Heart failure & cardiomyopathiesCross-sectional study
Sport Type Alone Does Not Reliably Predict Distinct Cardiac Phenotypes in Athletes
- Cross-sectional study
Authors' conclusion
ESC and AHA/ACC sport classifications capture population-level remodelling but cannot reliably be used to predict individual cardiac phenotypes.
Study context
- Population
- Elite athletes (310 women, 48 disciplines) and controls
- Participants
- 1,024 athletes
- Exposure
- Athletes vs Controls
- Athletesn = 775
- Controlsn = 249reference
- Outcome
- Whether sport classifications predict CMR-determined cardiac remodelling phenotypes (population level R2; individual level balanced accuracy)
Main finding
As reported in the abstract
Prediction of CMR remodelling phenotype by sport classification
- ESC categories vs RVEDV, R2
- 0.170
- RV remodelling prevalence, skill to endurance
- 8.3%-62.2%
- RV remodelling, OR per ESC category (P<0.001)
- 3.82
- AHA/ACC static component vs LV mass, R2
- 0.077
- AHA/ACC dynamic component vs RVEDV, R2
- 0.072
- Balanced accuracy, ESC (vs 25% chance)
- 34.2%
- Balanced accuracy, AHA/ACC (vs 25% chance)
- 37.7%
Observational data: associations, not effects.
Further findings
LV mass–RVEDV coupling
- LV mass and RVEDV coupled increases, R2
- 0.23
- Athletes with concordant patterns rather than discrete static or dynamic phenotypes
- 67%
Predominantly high-static athletes
- Normal geometry
- 73.8%
- Expected LV hypertrophy
- 17.5%
Original publication
Sport Type Alone Does Not Reliably Predict Distinct Cardiac Phenotypes in Athletes. Eur J Prev Cardiol. Published 30 August 2026. doi:10.1093/eurjpc/zwag451
Summarised from the published abstract; every number is checked against it