Key result
Endurance training drives eccentric cardiac remodeling, whereas resistance training induces concentric or mixed hypertrophy.
Why the study?
Regular physical exercise induces physiological cardiac hypertrophy with structural remodeling patterns that differ according to exercise modality, prompting a systematic comparison of structural characteristics following endurance and resistance training in healthy humans and animal models.
Does endurance exercise induce different structural characteristics of physiological cardiac hypertrophy compared to resistance exercise in healthy humans and animal models?
Systematic Review
Does endurance exercise induce different structural characteristics of physiological cardiac hypertrophy compared to resistance exercise in healthy humans and animal models?
This systematic review demonstrates that endurance and resistance exercise modalities induce distinct patterns of physiological cardiac remodeling (predominantly eccentric versus concentric/mixed hypertrophy, respectively) while preserving systolic function.
Answers are grounded in this paper and cite their sources.
Informs athlete cardiac imaging interpretation by training modality; extends synthesis of modality-specific physiological hypertrophy across humans and models.
Regular physical exercise induces physiological cardiac hypertrophy, although the structural remodeling pattern differs according to exercise modality. This systematic review compared the structural characteristics of exercise-induced cardiac hypertrophy following endurance and resistance training in healthy humans and animal models. A systematic search of PubMed, ScienceDirect, and SpringerLink was conducted to identify studies published between 1 January 2020 and 10 March 2026, in accordance with the PRISMA 2020 guidelines. Eligible studies included randomized controlled trials and longitudinal interventions involving at least four weeks of endurance or resistance exercise with structural cardiac outcomes. Risk of bias was assessed using the ROBINS-I tool for human studies and the SYRCLE tool for animal studies. Findings were synthesized narratively because of methodological heterogeneity. Nine studies were included in this systematic review, comprising three human studies and six animal studies. All studies evaluating resistance training were conducted in human longitudinal cohorts. Endurance training predominantly induced eccentric remodeling, characterized by increased left ventricular mass and chamber dimensions with preserved relative wall thickness, although concentric and mixed phenotypes were also observed, particularly with higher training intensities. Resistance training generally produced concentric or mixed hypertrophy associated with pressure overload. Among studies reporting cardiac functional outcomes, systolic function was generally preserved. These findings provide preliminary evidence that exercise modality and intensity may influence cardiac remodeling and may help guide future research on individualized exercise prescriptions, particularly in human populations.
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Natalia et al. (2026) conducted a systematic review in Physiological cardiac hypertrophy. Endurance exercise training vs. Resistance exercise training was evaluated on Structural cardiac remodeling (left ventricular mass, chamber dimensions, relative wall thickness). Endurance training predominantly induced eccentric cardiac remodeling while resistance training produced concentric or mixed hypertrophy across 9 included studies (3 human, 6 animal).
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