Sports Medicine

, Volume 38, Issue 1, pp 69–90 | Cite as

The Athlete’s Heart

A Contemporary Appraisal of the ‘Morganroth Hypothesis’
  • Louise H. Naylor
  • Keith George
  • Gerry O’Driscoll
  • Daniel J. Green
Review Article


As early as 1975, Morganroth and colleagues hypothesized that the cardiac morphological adaptation observed in athletes corresponded with the nature of the haemodynamic stimulus imposed on the ventricles during repeated exercise bouts. Endurance training purportedly leads to an eccentric form of cardiac hypertrophy, principally characterized by increased left ventricular (LV) cavity dimension, and thus LV mass (LVM), as a consequence of prolonged repetitive volume overload. In contrast, strength training is supposedly associated with a concentric form of hypertrophy where increased ventricular wall thickness, with no change in cavity size, underpins the elevated LVM as a consequence of the pressure overload produced during strenuous resistive exercise. The ‘Morganroth hypothesis’ has been broadly adopted in the scientific and medical literature, partly as a consequence of a large body of cross-sectional evidence suggesting that endurance athletes have greater cavity dimensions than control subjects or resistance athletes. However, in conflict with the ‘Morganroth hypothesis’, several studies suggest that LV wall thickness is increased more in endurance-, than strength-trained athletes and others have reported no morphological changes in resistance-trained athletes. Such controversial data may reflect variability in the training stimuli, with little obvious attempt to quantify these issues in previous research. Further reflection on the ‘Morganroth hypothesis’ may also be pertinent as more sensitive technologies, such as magnetic resonance imaging, are now being employed for the assessment of cardiac morphology. Finally, the process of scaling (or normalizing) cardiac size for between-subject differences in body size and composition has further complicated the description and understanding of cardiac morphology in athletes. Specifically, it is possible that the increased LVM observed in some athletes may merely reflect a ‘larger than normal’ body size. These considerations emphasise the limitations of the predominance of cross-sectional comparisons in the available literature, which assume that differences between groups are due to a training effect per se rather than other between-subject differences. The small number of longitudinal training studies undertaken in athletes suggest that individuals with athlete’s heart can exhibit further cardiac adaptation in response to training resumption. Longitudinal training studies undertaken in previously sedentary subjects generally indicate that exercise results in enlargement of LV cavity size, increases in wall thickness or LVM following training. However, there are currently limited longitudinal data available to comment on the effects of different modalities of exercise training on LV cavity dimension and wall thickness. In summary, significant caveats related to cross-sectional literature, the relative insensitivity of echocardiographic measurements and the paucity of evidence from longitudinal exercise training studies, warrant ongoing research to verify the ‘Morganroth hypothesis’.


Resistance Training Endurance Athlete Posterior Wall Thickness Cardiac Morphology Cardiac Adaptation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Maron BJ. Structural features of the athlete’s heart as defined by echocardiography. J Am Coll Cardiol 1986; 7: 190–203PubMedCrossRefGoogle Scholar
  2. 2.
    Green DJ, Naylor LH, George K, Cardiac and vascular adaptations to exercise training. In: Taylor NAS, Groeller H, McLennan PL, editors. Physiological bases of human performance during work and exercise. Oxford: Churchill Livingstone. In pressGoogle Scholar
  3. 3.
    Sharma S, Maron B, Whyte G, et al. Physiological limits of left ventricular hypertrophy in elite junior athletes: relevance of differential diagnosis of athlete’s heart and hypertrophic cardiomyopathy. J Am Coll Cardiol 2002; 40 (8): 1431–6PubMedCrossRefGoogle Scholar
  4. 4.
    Whyte GP, George K, Middleton N, et al. Training induced changes in maximum heart rate. Int J Sports Med 2007; 28: 1–5CrossRefGoogle Scholar
  5. 5.
    Morganroth J, Maron B, Henry W, et al. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975; 82: 521–4PubMedGoogle Scholar
  6. 6.
