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Updated: May 9, 2026
06:34
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Physiologic left ventricular cavity dilatation in elite athletes
A Pelliccia1, F Culasso, F M Di Paolo
1Institute of Sports Science, Italian National Olympic Committee, and University La Sapienza, Rome. ISS-Fisiologia@coni.it
Annals of Internal Medicine
|January 16, 1999
Summary
Highly trained athletes can develop enlarged left ventricular cavities, sometimes mimicking dilated cardiomyopathy. This study suggests such enlargement is often a physiological adaptation to intense training, not necessarily a disease.
Area of Science:
- Cardiology
- Sports Medicine
- Physiology
Background:
- Left ventricular cavity enlargement is observed in some elite athletes.
- This raises diagnostic challenges differentiating athlete's heart from dilated cardiomyopathy.
- Concerns exist regarding athlete disqualification from competitive sports.
Purpose of the Study:
- To assess the morphological characteristics of left ventricular enlargement in athletes.
- To determine the physiological limits of this enlargement.
- To understand its association with intensive, long-term athletic conditioning.
Main Methods:
- Evaluated left ventricular cavity dimensions in 1309 elite Italian athletes.
- Utilized echocardiography for measurements.
- Performed multivariate statistical analysis to identify determinants.
Main Results:
- Left ventricular dimensions varied widely (mean 55 mm in men, 48 mm in women).
- 14% of athletes showed substantial enlargement (≥60 mm).
- Enlarged cavities were associated with normal systolic function, no wall-motion abnormalities, and no cardiac symptoms.
Conclusions:
- Left ventricular cavity enlargement in athletes can reach dimensions similar to dilated cardiomyopathy.
- This is likely an extreme physiological adaptation to intensive training.
- Long-term implications of this cardiac remodeling remain unknown.
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