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Heart. 2014 Aug;100(16):1264-71. doi: 10.1136/heartjnl-2014-305904. Epub 2014 Jun 10.

Predominance of normal left ventricular geometry in the male 'athlete's heart'.

Author information

  • 1Research Institute for Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK.
  • 2Cardiopulmonary Exercise Testing Lab, Stanford University, Centre for Inherited Cardiovascular Disease, Stanford, California, USA.
  • 3Cardiology Department, Airedale General Hospital, Keighley, UK.
  • 4School of Sport, Cardiff Metropolitan University, Cardiff, UK.
  • 5Department of Physical Medicine & Rehabilitation, Department of Veterans Affairs, Northern California Health Care System, and University of California Davis Medical Centre, Sacramento, California, USA.
  • 6Research Institute for Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK Cardiology Department, Countess of Chester Hospital, Chester, UK.
  • 7St George's University Hospital London, London, South West London, UK.



This study evaluated (a) global LV adaption to endurance versus resistance training in male athletes, (b) LV assessment using by modern imaging technologies and (c) the impact of scaling for body size on LV structural data.


A prospective cross-sectional design assessed the LV in 18 elite endurance-trained (ET), 19 elite resistance-trained (RT) and 17 sedentary control (CT) participants. Standard 2D, tissue Doppler and speckle tracking echocardiography assessed LV structure and function. Indexing of LV structures to body surface area (BSA) was undertaken using ratio and allometric scaling.


Absolute and scaled LV end-diastolic volume (ET: 43.7±6.8; RT: 34.2±7.4; CT 32.5±8.9 mL/m(1.5); p<0.05) and LV mass (ET: 29.8±6.6; RT: 25.4±8.7; CT 25.9±6.4 g/m(2.7); p < 0.05) were significantly higher in ET compared with RT and CT. LV wall thickness were not different between ET and RT. 65% of ET and 95% of RT had normal geometry. Stroke volume was higher in ET compared with both RT and CT (p<0.05). Whilst regional tissue velocity data were not different between groups, longitudinal and basal circumferential strain (ε) was reduced in RT compared with ET.


In this comprehensive evaluation of the male athlete's heart (AH), normal LV geometry was predominant in both athlete groups. In the ET, 30% demonstrated an eccentric hypertrophy with no concentric hypertrophy in RT. Cardiac ε data in RT require further evaluation, and any interpretation of LV size should appropriately index for differences in body size.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

[PubMed - indexed for MEDLINE]
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