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Cited by 516Cardiovascular Effects of ExerciseCardiomyopathy and Myosin StudiesGenetics and Physical Performance

Structural features of the athlete heart as defined by echocardiography

Open access
Maron, Barry J.·1986·Journal of the American College of Cardiology
DOI 10.1016/s0735-1097(86)80282-0
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Abstract

The morphologic concepts of the "athlete heart" have been enhanced and clarified over the last 10 years by virtue of M-mode echocardiographic studies performed on more than 1,000 competitive athletes. Long-term athletic training produces relatively mild but predictable alterations in cardiac structure that result in an increase in calculated left ventricular mass. This increase in mass observed in highly trained athletes is due to a mild increase in either transverse end-diastolic dimension of the left ventricle or left ventricular wall thickness, or both. Cardiac dimensions in athletes compared with matched control subjects show increases of about 10% for left ventricular end-diastolic dimension, about 15 to 20% for wall thickness and about 45% for calculated left ventricular mass. Furthermore, there is evidence that the modest degree of "physiologic" left ventricular hypertrophy (both the cavity dilation and wall thickening) observed in athletes is dynamic in nature, that is, it may develop rapidly within weeks or months after the initiation of vigorous conditioning and may be reversed in a similar time period after the cessation of training. Several echocardiographic studies also suggest that the precise alterations in cardiac structure associated with training may differ depending on the type of athletic activity undertaken (that is, whether training is primarily dynamic [isotonic] or static [isometric]). Although the ventricular septal to free wall thickness ratio (on M-mode echocardiogram) is almost always within normal limits (less than 1.3), occasionally an athlete will show mild asymmetric thickening of the anterior basal septum (usually 13 to 15 mm). This circumstance may mimic certain pathologic conditions characterized by primary left ventricular hypertrophy such as nonobstructive hypertrophic cardiomyopathy. The long-term significance of increased left ventricular mass in trained athletes has not been conclusively defined. However, there is no evidence at this time suggesting that this form of hypertrophy is itself deleterious to the athlete or predisposes to (or prevents) the natural occurrence of cardiovascular disease later in life.

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  • Electrocardiographic studies show that athletes have enlarged hearts, later confirmed by comparative echocardiography on endurance athletes.

    “Indeed, electrocardiographic studies show that athletes have enlarged hearts (9) which was later confirmed by comparative echocardiography on endurance athletes (91).”

    From The Hippo signal transduction network for exercise physiologists (2016) · cites this paper as [91]

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Research works printed but not linked: 21

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Authors
Maron, B. J.
Affiliations
National Institutes of Health (US)
Corresponding author
Maron, Barry J.
ORCID
Maron, Barry J.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1986-01
Volume
7
Issue
1
Pages
190-203
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/s0735-1097(86)80282-0
OpenAlex
W2004640114
Cited by
516
References
88
Citations by year
2026: 8 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 5 · 2021: 9 · 2020: 13 · 2019: 10 · 2018: 10 · 2017: 7 · 2016: 11 · 2015: 21 · 2014: 16 · 2013: 9 · 2012: 10
FWCI
2.59
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Physical Performance
Keywords
athlete's heart, left ventricular hypertrophy, left ventricular mass, left ventricular wall thickness, left ventricular end-diastolic diameter, M-mode echocardiography, competitive athletes
MeSH terms
Adolescent, Adult, Aged, Cardiomyopathy, Hypertrophic, Child, Competitive Behavior, Death, Sudden, Echocardiography, Physical Exertion, Female, Heart, Heart Atria, Cardiomegaly, Heart Ventricles, Humans, Male, Middle Aged, Physical Education and Training, Physical Endurance, Sports, Time Factors, Atrial Function, Ventricular Function

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