    Morganroth J, Maron BJ. The athlete’s heart syndrome: a new perspective. Ann NY Acad Sci 1977; 301 (1): 931–41PubMedCrossRefGoogle Scholar
  7. 7.
    Haykowsky M, Dressendorfer R, Taylor D, et al. Resistance training and cardiac hypertrophy: unravelling the training effect. Sports Med 2002; 32: 837–49PubMedCrossRefGoogle Scholar
  8. 8.
    Ford L. Heart size. Circ Res 1976; 39 (3): 297–303PubMedCrossRefGoogle Scholar
  9. 9.
    Muntz K, Gonyea W, Mitchell J. Cardiac hypertrophy in response to an isometric training program in the cat. Circ Res 1981; 49 (5): 1092–101PubMedCrossRefGoogle Scholar
  10. 10.
    Douglas PS, O’Toole ML, Hiller DB, et al. Left ventricular structure and function by echocardiography in ultraendurance athletes. Am J Cardiol 1986; 58: 805–9PubMedCrossRefGoogle Scholar
  11. 11.
    Mitchell JH, Haskell WL, Raven PB. Classification of sports. Med Sci Sports Exerc 1994; 26: S242–5PubMedCrossRefGoogle Scholar
  12. 12.
    Fagard R. Athlete’s heart. Heart 2003; 89: 1445–61CrossRefGoogle Scholar
  13. 13.
    Pluim BM, Zwinderman AH, vander Laarse A, et al. The athlete’s heart: a meta-analysis of cardiac structure and function. Circulation 1999; 100: 336–44Google Scholar
  14. 14.
    Haykowsky MJ, Quinney HA, Gillis R, et al. Left ventricular morphology in junior and master resistance trained athletes. Med Sci Sports Exerc 2000; 32: 349–52PubMedCrossRefGoogle Scholar
  15. 15.
    Schmidt-Nielsen K. Scaling: why is animal size so important? Cambridge: Cambridge University Press, 1984Google Scholar
  16. 16.
    Batterham A, George K, Whyte G, et al. Scaling cardiac structural data by body dimensions: a review of theory, practice, and problems. Int J Sports Med 1999; 20 (8): 495–502PubMedCrossRefGoogle Scholar
  17. 17.
    MacDougall J, McKelvie R, Moroz D, et al. Factors affecting blood pressure during heavy weight lifting and static contractions. J Appl Physiol 1992; 73 (4): 1590–7PubMedGoogle Scholar
  18. 18.
    Pelliccia A, Maron B, Spataro A, et al. The upper limit of physiological hypertrophy in highly trained elite athletes. N Engl J Med 1991; 324: 295–301PubMedCrossRefGoogle Scholar
  19. 19.
    Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the ‘athlete’s heart’ assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol 1994; 74: 802–6PubMedCrossRefGoogle Scholar
  20. 20.
    Haykowsky M, Taylor D, Teo K, et al. Left ventricular wall stress during leg press exercise performed with a brief Valsalva maneuver. Chest 2001; 119: 150–4PubMedCrossRefGoogle Scholar
  21. 21.
    Myerson SG, Montgomery HE, World MJ, et al. Left ventricular mass: reliability of M-mode and 2-dimensional echocardiographic formulas. Hypertension 2002; 40: 673–8PubMedCrossRefGoogle Scholar
  22. 22.
    Pollick C, Fitzgerald PJ, Popp RL. Variability of digitized echocardiography: size, source and means of reduction. Am J Cardiol 1983; 51: 576–82PubMedCrossRefGoogle Scholar
  23. 23.
    Otterstad JE. Measuring left ventricular volume and ejection fraction with the biplane Simpson’s method. Heart 2002; 88: 559–60PubMedCrossRefGoogle Scholar
  24. 24.
