Rowe, Stephanie and Janssens, Kristel and Mitchell, Amy and D’Ambrosio, Paolo and De Paepe, Jarne and Van Soest, Sofie and Calvo-Lopez, Margarita and Cullen, Oscar and Spencer, Luke and Dausin, Christophe and Ghekiere, Olivier and Bogaert, Jan and Herbots, Lieven and Bekhuis, Youri and Pauwels, Rik and Willems, Rik and Heidbuchel, Hein and Claessen, Guido and La Gerche, André (2025) Female endurance athletes: smaller hearts but similar relationship between ventricular size, fitness and fibrosis as male athletes. British Journal of Sports Medicine, 59 (17). pp.1211-1218. ISSN 0306-3674
Full text not available from this repository.Abstract
Objectives
Exercise-induced cardiac remodelling is well described in male athletes but incompletely understood in females. This study aimed to examine sex differences in cardiac structure, function and fibrosis relative to fitness and to determine reference ranges for ‘normal’ chamber size in a large cohort of healthy male and female highly trained endurance athletes.
Methods
This multicentre international study used cardiac MRI and cardiopulmonary exercise testing (VO 2 peak) to assess sex-specific relationships between measures of biventricular chamber size, function, fibrosis and VO 2 peak.
Results
Of the 364 endurance athletes included, 36.5% were female. Compared with males, female athletes achieved lower VO 2 peak (51 (40–57) vs 59 (41–65) mL/kg/min, p<0.001), had smaller absolute and body surface area (BSA)-indexed left and right end-diastolic volumes (LVEDV, respectively) but similar volumes when indexed to fat-free mass. Both sexes showed a strong association between LVEDV and VO 2 peak (r=0.60–0.66) and a similar coefficient describing the linear relationship between VO 2 peak and LVEDV (Females: VO 2 peak(mL/min)=12.1×LVEDV+963.9; males: VO 2 peak=15.3×LVEDV+806.8, p=0.100) and BSA-indexed LVEDV (females: VO 2 peak (mL/kg/min)=0.37×LVEDV/BSA+12.5; males: VO 2 peak=0.51×LVEDV/BSA-1.2, p=0.059). There was no difference between right ventricular (RV) measures and VO 2 peak; however, males had 3.8 times higher odds of reduced RV ejection fraction. Prevalent myocardial scar was similar for both female (14.2%) and male (19.9%) athletes (p=0.180).
Conclusions
Female and male athletes demonstrate similar cardiac remodelling relative to fitness and no sex difference in myocardial scar. The female athlete’s heart can show profound adaptation, and previous assertions that female hearts have lesser capacity for remodelling should be reappraised.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 04 Dec 2025 04:30 |
| Last Modified: | 04 Dec 2025 04:30 |
| URI: | http://eprints.victorchang.edu.au/id/eprint/1764 |
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