High intensity training is associated with specific cardiac remodeling in young female athletesHigh Intensity Training Changes Heart Structure in Female Athletes

European journal of preventive cardiology Published June 9, 2026 Study authors: Laurier Noémie, Salvini Zoé, Syed Labib-Daiyan, Hodzic Amir, Ni Jiayi, Poirier Paul, d'Entremont Mar… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note that high-intensity training is associated with increased left ventricular mass and volume in female athletes.

The study evaluated cardiac remodeling in young female athletes by comparing echocardiographic and electrocardiographic indices against both female non-athletes and male athletes. The primary focus was on identifying the impact of high-intensity physical training on heart structure and electrical activity.

Findings indicated that female athletes exhibited higher left ventricular end-diastolic volume, mass, and left atrial volume compared to female non-athletes. Additionally, a comparison between genders showed that male athletes possessed higher left ventricular mass than their female counterparts. The analysis also noted variations in T-wave inversions among different ethnic groups within the female athlete population.

While the data suggests distinct cardiac adaptations related to athletic status, the authors note these are associations rather than proven causal links. These findings may serve as useful normative values for clinicians evaluating the hearts of young female athletes. However, clinical application should remain cautious as the results are based on a collection of observational data.

Researchers analyzed data from over 10,000 athletes to see how high-intensity physical training affects the heart. The study looked specifically at young female athletes between the ages of 18 and 35. They compared these women to both male athletes and women who did not participate in intense sports.

The results showed that female athletes had larger heart chambers and more muscle mass in the heart compared to women who were not athletes. These changes are common signs of how the heart adapts to heavy exercise. However, the study also noted that some specific electrical patterns on heart tests were more common in Black female athletes than in other groups.

Because this was a review of existing observational data, it shows a link between training and heart structure rather than proving one causes the other. These findings help doctors establish what is normal for active women. If you are an athlete, talk to a healthcare provider to understand how your specific training affects your heart health.

What this means for you:

High-intensity training is linked to larger heart muscle and chamber sizes in young female athletes.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID41289042

View Original Abstract ↓

AIMS: High-intensity physical training induces cardiac remodelling, but data on the female athlete's heart are limited. We aimed to determine the normal echocardiographic (ECHO) and electrocardiographic (ECG) indices in young female athletes, compare them with female non-athletes and male athletes, and evaluate differences between female athletes of different races/ethnicities and types of sports. METHODS AND RESULTS: We searched four databases for studies including female athletes aged 18-35. A meta-analysis compared cardiovascular indices between female athletes and the groups above. We included 41 quantitative studies enrolling 11 956 female athletes, 14 014 male athletes, and 549 female non-athletes. Mean age (95% confidence intervals) in years was 22.4 (21.5-23.3) for female athletes, 23.7 (22.3-25.0) for female non-athletes, and 22.3 (21.3-23.3) for male athletes. Female athletes had higher left ventricular end-diastolic volume index [72.5 (66.3-78.8) vs. 55.4 (46.4-64.7) mL/m², P = 0.001], left ventricular mass index (LVMi) [80.8 (75.9-85.7) vs. 62.1(56.6-67.6) g/m², P < 0.0001], and left atrial volume index [29.2 (25.4-32.9) vs. 22.4 (18.7-26.1) mL/m², P = 0.01] than female non-athletes. The LVMi was 21% higher in male athletes than female athletes [98.3 (89.7-106.9) vs. 81.4 (76.6-86.2) g/m2, P < 0.0001]. Black female athletes had more frequent T-wave inversions on ECG than other races/ethnicities [15.2 (7.3-28.8) % of Black vs. 5.4 (2.9-9.9) % of White vs. 2.6 (0.7-9.9) % of Pacific Islanders vs. 0.7 (0.04-9.7) % of Metis, P = 0.04]. CONCLUSION: We confirmed sex-specific left ventricular remodelling, with more eccentric remodelling in female athletes. Black female athletes showed more T-wave inversions than female athletes of other races/ethnicities. Our aggregate means of ECHO and ECG indices may serve as normative values for young female athletes.

High intensity training is associated with specific cardiac remodeling in young female athletesHigh Intensity Training Changes Heart Structure in Female Athletes

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High intensity training is associated with specific cardiac remodeling in young female athletesHigh Intensity Training Changes Heart Structure in Female Athletes

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