MORPHOLOGY OF THE ATHLETES HEART ASSESSED BY ECHOCARDIOGRAPHY IN 947 ELITE ATHLETES REPRESENTING 27 SPORTS

In the present study, we used echocardiography to investigate the morp hologic adaptations of the heart to athletic training in 947 elite ath letes representing 27 sports who achieved national or international le vels of competition. Cardiac morphology was compared for these sports, using multivariate statistical models. Left ventricular (LV) diastoli c cavity dimension above normal (> 54 mm, ranging up to 66 mm) was ide ntified in 362 (38%) of the 947 athletes. LV wall thickness above norm al (> 12 mm, ranging up to 16 mm) was identified in only 16 (1.7%) of the athletes. Athletes training in the sports examined showed consider able differences with regard to cardiac dimensions. Endurance cyclists , rowers, and swimmers had the largest LV diastolic cavity dimensions and wall thickness. Athletes training in sports such as track sprintin g, field weight events, and diving were at the lower end of the spectr um of cardiac adaptations to athletic training. Athletes training in s ports associated with larger LV diastolic cavity dimensions also had h igher values for wall thickness. Athletes training in isometric sports , such as weightlifting and wrestling, had high values for wall thickn ess relative to cavity dimension, but their absolute wall thickness re mained within normal limits. Analysis of gender-related differences in cardiac dimensions showed that female athletes had smaller LV diastol ic cavity dimension (average 2 mm) and smaller wall thickness (average 0.9 mm) than males of the same age and body size who were training in the same sport. Our results demonstrate that sports differ greatly wi th regard to their impact on LV dimensions and that, in general, athle tes training in sports associated with large diastolic cavity dimensio n also have relatively high values for wall thickness. Our findings al so show that gender has an influence on the morphology of the ''athlet e's heart'' independent of type of sport, age, and body size.