Left ventricular remodelling in a large cohort of strength competitive athletes: not so common and differs by sex

Abstract

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by FMBA of Russia Background. There are still very limited data about physiological cardiac adaptation in strength athletes. Purpose. To describe structural and functional features of left ventricular (LV) in a large cohort of healthy strength athletes. Methods. A total of 673 Caucasian athletes (weight-lifting, males/females = 238/157, and Martial Arts, males/females = 200/78) competing in Russian National and International level events were recruited within 2010-2017. Data of standard 2D echocardiography (Echo) and comprehensive medical history were analyzed. Data are presented as median (IQR) and compared by nonparametric tests (table). To assess LV geometry all athletes were divided into 6 groups according to 4-tiered classification based on mass index, concentricity and end-diastolic volume (EDV) index of LV (Figure). Results. Both absolute and indexed values of LV structural features were higher in males. Females exhibited higher functional parameters. Only 54 (8%) athletes had elevated LV mass (no sex difference), 23 (3.4%) – LV wall ≥ 12mm (only males) and 78 (11.6%) – changes in LV geometry. There was a prevalence of females in eccentric non-dilated LV hypertrophy (LVH) group (p = 0.088), which was previously accepted as a benign pattern of LV remodelling in non-athlete populations. Males had more often concentric types of LV remodelling (36 of 54 athletes). Among dilated types of LVH, there was a prevalence of males (p = 0.070). Conclusions. LV remodelling is not common in strength athletes and differs by sex with a more favourable profile in females. Clinical and Echo parameters Total n = 673 males n = 438 females n = 235 males vs females p-value Age, years 20(4) 20(4) 20(5) 0.06 BSA, m² 1.84(0.39) 1.96(0.39) 1.66(0.25) <0.001 Sports practice, years 10(6) 10(7) 10(6) 0.12 LV EDD, mm 49(6) 50(5) 46(4) <0.001 LV EDD/(BSA)^0.5 35.8(3) 35.9(3) 35.6(3) 0.017 LV EDV, ml 108(38) 118(32) 92(24) <0.001 LV EDV/(BSA)^1.5 42.8(9) 42.9(10) 42.3(9) 0.14 Maximal LV WT, mm 10(1) 10(2) 9(1) <0.001 LV mass/BSA, g/m² 86(24) 91(22) 75(16) <0.001 LV Concentricity, g/(ml)^0.67 6.9(1.6) 7.4(1.6) 6.2(1.4) <0.001 LV EF, % 60(5) 60(4) 62(4) <0.001 Mitral E velocity, cm/sec 87(19) 85(19) 89(19) <0.001 BSA - body surface area; EDD - end-diastolic dimension; WT - wall thickness Abstract Figure. Types of LV geometry in athletes

Left Ventricular Hypertrophy in Male and Female Judo Athletes

“…A study of a total of 1083 combat sports athletes (males, n=639; females, n=444), found significantly lower LVM and RWT values in females than in male athletes, which matches our findings 10 . Furthermore, our data is inconsistent with previous research from 2021, conducted on a sample of 200 men and 78 women in weightlifting and various martial arts, which showed that female athletes were significantly more likely to have an eccentric type of hypertrophy than men who were more likely to have concentric remodeling of the LV 19 . The adaptations involve the entire cardiovascular system, particularly in athletes, LV root remodeling can also be expected due to the hemodynamic load caused by intensive training 22 .…”

“…The literature has already established that judokas, regardless of gender, have a significantly higher RWT and greater left ventricular mass than non-athletes of the same gender 17 , however the cardiac remodeling is complex and depends on various factors 18 . The results obtained are in line with research conducted to date, which indicate that gender is a significant factor that has an important influence on the change of heart geometry in athletes 19 20 . Whyte et al 21 conducted a survey of judokas, including 17 male and 14 female athletes, and 11 participants in the control group.…”