Male adolescent cross-country skiers displayed greater indexed left ventricular end-diastolic volumes than females from age 12 (81 vs 76 mL/m², p≤0.01) and progressed further by age 18.
Cohort (n=76)
Does sex affect cardiac remodeling in adolescent cross-country skiers?
Sex-related differences in exercise-induced cardiac remodeling are evident from age 12 and progress through adolescence, with males showing greater remodeling beyond reference values.
Absolute Event Rate: 81% vs 76%
p-value: p=≤0.01
BACKGROUND: Athlete'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. METHODS: We 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. RESULTS: Males 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. CONCLUSION: Sex-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.
Forså et al. (Sun,) conducted a cohort in Athlete's heart (n=76). Male sex vs. Female sex was evaluated on Indexed left ventricular end-diastolic volumes (LV EDVi) at age 12 (p=≤0.01). Male adolescent cross-country skiers displayed greater indexed left ventricular end-diastolic volumes than females from age 12 (81 vs 76 mL/m², p≤0.01) and progressed further by age 18.
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