    Jenkins C, Bricknell K, Chan J, et al. Comparison of two-and three-dimensional echocardiography with sequential magnetic resonance imaging for evaluating left ventricular volume and ejection fraction over time in patients with healed myocardial infarction. Am J Cardiol 2007; 99: 300–6PubMedCrossRefGoogle Scholar
  25. 25.
    Deague J, Wilson C, Grigg L, et al. Discrepancies between echocardiographic measurements of left ventricular mass in a healthy population. Clin Sci 1999; 97: 377–83PubMedCrossRefGoogle Scholar
  26. 26.
    Lang RM, Beirig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee writing group. J Am Soc Echo 2005; 18: 1440–63CrossRefGoogle Scholar
  27. 27.
    Friedman B, Waters J, Kwan O, et al. Comparison of magnetic resonance imaging and echocardiography in determination of cardiac dimensions in normal subjects. J Am Coll Cardiol 1985; 5 (6): 1369–76PubMedCrossRefGoogle Scholar
  28. 28.
    Heatlie GJ, Pointon K. Cardiac magnetic resonance imaging. Postgrad Med J 2004; 80 (939): 19–22PubMedCrossRefGoogle Scholar
  29. 29.
    Plien S, Smith W, Ridgway J, et al. Measurement of left ventricular dimensions using real-time acquisition in cardiac magnetic resonance imaging: comparison with conventional gradient echo imaging. MAGMA 2001; 13 (2): 101–8Google Scholar
  30. 30.
    Wernstedt P, Sjostedt C, Ekman I, et al. Adaptation of cardiac morphology and function to endurance and strength training: a comparative study using MR imaging and echocardiography in males and females. Scand J Med Sci Sports 2002; 12: 17–25PubMedCrossRefGoogle Scholar
  31. 31.
    De Castro S, Pelliccia A, Caselli S, et al. Remodelling of the leftventricle in athlete’s heart: a three dimensional echocardiographic and magnetic resonance imaging study. Heart 2006; 92 (7): 975–6PubMedCrossRefGoogle Scholar
  32. 32.
    Jenkins C, Bricknell K, Hanekom L, et al. Reproducibility and accuracy of echocardiographic remodelling of the left ventricle in athlete-s heart: a three dimensional echocardiographic and magnetic resonance imurements of left ventricular parameters using real-time three-dimensional echocardiography. J Am Coll Cardiol 2004; 44: 878–86PubMedCrossRefGoogle Scholar
  33. 33.
    Epstein M, Goldberg S, Allen H, et al. Great vessel, cardiac chamber, and wall growth patterns in normal children. Circulation 1975; 51 (6): 1124–9PubMedCrossRefGoogle Scholar
  34. 34.
    Astrand P, Rodahl K. Textbook of work physiology: physiological bases of exercise. 3rd ed. New York: McGraw-Hill, 1986Google Scholar
  35. 35.
    Lauer MS, Larson MG, Levy D. Gender-specific reference M-mode values in adults: population-derived values with consideration of the impact of height. J Am Coll Cardiol 1995; 26 (4): 1039–46PubMedCrossRefGoogle Scholar
  36. 36.
    Shub C, Klein A, Zachariah P, et al. Determination of left ventricular mass by echocardiography in a normal population: effect of age and sex in addition to body size. Mayo Clin Proc 1994; 69 (3): 205–11PubMedCrossRefGoogle Scholar
  37. 37.
    Longhurst JC, Kelly AR, Gonyea WJ, et al. Echocardiographic left ventricular masses in distance runners and weight lifters. J Appl Physiol 1980; 48 (1): 154–62PubMedGoogle Scholar
  38. 38.
    Batterham AM, George KP. Modeling the influence of body size and composition on M-mode echocardiographic dimensions. Am J Physiol 1998; 274 (2): H701–8PubMedGoogle Scholar
  39. 39.
    de Simone G, Devereux R, Meyer R, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992; 20 (5): 1251–60PubMedCrossRefGoogle Scholar
  40. 40.
