ArticleOpen heart2023
Young athlete's growing heart: sex differences in cardiac adaptation to exercise training during adolescence.
Article in Open heart, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Cardiac evaluation of paediatric athletes.European heart journal · 2026Guideline
- Sex-Specific Differences in Cardiovascular Adaptations and Risks in Elite Athletes: Bridging the Gap in Sports Cardiology.Clinical cardiology · 2024Pooled it
- A systematic review of explainable artificial intelligence and cardiac electrophysiological models addressing sports-related sudden cardiac death and arrest in adolescents and young adults.NPJ digital medicine · 2026Article
- Exercise-induced cardiac hypertrophy: cellular and molecular mechanisms of cardiac adaptation following physical activity.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026Review
- Sex- and body surface area-specific distribution and developmental trends of left ventricular structure and function during early adolescence.European journal of pediatrics · 2026Article
- Electrocardiographic Changes in Juvenile Athletes in Relation to Sex, Age, and Sport Category.Pediatric cardiology · 2026Article
- Left ventricular morphological and functional predictors ofExperimental physiology · 2026Observational
- Greater weekly exercise volume is associated with lower prevalence of metabolic comorbidities, psychiatric conditions, and exertional symptoms in youth athletes undergoing pre-participation screening: an observational study.Frontiers in cardiovascular medicine · 2026Article
- Development of the Cardiovascular System During Adolescence.Advances in experimental medicine and biology · 2026Review
- Racial disparities in electrical and structural cardiac adaptation among adolescent athletes: A systematic review and meta-analysis.World journal of cardiology · 2025Article
- Investigation of Body Composition and Cardiac Sports Adaptation in Elite Water Polo Players.Sports (Basel, Switzerland) · 2025Article
- Cardiac adaptations in young triathletes: a 9-month longitudinal study during the peak height velocity period.European journal of applied physiology · 2025Article
- Hearts apart: sex differences in cardiac remodeling in health and disease.The Journal of clinical investigation · 2024Review
- Right Ventricular Structure and Function in Adolescent Athletes: A 3D Echocardiographic Study.International journal of sports medicine · 2024Article
- Pulmonary responses following cardiac rehabilitation and the relationship with functional outcomes in children and young adults with heart disease.Frontiers in surgery · 2024Article
- The athlete's heart: insights from echocardiography.Echo research and practice · 2023Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAthlete's heart is a condition of exercise-induced cardiac remodelling. Adult male endurance athletes more often remodel beyond reference values. The impact of sex on remodelling through adolescence remains unclear. Paediatric reference values do not account for patient sex or exercise history. We aimed to study the effect of sex on cardiac remodelling throughout adolescence.
methodsWe recruited 76 male (M) and female (F) 12-year-old cross-country skiers in a longitudinal cohort study. Echocardiography was performed and analysed according to guidelines at age 12 (48 M, 28 F), 15 (34 M, 14 F) and 18 (23 M, 11 F). Repeated echocardiographic measurements were analysed by linear mixed model regression.
resultsMales displayed greater indexed left ventricular end-diastolic volumes (LV EDVi) from age 12 (M 81±7 vs F 76±7, mL/m², p≤0.01), and progressed further until follow-up at age 18 (M 2.3±9.7 vs F -3.9±4.5 ΔmL/m², p≤0.01). LV EDVi remained above adult upper reference values in both groups. Males increased LV Mass Index from age 12 to 18 (M 33±27 vs F 4±19, Δg/m², p≤0.01). Males displayed LV mass above paediatric reference values at ages 15 and 18. A subset of males (35%) and females (25%) displayed wall thickness above paediatric reference values at age 12. Cardiac function was normal. There was no sex difference in exercise hours.
conclusionSex-related differences in athlete's heart were evident from age 12, and progressed throughout adolescence. Remodelling beyond reference values was more frequent than previously reported, particularly affecting males. Age, sex and exercise history may assist clinicians in distinguishing exercise-induced remodelling from pathology in adolescents.
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