title: Effect of Sex and Sporting Discipline on LV Adaptation to Exercise.
abstract: This study sought to investigate the effect of different types of exercise on left ventricular (LV) geometry in a large group of female and male athletes.
  
  
  
  Studies assessing cardiac adaptation in female and male athletes indicate that female athletes reveal smaller increases in LV wall thickness and cavity size compared with male athletes. However, data on sex-specific changes in LV geometry in athletes are scarce.
  
  
  
  A total of 1,083 healthy, elite, white athletes (41% female; mean age 21.8 ± 5.7 years) assessed with electrocardiogram and echocardiogram were considered. LV geometry was classified into 4 groups according to relative wall thickness (RWT) and left ventricular mass (LVM) as per European and American Society of Echocardiography guidelines: normal (normal LVM/normal RWT), concentric hypertrophy (increased LVM/increased RWT), eccentric hypertrophy (increased LVM/normal RWT), and concentric remodeling (normal LVM/increased RWT).
  
  
  
  Athletes were engaged in 40 different sporting disciplines with similar participation rates with respect to the type of exercise between females and males. Females exhibited lower LVM (83 ± 17 g/m2vs. 101 ± 21 g/m2; p < 0.001) and RWT (0.35 ± 0.05 vs. 0.36 ± 0.05; p < 0.001) compared with male athletes. Females also demonstrated lower absolute LV dimensions (49 ± 4 mm vs. 54 ± 5 mm; p < 0.001) but following correction for body surface area, the indexed LV dimensions were greater in females (28.6 ± 2.7 mm/m2vs. 27.2 ± 2.7 mm/m2; p < 0.001). Most athletes showed normal LV geometry. A greater proportion of females competing in dynamic sport exhibited eccentric hypertrophy compared with males (22% vs. 14%; p < 0.001). In this subgroup only 4% of females compared with 15% of males demonstrated concentric hypertrophy/remodeling (p < 0.001).
  
  
  
  Highly trained athletes generally show normal LV geometry; however, female athletes participating in dynamic sport often exhibit eccentric hypertrophy. Although concentric remodeling or hypertrophy in male athletes engaged in dynamic sport is relatively common, it is rare in female athletes and may be a marker of disease in a symptomatic athlete.
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Gherardo
authors.initials: G
authors.lastname: Finocchiaro
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Harshil
authors.initials: H
authors.lastname: Dhutia
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: D'Silva
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Aneil
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Steriotis
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Lynne
authors.initials: L
authors.lastname: Millar
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Keerthi
authors.initials: K
authors.lastname: Prakash
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Rajay
authors.initials: R
authors.lastname: Narain
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Papadakis
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Rajan
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom. Electronic address: sasharma@sgul.ac.uk.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D056352:Athletes; D059267:Cardiomegaly, Exercise-Induced; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012737:Sex Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D055815:Young Adult
keywords: athlete’s heart; left ventricular geometry; physiological adaptation to exercise