    George KP, Whyte GW, Sharma S, et al. The relationship between echocardiographic indices of cardiac size and body dimensions: an allometric analysis in 453 elite junior athletes. Clin Sci 2001; 100: 47–54PubMedCrossRefGoogle Scholar
  41. 41.
    Abergel E, Chatellier G, Hagege AA, et al. Serial left ventricular adaptations in world-class professional cyclists: implications for disease screening and follow-up. J Am Coll Cardiol 2004; 44 (1): 144–9PubMedCrossRefGoogle Scholar
  42. 42.
    Bekaert I, Pannier J, Van De Weghe C, et al. Non-invasive evaluation of cardiac function in professional cyclists. Br Heart J 1981; 45: 213–8PubMedCrossRefGoogle Scholar
  43. 43.
    Caso P, D’Andres A, Galderisi M, et al. Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function. Am J Cardiol 2000; 85: 1131–6PubMedCrossRefGoogle Scholar
  44. 44.
    Child J, Barnard R, Taw R. Cardiac hypertrophy and function in master endurance runners and sprinters. J Appl Physiol 1984; 57 (1): 176–81PubMedGoogle Scholar
  45. 45.
    Colan SD, Sanders SP, MacPheraon D, et al. Left ventricular diastolic function in elite athletes with physiologic cardiac hypertrophy. J Am Coll Cardiol 1985; 6: 545–9PubMedCrossRefGoogle Scholar
  46. 46.
    Douglas PS. Cardiac considerations in the triathlete. Med Sci Sports Exerc 1989; 21 (5): S214–8PubMedGoogle Scholar
  47. 47.
    Fagard R, Van Den Broeke C, Bielen E, et al. Assessment of the stiffness of the hypertrophied left ventricle of bicyclists using left ventricular inflow Doppler velocimetry. J Am Coll Cardiol 1987; 9 (6): 1250–4PubMedCrossRefGoogle Scholar
  48. 48.
    Finkelhor RS, Hanak LJ, Bahler RC. Left ventricular filling in endurance-trained subjects. J Am Coll Cardiol 1986; 8: 289–93PubMedCrossRefGoogle Scholar
  49. 49.
    Fisman E, Motro M, Adler Y, et al. Intensive isotonic training modifies basal and exercise Doppler indexes of systolic function: a comparative study of athletes and sedentary men. Am J Cardiol 2001; 88: 594–8PubMedCrossRefGoogle Scholar
  50. 50.
    Fisman E, Pelliccia A, Motro M, et al. Effect of intensive resistance training on isotonic exercise Doppler indexes of left ventricular systolic function. Am J Cardiol 2002; 89: 887–91PubMedCrossRefGoogle Scholar
  51. 51.
    Gates P, Campbell I, George K. Concentric left ventricular morphology in aerobically trained kayak canoeists. J Sports Sci 2004; 22 (9): 859–65PubMedCrossRefGoogle Scholar
  52. 52.
    George KP, Gates PE, Whyte G, et al. Echocardiographic examination of cardiac structure and function in elite cross trained male and female Alpine skiers. Br J Sports Med 1999; 33: 93–9PubMedCrossRefGoogle Scholar
  53. 53.
    Karjalainen J, Matntysaari M, Viitasalo M, et al. Left ventricular mass, geometry, and filling in endurance athletes: association with exercise blood pressure. J Appl Physiol 1997; 82: 531–7PubMedGoogle Scholar
  54. 54.
    Laurenceau J, Turcot J, Dumesnil J. Echocardiographic findings in Olympic athletes [abstract]. Circulation 1977; 56: I11–25Google Scholar
  55. 55.
    Pluim BM, Lamb HJ, Kayser HWM, et al. Functional and metabolic evaluation of the athlete-s heart by magnetic resonance imaging and dobutamine stress magnetic resonance spectroscopy. Circulation 1998; 97 (7): 666–72PubMedCrossRefGoogle Scholar
  56. 56.
