Age- and Sex-Differences in Cardiac Characteristics Determined by Echocardiography in Masters Athletes
2021
Background: Cardiac function and morphology are known to differ between men
and women. Sex differences seen with echocardiography have not been studied
systematically in masters athletes.
Purpose: To evaluate sex differences in cardiac structure, function and left ventricular
(LV) systolic global longitudinal strain among masters athletes.
Methods: This cross-sectional study comprises of 163 masters athletes (M = 109,
60 ± 12 years; F = 55, 57 ± 12 years, range 36–91 years) who participated at the 23rd
World Masters Athletics Championship held in Malaga, Spain. All athletes underwent
state-of-the-art echocardiography including cardiac function, morphology, strain and
hemodynamic assessment.
Results: Left ventricular mass was higher in male than in female athletes (174 ± 44
vs. 141 ± 36 g, p < 0.01) due to greater end-diastolic intraventricular septal, LV
posterior wall and LV basal diameter. However, LV mass index did not differ between
the groups. End-diastolic LV volume and right ventricular area, both indexed to bodysurface-area, were greater in men than in women (52.8 ± 11.0 vs. 46.1 ± 8.5 ml/m2,
p < 0.01, 9.5 ± 2.4 vs. 8.1 ± 1.7 cm2/m2, p < 0.01). In contrast, women had higher
LV systolic global longitudinal strain (-20.2 ± 2.6 vs. -18.8 ± 2.6%, p < 0.01) and
LV outflow tract flow velocity (75.1 ± 11.1 vs. 71.2 ± 11.1 cm/s, p = 0.04). Systolic
and diastolic blood pressure, LV ejection fraction, and stroke volume index were not
different between sexes.
Conclusion: Cardiac sex differences are present even among masters athletes. Lifelong
exercise training does not appear to exasperate morphological difference to a point of
cardiac risk or dysfunction in both male and female athletes.
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