The Study
Diastolic function and dysfunction in athletes
This study is like a summary of many pictures taken of athletes' hearts — it shows what most of them look like, but it doesn't prove that training made those changes. It just says, 'Hey, athletes often have bigger hearts and different blood flow patterns.'
Analysis score
Maximum 5 for a narrative review.
Where the score came from
Athletes' hearts get bigger and fill faster because they train so hard — it's like a supercharged engine that needs more fuel, so it grows to pump more blood.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 52 / 100
Quality score
Systematic reviews and meta-analyses of cohort studies. They sit above a single cohort study but below a single randomized trial, because the underlying evidence is still observational.
Key takeaways
Summary
Based on the study abstract and findings.
- 1These changes are normal and healthy for athletes — they help them perform better, not indicate disease.
- 2The same numbers would be dangerous in a non-athlete.
- 3Athletes have: 1) bigger heart chambers, 2) E/A ratio >2 (faster early filling), 3) left atrium >34 mL/m², 4) resting ejection fraction often <50%, and 5) 5x higher risk of atrial fibrillation.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
European Heart Journal Cardiovascular Imaging
Year
2024
Authors
H. Dalen, J. M. Letnes, M. Høydal, U. Wisløff
Related Content
Claims (7)
Endurance athletes have a longer time for blood to fill the heart between beats while at rest, which allows more blood to enter the heart with each cycle, without their heart beating faster than that of non-athletes.
Endurance athletes often have a slightly lower left ventricular ejection fraction than average, but this is a normal response to training and improves during exercise, unlike heart disease where the function remains impaired.
Endurance athletes are five times more likely to develop atrial fibrillation than people who do not engage in endurance sports, and this is linked to long-term changes in the heart's structure, nervous system regulation, and inflammation from prolonged exercise.
In endurance athletes, a left atrial volume index above 34 mL/m² is commonly a normal adaptation to training and does not indicate heart disease when training status and heart chamber size are considered.
Endurance athletes have a larger left ventricle, a larger left atrium, and a higher E/A ratio than non-athletes, and these changes are normal adaptations to long-term intense training, not signs of heart disease.
Endurance athletes have a specific heart filling pattern at rest characterized by an E/A ratio above 2, which reflects more efficient relaxation and recoil of the heart muscle during the early filling phase, distinct from abnormal heart filling patterns seen in disease.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.