Female athletes exhibit distinct cardiovascular adaptations compared to males, including longer QT intervals, eccentric remodeling, and higher rates of symptomatic atrial fibrillation.
Systematic Review
What are the sex-specific differences in cardiovascular adaptations and risks among elite athletes?
There are significant sex-specific differences in cardiovascular adaptations to athletic training, highlighting the need for tailored screening and management in sports cardiology.
BACKGROUND: The growing participation of women in competitive sports necessitates a comprehensive understanding of sex-specific cardiovascular adaptations and risks. Historically, research has predominantly focused on male athletes, leaving a gap in knowledge about the unique cardiovascular dynamics of female peers. HYPOTHESIS: we hypothesized that female athletes exhibit distinct cardiovascular adaptations and face different risks, influenced by physiological, hormonal, and structural differences. METHODS: A systematic review of the literature was conducted, analyzing studies on cardiovascular responses and adaptations in athletes. Data were extracted on hemodynamic changes, autonomic and neural reflex regulation, cardiac remodeling, and arrhythmias. Comparative analyses were performed to identify sex-specific patterns and discrepancies in cardiovascular health outcomes. RESULTS: We revealed considerable sex differences in cardiovascular adaptations to athletic training. Female athletes generally have longer QT intervals, greater sinoatrial node automaticity, and enhanced atrioventricular node function compared to males. They also exhibit lower sympathetic activity, lower maximal stroke volumes, and a tendency toward eccentric cardiac remodeling. Conversely, male athletes are more prone to concentric hypertrophy and higher incidences of bradyarrhythmia and accessory pathway arrhythmias. Female athletes are more likely to experience symptomatic atrial fibrillation and face higher procedural complications during catheter ablation. CONCLUSIONS: Our findings underscore the necessity for sex-specific approaches in sports cardiology. Recognizing and addressing these differences could enhance performance and reduce adverse cardiac events in athletes. Future research should focus on developing tailored screening, prevention, and treatment strategies to bridge the knowledge gap and promote cardiovascular health in both male and female athletes.
Afaghi et al. (Sun,) conducted a systematic review in Cardiovascular adaptations and risks in elite athletes. Athletic training in female athletes vs. Male athletes was evaluated on Sex-specific patterns and discrepancies in cardiovascular health outcomes, hemodynamic changes, cardiac remodeling, and arrhythmias. Female athletes exhibit distinct cardiovascular adaptations compared to males, including longer QT intervals, eccentric remodeling, and higher rates of symptomatic atrial fibrillation.