    Pearson A, Schiff M, Mrosek D, et al. Left ventricular diastolic function in weight lifters. Am J Cardiol 1986; 58: 1254–9PubMedCrossRefGoogle Scholar
  57. 57.
    Nishimura T, Yamada Y, Kawai C. Echocardiographic evaluation of long-term effects of exercise on left ventricular hypertrophy and function in professional bicyclists. Circulation 1980; 61 (4): 832–40PubMedCrossRefGoogle Scholar
  58. 58.
    Milliken M, Stray-Gundersen J, Peshock R, et al. Left ventricular mass as determined by magnetic resonance imaging in male endurance athletes. Am J Cardiol 1988; 62 (4): 301–5PubMedCrossRefGoogle Scholar
  59. 59.
    Pavlik G, Olexo Z, Osvath P, et al. Echocardiographic characteristics of male athletes of different ages. Br J Sports Med 2001; 35: 95–9PubMedCrossRefGoogle Scholar
  60. 60.
    Pela G, Bruschi G, Montagna L, et al. Left and right ventricular adaptation assessed by Doppler tissue echocardiography in athletes. J Am Soc Echo 2004; 17 (3): 205–11CrossRefGoogle Scholar
  61. 61.
    Pelliccia A, Spataro A, Caselli G, et al. Absence of left ventricular wall thickening in athletes engaged in intense power training. Am J Cardiol 1993; 72: 1048–54PubMedCrossRefGoogle Scholar
  62. 62.
    Pelliccia A, Maron BJ, Culasso F, et al. Athlete’s heart in women. Echocardiographic characterization of highly trained elite female athletes. JAMA 1996; 276 (3): 211–5PubMedCrossRefGoogle Scholar
  63. 63.
    Scharhag J, Schneider G, Urhausen A, et al. Athlete’s heart: right and left ventricular mass and function in male endurance athletes and uintrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol 2002; 40 (10): 1856–63PubMedCrossRefGoogle Scholar
  64. 64.
    Shapiro L. Physiological left ventricular hypertrophy. Br Heart J 1984; 52: 130–5PubMedCrossRefGoogle Scholar
  65. 65.
    Pluim BM, Swenne CA, Zwinderman AH, et al. Correlation of heart rate variability with cardiac functional and metabolic variables in cyclists with training induced left ventricular hypertrophy. Heart 1999; 81: 612–7PubMedGoogle Scholar
  66. 66.
    Riley-Hagan M, Peshock R, Stray-Gundersen J, et al. Left ventricular dimensions and mass using magnetic resonance imaging in female endurance athletes. Am J Cardiol 1992; 69: 1067–74PubMedCrossRefGoogle Scholar
  67. 67.
    Yeater R, Reed C, Ullrich I, et al. Resistance trained athletes using or not using anabolic steroids compared to runners: effects on cardiorespiratory variables, body composition, and plasma lipids. Br J Sports Med 1996; 30: 11–4PubMedCrossRefGoogle Scholar
  68. 68.
    Triposkiadis F, Ghiokas S, Skoularigis I, et al. Cardiac adaptation to intensive training in prepubertal swimmers. Eur J Clin Invest 2002; 32: 16–23PubMedCrossRefGoogle Scholar
  69. 69.
    Turpeinen A, Kuikka J, Vanninen E, et al. Athletic heart: a metabolic, anatomical, and functional study. Med Sci Sports Exerc 1996; 28: 33–40PubMedGoogle Scholar
  70. 70.
    Schmidt-Trucksass A, Schmid A, Haussler C, et al. Left ventricular wall motion during diastolic filling in endurance-trained athletes. Med Sci Sports Exerc 2000; 33 (2): 189–95Google Scholar
  71. 71.
    Whyte GP, George K, Nevill A, et al. Left ventricular morphology and function in female athletes: a meta-analysis. Int JSports Med 2004; 25 (5): 380–3CrossRefGoogle Scholar
  72. 72.
