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Hypertrabeculation in Olympic Athletes: Advanced LV Function Analysis by CMR.

Alessandro Spinelli1, Sara Monosilio1,2, Giuseppe Di Gioia1

  • 1Institute of Sports Medicine and Science, Italian National Olympic Committee, 00197 Rome, Italy.

Journal of Cardiovascular Development and Disease
|October 28, 2025
PubMed
Summary
This summary is machine-generated.

Left ventricular hypertrabeculation is common in elite athletes but appears to be a benign finding. This cardiac MRI study found no associated structural or functional abnormalities in asymptomatic athletes.

Keywords:
CMRathlete’s hearthemodynamic forceshypertrabeculationstrain

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Medical Imaging

Background:

  • Left ventricular (LV) hypertrabeculation is an increasingly recognized cardiac phenotype.
  • Its functional relevance, particularly in athletes with chronic overload, remains uncertain.
  • Understanding this condition is crucial for differentiating physiological adaptation from pathology.

Purpose of the Study:

  • To evaluate the prevalence of excessive left ventricular trabeculation in Olympic athletes.
  • To assess the physiological correlation between LV hypertrabeculation and LV remodeling.
  • To determine if LV hypertrabeculation is associated with cardiac abnormalities in elite athletes.

Main Methods:

  • A cross-sectional study of 320 Olympic-level athletes without cardiovascular disease.
  • Cardiac magnetic resonance (CMR) imaging was used to define and assess hypertrabeculation using Petersen criteria.
  • Comparison of hypertrabeculated athletes with matched non-hypertrabeculated controls, analyzing LV morphology, function, strain, and hemodynamic forces (HDFs).

Main Results:

  • Left ventricular hypertrabeculation was identified in 9% of the athlete cohort.
  • No significant differences were found between hypertrabeculated and non-hypertrabeculated groups in LV volumes, ejection fraction, mass, wall thickness, or strain parameters.
  • Hemodynamic forces and tissue characterization (T1/T2 mapping) were also comparable, with all values within normal ranges.

Conclusions:

  • Left ventricular hypertrabeculation is a relatively common finding in asymptomatic elite athletes.
  • The presence of LV hypertrabeculation, as assessed by CMR, is not associated with structural or functional cardiac abnormalities in this cohort.
  • These findings support the interpretation of LV hypertrabeculation as a benign variant in well-trained athletes with normal cardiac function.