Influence of sex on ventricular remodeling in collegiate athletes

Previous reports indicate that the "athlete's heart" is more prominent in males than females, but the mechanisms responsible for this sex difference have not been elucidated. This study examined male-female differences in cardiac mass and volume in highly trained athletes and normally active individuals to assess the relative contributions of pre-existing sex differences and sports training to cardiac findings.

Echocardiographic and electrocardiographic findings were compared between 20 male and 21 female collegiate athletes and 22 male and 29 female normally-active subjects.

Cardiac mass (per kg lean body mass) was significantly greater in the male compared to female athletes (3.62±0.55 and 3.31±0.56 g.kg-1, respectively). A similar magnitude of difference in average relative cardiac mass was observed between the normally active males and females, and cardiac mass was greater in athletic versus nonathletic groups by +14.9% in the males and +13.3% in the females. Relative left ventricular volume was greater in the male athletes (47.5±6.3 ml•BSA-1.5) compared to male nonathletes (42.9±6.1 ml•BSA-1.5); no such difference was observed in the females.

These findings suggest that sex differences in both the untrained state and magnitude of training response contribute to male-female differences in the "athlete's heart"