    Paulsen W, Boughner D, Ko P, et al. Left ventricular function in marathon runners: echocardiographic assessment. J Appl Physiol 1981; 51 (4): 881–6PubMedGoogle Scholar
  73. 73.
    Fagard R, Aubert A, Staessen J, et al. Cardiac structure and function in cyclists and runners: comparative echocardiographic study. Br Heart J 1984; 52: 124–9PubMedCrossRefGoogle Scholar
  74. 74.
    Wieling W, Borghols E, Hollander A, et al. Echocardiographic dimensions and maximal oxygen uptake in oarsmen during training. Br Heart J 1981; 46 (2): 190–5PubMedCrossRefGoogle Scholar
  75. 75.
    Naylor L, Arnolda L, Deague J, et al. Reduced diastolic function in elite athletes is augmented with the resumption of exercise training. J Physiol 2005; 563: 957–63PubMedCrossRefGoogle Scholar
  76. 76.
    Pelliccia A. Determinants of morphologic cardiac adaptation in elite athletes: the role of athletic training and constitutional factors. Int J Sports Med 1996; 17: S157–63PubMedCrossRefGoogle Scholar
  77. 77.
    Guazzi M, Mustane FC, Glassberg HL, et al. Detection of changes in diastolic function by pulmonary venous flow analysis on women athletes. Am Heart J 2001; 141: 139–47PubMedCrossRefGoogle Scholar
  78. 78.
    Baldi JC, McFarlane K, Oxenham HC, et al. Left ventricular diastolic filling and systolic function of young and older trained and untrained men. J Appl Physiol 2003; 95: 2570–5PubMedGoogle Scholar
  79. 79.
    Claessens C, Claessens P, Claessens M, et al. Echocardiographic and physiological performenace characteristics of triathletes. Can J Cardiol 2000; 16: 993–1002PubMedGoogle Scholar
  80. 80.
    Deligiannis A, Zahopoulou E, Mandroukas K. Echocardiographic study of cardiac dimensions and function in weight lifters and body builders. Int J Sports Cardiol 1988; 5: 24–32Google Scholar
  81. 81.
    Gates PE, Tanaka H, Graves J, et al. Left ventricular structure and diastolic function with human ageing: relation to habitual exercise and arterial stiffness. Eur Heart J 2003; 24 (24): 2213–20PubMedCrossRefGoogle Scholar
  82. 82.
    George KP, Batterham AM, Jones B. Evidence of concentric left ventricular enlargement in female weightlifters. Eur J Appl Physiol Occup Physiol 1998; 79: 88–92PubMedCrossRefGoogle Scholar
  83. 83.
    George KP, Batterham AM, Jones B. The impact of scalar variable and process on athlete-control comparisons of cardiac dimensions. Med Sci Sports Exerc 1998; 30: 824–30PubMedCrossRefGoogle Scholar
  84. 84.
    Haykowsky MJ, Teo KK, Quinney AH, et al. Effects of long term resistance training on left ventricular morphology. Can J Cardiol 2000; 16: 35–8PubMedGoogle Scholar
  85. 85.
    MacFarlane N, Northbridge DB, Wright AR, et al. A comparative study of left ventricular structure and function in elite athletes. Br J Sports Med 1991; 25 (1): 45–8PubMedCrossRefGoogle Scholar
  86. 86.
    Sepulveda F, De Oliveira E, De Oliveira PG, et al, editor. M-mode echocardiography study of twenty-two top class racing cyclists. Sports Med Phys Fit 1989; 29: 136–40Google Scholar
  87. 87.
    Urhausen A, Monz T, Kindermann W. Sports-specific adaptation of left ventricular muscle mass in athlete’s heart: an echocardiographic study with combined isometric and dynamic exercise trained athletes (male and female rowers). Int J Sports Med 1996; 17 Suppl. 3: S145–51CrossRefGoogle Scholar
  88. 88.
