Key result
Professional wrestlers show predominantly normal cardiac geometry, with ~90% maintaining normal LV structure.
Why the study?
Evidence on cardiac adaptation in elite wrestlers remains limited, motivating an assessment of electrical and structural cardiac remodeling with a focus on sex-specific differences.
Does long-term professional wrestling training induce pathological structural or electrical cardiac remodeling in elite athletes?
Cross-Sectional (n=68)
No
Does long-term professional wrestling training induce pathological structural or electrical cardiac remodeling in elite athletes?
Elite professional wrestlers exhibit largely physiological cardiac adaptations with preserved biventricular function and a low prevalence of concentric remodeling, challenging the binary Morganroth hypothesis for resistance-trained athletes.
Supports normal geometry without pathology in wrestlers; leaves open Morganroth hypothesis applicability to mixed training regimens.
Background Evidence on cardiac adaptation in elite wrestlers remains limited. This study assessed electrical and structural cardiac remodeling in elite wrestlers, with particular focus on sex‐specific differences. Methods Elite World Wrestling Entertainment athletes undergoing electrocardiographic and echocardiographic evaluation during routine cardiovascular screening were included. Left ventricular (LV) geometry was classified according to relative wall thickness and LV mass on the basis of international recommendations. This was a retrospective analysis of prospectively acquired data. Results The cohort included 68 athletes (mean age, 28±6 years; 47 [69%] men), with similar weekly training volume between sexes (11.6±5 h/wk). No athlete reported performance‐enhancing drug use, although 1 admitted high‐energy drink consumption. Electrocardiographic abnormalities were observed in 2 athletes (3%). Women showed smaller absolute LV end‐diastolic diameter (46±4 versus 52±5 mm, P <0.001), but greater indexed LV dimensions (27±3 versus 25±3 mm/m 2 , P =0.003). Two female athletes had LV ejection fraction <50%. Right ventricular enlargement was observed in 23% of men and 14% of women ( P =0.52), without sex differences in right ventricular fractional area change (39±6% versus 40±6%, P =0.42). Two male athletes had right ventricular fractional area change <34%. LV geometry was predominantly normal (89% men, 95% women), while concentric remodeling was identified in 6 athletes (9%), including 5 men and 1 woman. Conclusions Elite wrestlers demonstrate predominantly normal cardiac electrical and structural profiles, with low prevalence of pathological findings. Sex‐related differences were observed in cardiac dimensions, particularly after indexation to body surface area.
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Dei et al. (2026) conducted a cross-sectional in Cardiac remodeling (n=68). Professional wrestling training (female athletes) vs. Professional wrestling training (male athletes) was evaluated on Absolute left ventricular end-diastolic diameter (LVEDD) (p=<0.001). Professional wrestlers demonstrated predominantly normal cardiac geometry (89% of men, 95% of women), with female athletes showing smaller absolute but greater indexed left ventricular dimensions.
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