What is the clinical evidence from this study?

Study design: Other. Population: Exercise induced cardiac remodeling. Primary outcome: Left ventricular ejection fraction (LVEF) after exercise testing (HR 0.76).

What does this research mean for the field?

Echocardiography is essential for differentiating physiological adaptations from pathological changes in athletes' hearts. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to understand how evolving diagnostic criteria for cardiac conditions impact evaluations in athletes.

January 20, 2026Open Access

Echocardiography in Athletes: the Ever-Evolving Assessment of Physiology Versus Pathology

Key Result

Echocardiography is essential for differentiating physiological adaptations from pathological changes in athletes' hearts.

Key Points

The aim is to understand how evolving diagnostic criteria for cardiac conditions impact evaluations in athletes.
Review recent publications on cardiac diagnostic criteria
Analyze differences between physiological adaptations and pathological conditions
Discuss implications for cardiologists in practice
New diagnostic criteria emphasize excessive trabeculations over non-compaction
Improved understanding of arrhythmogenic cardiomyopathies
Heightened awareness necessary to differentiate exercise adaptations from pathologies

Structured PICO

Population

Athletes undergoing echocardiographic evaluation for exercise-induced cardiac remodeling versus pathology

Intervention

Echocardiography

This review highlights the evolving echocardiographic criteria needed to accurately differentiate benign exercise-induced cardiac remodeling from underlying cardiomyopathies in athletes.

Main Result

Effect estimate: HR 0.76

Limitations

Lack of specific numbers for primary outcome results
Limited data on racial differences and specific training impacts

Abstract

There have been recent publications regarding improved diagnostic criteria for apical hypertrophic cardiomyopathy, shift towards "excessive trabeculations" rather than historically termed non-compaction, and expanding knowledge of arrhythmogenic cardiomyopathies. Exercise induced cardiac remodeling can be mistaken for these pathologies, among others. As the evaluation of cardiomyopathies changes with the growing understanding of the pathology, it is important that these updates are compared to the potential physiologic adaptation seen in athletic training. It is imperative for the practicing cardiologist to remain knowledgeable of these evolving guidelines.

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Cite This Study

Fritzlen et al. (Sat,) conducted a other in Exercise induced cardiac remodeling. Echocardiography is essential for differentiating physiological adaptations from pathological changes in athletes' hearts.

synapsesocial.com/papers/696f1a239e64f732b51ee5be https://doi.org/https://doi.org/10.1007/s11886-025-02327-3

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