    Urhausen A, Monz T, Kindermann W. Echocardiographic criteria of physiological left ventricular hypertrophy in combined strength- and endurance-trained athletes. Int J Cardiac Imaging 1997; 13: 43–52CrossRefGoogle Scholar
  89. 89.
    Urhausen A, Monz T, Kindermann W. Sports-specific adaptation of left ventricular muscle mass in athlete’s heart: an echocardiographic study of 400-m runners and soccer players. Int J Sports Med 1996; 17 Suppl. 3: S152–6CrossRefGoogle Scholar
  90. 90.
    Van Den Broeke C, Fagard R. Left ventricular structure and function, assessed by imaging and Doppler echocardiography, in athletes engaged in throwing events. Int J Sports Med 1988; 9: 407–11PubMedCrossRefGoogle Scholar
  91. 91.
    Whalley G, Doughty R, Ganmble G, et al. Association of fat-free mass and training status with left ventricular size and mass in endurance-trained athletes. J Am Coll Cardiol 2004; 44: 892–6PubMedCrossRefGoogle Scholar
  92. 92.
    Whyte G, Sharma S, George K, et al. Alterations in cardiac morphology and function in elite multi-disciplinary athletes. Int J Sports Med 1999; 20: 222–6PubMedCrossRefGoogle Scholar
  93. 93.
    Whyte G, George K, Sharma S, et al. Left ventricular structure and function in elite judo players. Clin Exerc Physiol 2000; 2: 204–8Google Scholar
  94. 94.
    Zandrino F, Molinari G, Smeraldi A, et al. Magnetic resonance imaging of athlete’s heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries. Eur Radiol 2000; 10: 319–25PubMedCrossRefGoogle Scholar
  95. 95.
    Urhausen A, Kindermann W. One- and two-dimensional echo-cardiography in body builders and endurance-trained subjects. Int J Sports Med 1989; 10: 139–44PubMedCrossRefGoogle Scholar
  96. 96.
    Nishimura RA, Appleton CP, Redfield MM, et al. Noninvasive Doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: a simultane ous Doppler echocardiographic and cardiac catheterization study. J Am Coll Cardiol 1996; 28 (5): 1226–33PubMedCrossRefGoogle Scholar
  97. 97.
    Roy A, Doyon M, Dumesnil J, et al. Endurance vs strength training: comparison of cardiac structures using normal predictive values. J Appl Physiol 1988; 64 (6): 2552–7PubMedGoogle Scholar
  98. 98.
    Urhausen A, Holpes R, Kindermann W. One- and two-dimensional echocardiography in body builders using anabolic steroids. Eur J Appl Physiol 1989; 58: 633–40CrossRefGoogle Scholar
  99. 99.
    Scharhag J, Schneider G, Urhausen A, et al. Athlete’s heart. right and left ventricular mass and function in male endurance athletes and untrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol 2002; 40 (10): 1856–63PubMedCrossRefGoogle Scholar
  100. 100.
    Arbab-Zadeh A, Dijk E, Prasad A, et al. Effect of aging and physical activity on left ventricular compliance. Circulation 2004; 110: 1799–805PubMedCrossRefGoogle Scholar
  101. 101.
    Lalande S, Baldi JC. Proportionally smaller left ventricular mass in elite Olympic weight lifters. Am J Cardiol 2007; 100: 1177–80PubMedCrossRefGoogle Scholar
  102. 102.
    Fleck SJ. Cardiovascular adaptations to resistance training. Med Sci Sports Exerc 1988; 20 (5): S146–51PubMedGoogle Scholar
  103. 103.
    Longhurst JC, Stebbins CL. The power athlete. Cardiol Clin 1997; 15 (3): 413–29PubMedCrossRefGoogle Scholar
  104. 104.
    Ehsani A, Hagberg J, Hickson R. Rapid changes in left ventricular dimensions and mass in response to physical conditioning and deconditioning. Am J Cardiol 1978; 42 (1): 52–6PubMedCrossRefGoogle Scholar
  105. 105.
