Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes

1 Division of Cardiology, Massachusetts General Hospital, Boston; 2 Department of Medicine, Massachusetts General Hospital, Boston; and 3 University Health Services, Harvard University, Cambridge, Massachusetts Submitted 31 October 2007 ; accepted in final form 18 December 2007 This prospective, longitudinal study examined the effects of participation in team-based exercise training on cardiac structure and function. Competitive endurance athletes (EA, n = 40) and strength athletes (SA, n = 24) were studied with echocardiography at baseline and after 90 days of team training. Left ventricular (LV) mass increased by 11% in EA (116 ± 18 vs. 130 ± 19 g/m 2 ; P < 0.001) and by 12% in SA (115 ± 14 vs. 132 ± 11 g/m 2 ; P < 0.001; P value for the compared = NS). EA experienced LV dilation (end-diastolic volume: 66.6 ± 10.0 vs. 74.7 ± 9.8 ml/m 2 , = 8.0 ± 4.2 ml/m 2 ; P < 0.001), enhanced diastolic function (lateral E ' : 10.9 ± 0.8 vs. 12.4 ± 0.9 cm/s, P < 0.001), and biatrial enlargement, while SA experience LV hypertrophy (posterior wall: 4.5 ± 0.5 vs. 5.2 ± 0.5 mm/m 2 , P < 0.001) and diminished diastolic function (E' basal lateral LV: 11.6 ± 1.3 vs. 10.2 ± 1.4 cm/s, P < 0.001). Further, EA experienced right ventricular (RV) dilation (end-diastolic area: 1,460 ± 220 vs. 1,650 ± 200 mm/m 2 , P < 0.001) coupled with enhanced systolic and diastolic function (E' basal RV: 10.3 ± 1.5 vs. 11.4 ± 1.7 cm/s, P < 0.001), while SA had no change in RV parameters. We conclude that participation in 90 days of competitive athletics produces significant training-specific changes in cardiac structure and function. EA develop biventricular dilation with enhanced diastolic function, while SA develop isolated, concentric left ventricular hypertrophy with diminished diastolic relaxation. exercise physiology; cardiac remodeling; athlete's heart Address for reprint requests and other correspondence: A. L. Baggish, Div. of Cardiology, Dept. of Medicine, Massachusetts General Hospital, Yawkey 5, 55 Fruit St., Boston, MA 02114 (e-mail: abaggish{at}partners.org )