title: Sex-related differences in left ventricular structure in early adolescent non-professional athletes.
abstract: BACKGROUND
  Professional athletes exhibit lower left ventricular wall thicknesses, diameters and mass (in females), with less frequent training-related electrocardiogram (ECG) changes, as compared with controls.
  
  
  METHODS
  We studied the association of sex with left ventricular structure in trained early adolescents. Two hundred and six adolescent Caucasian athletes (mean age 13.8 ± 1.6, range 11.8-16.9 years, 158 males and 48 females), with similar degree of training underwent ECG and echocardiographic measurements of left ventricular diameters, thicknesses and mass, with relative wall thickness as the remodelling index.
  
  
  RESULTS
  As compared with females, males exhibited greater maximal wall thickness (males = 8.7 ± 1.2 vs. females = 7.9 ± 0.8) and indexed left ventricular mass (100 ± 18 g/m(2) vs. 79 ± 12, p < 0.001), without differences in relative wall thickness (males = 0.35 ± 0.04 vs. females = 0.34 ± 0.04) and with higher prevalence of ECG-based left ventricular hypertrophy, sinus bradycardia and ST-elevation. An analysis of covariance, using age, body surface area, systolic blood pressure, heart rate and sex as the covariates, reported that sex is a strong predictor of left ventricular mass, maximal wall thickness, left ventricular diastolic diameter and ECG-based left ventricular hypertrophy. In a binary logistic regression model analysis sex, like left ventricular mass, predicted ST-trait elevation.
  
  
  CONCLUSIONS
  Our results suggest that, in early adolescence, female athletes have lower left ventricular mass and thicknesses compared with males, without geometrical differences. Therefore, sex, independent of age, is a strong determinant of structural parameters also in early adolescent athletes. These data indicate that sex-specific parameters are needed in the pre-participation cardiovascular screening of adolescent athletes.
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy giovanna.pela@unipr.it.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pelà
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Crocamo
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Li Calzi
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Gianfreda
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Margherita I
authors.initials: MI
authors.lastname: Gioia
authors.affiliation: Department of Molecular Medicine, University of Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Visioli
authors.affiliation: AUSL Cardiology Unit, Parma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pattoneri
authors.affiliation: Department of Biomedical, Biotechnological, and Translational Sciences (S.Bi.Bi.T.), Unit of Pathology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Corradi
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Goldoni
authors.affiliation: Department of Clinical and Experimental Medicine and Laboratory of Clinical Physiology, University Medical School and University Hospital of Parma, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Montanari
mesh_terms: D000293:Adolescent; D056352:Athletes; D002648:Child; D003971:Diastole; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010807:Physical Endurance / Q000502:physiology*; D012189:Retrospective Studies; D012737:Sex Factors; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Athlete’s heart; echocardiography; left ventricular geometry; left ventricular mass; pre-participation screening process