    Fagard R, Aubert A, Lysens R, et al. Noninvasive assessment of seasonal varations in cardiac structure and function in cyclists. Circulation 1983; 67 (4): 896–901PubMedCrossRefGoogle Scholar
  106. 106.
    Shapiro L, Smith R. Effect of training on left ventricular structure and function: an echocardiographic study. Br Heart J 1983; 50: 534–9PubMedCrossRefGoogle Scholar
  107. 107.
    du Manoir GR, Haykowsky MJ, Syrotuik DG, et al. The effect of high-intensity rowing and combined strength and endurance training on left ventricular systolic function and morphology. Int J Sports Med 2007; 28: 488–94CrossRefGoogle Scholar
  108. 108.
    Haykowsky MJ, Chan S, Bhambhani Y, et al. Effects of combined endurance and strength training on left ventricular morphology in male and female rowers. Can J Cardiol 1998; 14: 387–91PubMedGoogle Scholar
  109. 109.
    De Maria A, Neumann A, Lee G, et al. Alterations in ventricular mass and performance induced by exercise training in man evaluated by echocardiography. Circulation 1978; 57 (2): 237–44CrossRefGoogle Scholar
  110. 110.
    Mier CM, Turner MJ, Ehsani AA, et al. Cardiovascular adaptations to 10 days of cycle exercise. J Appl Physiol 1997; 83 (6): 1900–6PubMedGoogle Scholar
  111. 111.
    Stein R, Michiellie D, Diamond J, et al. The cardiac response to exercise training: echocardiographic analysis at rest and during exercise. Am J Cardiol 1980; 46: 219–25PubMedCrossRefGoogle Scholar
  112. 112.
    Adams T, Yanowitz F, Fisher A, et al. Noninvasive evaluation of exercise training in college-age men. Circulation 1981; 64 (5): 958–65PubMedCrossRefGoogle Scholar
  113. 113.
    Sadaniantz A, Yurgalevitch S, Zmuda JM, et al. One year of exercise does not alter resting left ventricular systolic or diastolic function. Med Sci Sports Exerc 1996; 28 (11): 1345–50PubMedCrossRefGoogle Scholar
  114. 114.
    Kanakis C, Hickson R. Left ventricular response to a program of lower-limb strength training. Chest 1980; 78 (4): 618–21PubMedCrossRefGoogle Scholar
  115. 115.
    Haykowsky M, Humen D, Teo K, et al. Effects of 16 weeks of resistance training on left ventriucular morphology and systolic function in healthy men >60 years of age. Am J Cardiol 2000; 85: 1002–6PubMedCrossRefGoogle Scholar
  116. 116.
    Haykowsky M, McGavock J, Vonder Muhll I, et al. Effect of exercise training on peak aerobic power, left ventricular morphology, and muscle strength in healthy older women. J Gerontol A Biol Sci Med Sci 2005; 60: 307–11PubMedCrossRefGoogle Scholar
  117. 117.
    Levy WC, Cerqueira MD, Abrass IB, et al. Congestive heart failure/myocardial responses/valvular heart disease: endurance exercise training augments diastolic filling at rest and during exercise in healthy young and older men. Circulation 1993; 88 (1): 116–26CrossRefGoogle Scholar

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© Adis Data Information BV 2008

Authors and Affiliations

  • Louise H. Naylor
    • 1
    • 2
  • Keith George
    • 3
  • Gerry O’Driscoll
    • 4
  • Daniel J. Green
    • 2
    • 3
  1. 1.Cardiac Transplant UnitRoyal Perth HospitalPerthAustralia
  2. 2.School of Sport Science, Exercise and HealthThe University of Western AustraliaPerthAustralia
  3. 3.Research Institute for Sport and Exercise SciencesLiverpool John Moores University, Henry Cotton CampusUK
  4. 4.School of MedicineThe University of Notre DameFremantleAustralia

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