The effects of training and sex on cardiac adaptation in elite rowers across a competitive season

Purpose Exercise-induced cardiac adaptation is well-studied in male athletes. However, evidence for longitudinal adaptation, particularly in females, is limited. This study compared cardiac adaptation between elite female and male rowers across a competitive season. Methods Ten females (19 ± 0.9 years) and 11 males (20 ± 1.7 years) were assessed across 21 weeks at early (ES), mid- (MS), and late season (LS). Echocardiography (2D, 3D, strain), peak oxygen consumption (V̇O 2 peak), weekly training volume (sessions) and intensity (minutes in heart rate zones) were documented. Bayesian two-way repeated measures ANOVA assessed sex and training effects. Results Training volume was comparable between sexes; however, females spent less time at maximal heart rate intensity. An interaction effect for V̇O 2 peak demonstrated the highest value at LS in females (55.8 ± 1.6 mL kg min −1 ) and MS in males (64.1 ± 1.6 mL kg min −1 ). Females had smaller left ventricular (LV) 2D mass and volume with no training-induced response in either sex. A sex-specific interaction was observed for 3D LV mass: females peaked at MS (221.2 ± 20.6 g) compared to males at LS (301.9 ± 20.9 g). Females also had smaller LV diameter, wall thickness and right heart dimensions. Across the season, most females (67%) exhibited eccentric hypertrophy, whilst males (89%) showed concentric hypertrophy. However, classifications varied throughout the season. No sex or training effects were observed for strain. Conclusion Whilst sex strongly influences cardiac morphology in elite rowers, sex-specific adaptation in 3D LV mass and LV geometry changes emphasise cardiac plasticity with training in athletes.