Key result
Elite sailors exhibit LV dilation in ~18% of athletes alongside frequent sinus bradycardia.
Why the study?
Sailing is a unique multi-training modality sport with limited prior description of cardiac adaptation to training, which has direct implications for pre-participation cardiac screening.
What are the electrical and structural cardiac adaptations in elite sailors, and do they differ by sex or sailing discipline?
What are the electrical and structural cardiac adaptations in elite sailors, and do they differ by sex or sailing discipline?
Elite sailors exhibit specific electrical and structural cardiac adaptations, including chamber dilation and discipline-specific functional differences, which must be recognized during pre-participation cardiac screening to prevent misdiagnosis.
Chamber dilation and repolarization changes warrant cautious ECG/echo interpretation in sailors; extends athlete heart data but leaves open prognostic validation.
Background: Structural and functional adaptation of the heart to chronic exercise is dependent on multiple factors, including the volume and type of training, and has direct implications for pre-participation cardiac screening (PPCS). Sailing is a unique multi-training modality sport with limited prior description of cardiac adaptation to training. The aims of this study are (1) to describe electrocardiogram (ECG) changes in sailors, informing PPCS guidelines; (2) to assess structural and functional cardiac changes in sailors; and (3) to examine sex- or discipline-specific cardiac adaptations in sailors. Methods: Seventy elite sailors (33 females) underwent standard ECG and echocardiography. Echocardiographic data were compared to population norms and analysed by sex and sailing discipline based on training type: isometric (IG), pumping (PG), and movement (MG). Results: One sailor presented with abnormal ECG findings (T wave inversion) which warranted further investigation. Primary training-related ECG changes noted were early repolarisation (24%) and sinus bradycardia (30%). The left ventricular volume index was dilated in 18% of all sailors compared to reference values, with similar findings noted on right ventricular parameters for 22% of the study population, although in males only. The impact of predominant training stimulus (IG, PG, MG) did not mediate differences in the structure of any cardiac chambers (p > 0.05). Ejection fraction was lower in the PG (Δ4%, p ≤ 0.001), whereas global longitudinal strain was higher (Δ2%, p = 0.02) compared to MG and IG. Conclusions: Elite-level sailors present with electrical and structural cardiac phenotypes associated with exercise adaptation, with dilation of both left- and right-sided chambers. These data should be considered when interpreting results of PPCS in male and female sailors from different, specific disciplines.
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Maxwell et al. (2026) studied this question. Eighteen percent of elite sailors exhibited left ventricular dilation compared to reference values, with 30% showing sinus bradycardia and 24% with early repolarisation.
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