AUTHOR=Minetto Marco Alessandro , Toso Elisabetta , Della Vecchia Federico , Ferraris Andrea , Magistrali Massimo , Alunni Gianluca , Busso Chiara , Pietrobelli Angelo , Shepherd John A. , Heymsfield Steven B. TITLE=The impact of different body surface area prediction equations on ventricular dilatation prevalence in youth soccer players JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1627460 DOI=10.3389/fcvm.2025.1627460 ISSN=2297-055X ABSTRACT=BackgroundThe normalization of echocardiographic variables for body surface area (BSA) enables to obtain relative indexes of ventricular size that are useful for diagnosis and monitoring of non-ischaemic cardiomyopathies. The BSA values commonly considered in the clinical practice are obtained using predictive equations. Our aims were to investigate the accuracy of different predictive equations for BSA estimation and to evaluate the impact of different BSA normalizations on ventricular dilatation prevalence in youth soccer players.MethodsTwo samples of 369 and 111 youth soccer players of both genders were recruited. Acquisition of optical images (for the players of the first sample), two-dimensional echocardiographic assessment (for the players of the second sample), and weight and height measurements (for the players of both samples) were performed. BSA estimates were derived from optical images and from ten different predictive equations obtained from the literature.ResultsIn the first sample of 369 players, we found differences among the BSA estimates obtained with ten predictive equations in both male and female players and we also found that all predictive equations in male players and almost all predictive equations in female players overestimated BSA compared to the optical imaging-derived BSA. In the second sample of 111 soccer players, we found that the normalization of each echocardiographic variable for different BSA values resulted in significantly different relative values and that ventricular dilatation prevalence was a function of BSA normalization.ConclusionNewly developed equations seemed the most accurate for BSA estimation in both male and female players: therefore, we suggest to adopt these equations for BSA estimation in youth soccer players. The BSA normalization impacts on the ventricular dilatation prevalence: therefore, we suggest to adopt the proper normalization approach to improve the clinical validity of echocardiography in athletes.