (8%), p=0.005 change over time). In stratified models, black race was associated with acquired C-LVH in NLM (OR: 3.70, 95% CI 1.12 to 12.21, p=0.03) and LM was associated with acquired C-LVH in white athletes (OR: 3.40, 95% CI 1.03 to 11.27, p=0.048). CONCLUSIONS: Independent of family income and changes in weight and blood pressure, black race was associated with acquired C-LVH among collegiate ASF NLM and LM was associated with acquired C-LVH in white athletes.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/rdf).
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