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Athletic Cardiac Remodeling in US Professional Basketball Players

Study researchers and article authors

David J. Engel, MD; Allan Schwartz, MD; Shunichi Homma, MD


The stated goal of this study was “To perform a comprehensive cardiac structural analysis of National Basketball Association (NBA) professional athletes.” The study authors chose to conduct this analysis due to the lack of data regarding cardiac remodeling that occurs within US basketball players. This lack of data makes it more difficult to evaluate athletes for their risk of suffering from sudden cardiac death (SCD), which occurs with more frequency among basketball players than among athletes from other sports.

In order to achieve this goal, researchers examined the preseason ECG examinations from 526 NBA athletes who were on the active rosters during the 2013-2014 and 2014-2015 seasons. Collection, study, and analysis of the data was complete by May 2015.

There were six elements of the data that were analyzed for each athlete. They were as follows:

  • Left ventricular size
  • Left ventricular mass
  • Left ventricular wall thickness
  • Left ventricular hypertrophy patterns and functions
  • Left atrial volume
  • Aortic root diameter

The study encountered the following results:

  • Left ventricular size and mass were proportional to the size of the athlete. This proportionality remained consistent even in the largest NBA athletes.
  • 27.4 percent of participants demonstrated some form of left ventricular hypertrophy
  • African American athletes had greater left ventricular wall thickness and left ventricular mass than did white athletes.
  • Left atrial volume tended to be greater in athletes who had greater left atrial mass.
  • The aortic root diameter in the athletes varied from 25 to 42.
  • Aortic root diameters plateaued in the larger athletes.
  • Aortic root sizes were similar to those found in athletes from other sports.
  • Despite LV dilation in many of the athletes, LVEDD was normal when the increased size of the athletes was accounted for.
  • Only 1 percent of athletes were found to have an LVEF of less than 50 percent, and in all athletes the ventricles worked correctly with exercise.

As a result of these findings, the study concluded that any evaluation of a basketball player’s cardiac health must be taken in the context of their entire medical history and physical state. The authors hoped that their study would help to establish comparative data that could be useful in more accurately conducting cardiac assessments for NBA players.