To characterize sport-specific exercise-induced cardiac remodeling in elite baseball players using echocardiography.
Approach:
Study Design: A cross-sectional echocardiographic study of elite baseball players participating in the Major League Baseball Combine.
Participants: 588 players from the MLB Combine in June 2022, 2023, and 2024.
Measurements: Echocardiographic measurements of cardiac structure and function were obtained following American Society of Echocardiography guidelines.
Data Analysis: Data were analyzed using SAS 9.4, with descriptive statistics calculated for all variables.
Key Findings:
Left ventricular dilation in 37% of players and right ventricular dilation in 28%.
Biventricular systolic function and global longitudinal strain were within normal limits.
Left ventricular hypertrophy was rare, with only three cases reported.
Normal echocardiographic findings in 98% of athletes.
The most common abnormality was a bicuspid aortic valve, observed in 1% of the cohort.
Interpretation:
The findings establish normative data for expected cardiac adaptations in elite baseball players, aiding in the differentiation of physiologic remodeling from pathologic changes.
Limitations:
Cross-sectional analysis without longitudinal follow-up.
No clinical outcome analyses or subgroup analyses reported.
Lack of comparisons with nonathlete control populations.
Classification of ventricular dilation findings relative to overall normal echocardiographic findings was not described.
Conclusion:
The study is the first to characterize exercise-induced cardiac remodeling in elite baseball players and reports a prevalence of abnormalities comparable to the general population.
An interpretable machine-learning model classified angiographic coronary artery disease in patients referred for coronary angiography, but high disease prevalence and unclear inflammatory signals limited clinical interpretation.
