Key result
Olympic athletes show no major cardiac remodeling differences versus elite athletes despite higher training volumes.
Why the study?
Differences between Olympic athletes and elite/national athletes not qualified for the Olympics have not been investigated.
Do Olympic athletes differ from elite/national athletes in clinical, echocardiographic, and laboratory parameters?
Cross-Sectional (n=1,472)
Do Olympic athletes differ from elite/national athletes in clinical, echocardiographic, and laboratory parameters?
Expertise and volume of training, rather than distinct cardiac remodeling or physiological parameters, appear to be the critical factors differentiating Olympic athletes from national-level elite athletes.
Greater training volume was unlinked to distinct cardiac remodeling; leaves open expertise as key differentiator in prospective studies.
OBJECTIVE: Olympic athletes (OAs) represent a unique subset of highly trained subjects achieving extraordinary performance. Differences between OAs and elite/national athletes (EAs), defined as athletes not qualified for the Olympics, are not investigated. DESIGN: Therefore, we compared OAs with EAs enrolling 1472 athletes (63.6% OAs; 56.9%, men, mean age 25.8 ± 5.1 years) of power (24.7%), skills (12.5%), endurance (20.8%), and mixed (37.4%) disciplines performing clinical, anthropometric, echocardiographic, exercise stress, and blood test analysis. RESULTS: Olympic athletes were older (power: 25.9 ± 4.6 vs 24.1 ± 4.7, P = 0.0002; skills: 28.6 ± 6.5 vs 25.2 ± 6.5, P = 0.0003; endurance: 27.2 ± 4.5 vs 23.7 ± 3.9, P = 0.001; mixed: 27.9 ± 4.7 vs 22.8 ± 4.4, P = 0.001) and trained for more hours (power: 26.1 ± 10.9 vs 19.9 ± 7.5, P < 0.0001; skills: 29.1 ± 9.4 vs 21 ± 9.4, P = 0.0004; endurance: 26.4 ± 8.7 vs 19.4 ± 8.5, P = 0.001; mixed: 28.4 ± 9.5 vs 22.2 ± 9.2, P = 0.001) compared with EAs. No morphological cardiac differences were observed. At the exercise test, the maximum watt reached was similar (except that in power, P = 0.004). Olympic athletes showed statistically significant lower serum calcium, lower thyroid stimulating hormone, and relatively higher total and low-density lipoprotein cholesterol. CONCLUSIONS: Olympic athletes are older, have a larger body mass, and can sustain a larger training volume than elite athletes. However, no major differences in cardiac remodeling or clinical and laboratory parameters differentiate these 2 groups. Expertise and volume of training appear to represent the critical factors to translate from the national to the Olympic level.
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Gioia et al. (2025) conducted a cross-sectional in Athletes (n=1,472). Olympic athlete status vs. Elite/national athlete status was evaluated on Differences in clinical, anthropometric, echocardiographic, exercise stress, and blood test parameters. Olympic athletes were older and sustained a larger training volume than elite/national athletes, with no major differences in cardiac remodeling or clinical and laboratory parameters.
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