Electrical and structural remodelling in female athlete's heart: A comparative study in women vs men athletes and controls.

Athlete's heart is associated with physiological electrical and structural remodelling. Despite the plethora of data published on male athletes, solid data derived from female athletes, compared to male counterparts or sedentary women, are still scarce. We aimed to analyze the electrical, structural, and functional characteristics of athlete's heart in female and male athletes vs sedentary controls. Olympic athletes and sedentary controls were evaluated by resting ECG and echocardiography. Athletes were divided into 4 different sports groups. The study population included 1096 individuals (360 female athletes, 410 male athletes, 130 sedentary women and 196 sedentary men). Female athletes had lower resting heart rate, longer PR interval, higher voltage of R, and T waves and more frequently incomplete RBBB, left ventricular (LV) hypertrophy, early repolarization, and anterior T-wave inversion as compared to controls. Biventricular cavity dimensions and LV wall thickness were greater in female athletes than in female controls. However, women showed a lower degree of training-induced structural remodelling than men. In female athletes, both cavity dimensions and LV wall thickness increased from those engaged in skill and power to mixed and endurance disciplines. However, in female athletes, contrary to males, the ECG changes were not significantly different according to the different types of sport discipline. Highly-trained women demonstrate relevant training-induced electrical and structural remodelling. However, the type of sport did not influence ECG parameters in women, contrary to men, while it impacted biventricular morphologic remodelling, with endurance athletes showing the greatest degree of adaptation. • In this study, we analyzed the electrocardiographic and structural cardiac remodelling in female competitive athletes, compared with sedentary female controls and the male athletic population, with a specific focus on the impact of sports disciplines on cardiac adaptation. • The main findings of the study are: i) chronic exercise training led to significant ECG changes in female athletes as compared to age-matched sedentary controls; ii) a relevant training-induced structural heart remodelling is observed in female athletes, although of minor degree as compared to male athletes; iii) the different types of sport had in women (as in men) a different impact, with the endurance athletes showing the greatest degree of morphologic cardiac remodelling, while the extent of electrical changes are in women minimal, contrary to what observed in men. [ABSTRACT FROM AUTHOR]