Geert Kleinnibbelink

Chapter 4 104 Figure 3 . Change in (A) LV mass index and (B) LV diameter index in elite rowers before (‘Pre’: blue bars with striped lines) and after (‘Post’: red bars with dots) a 9-month training period distributed to sex. Error bars represent SD. DISCUSSION The aimof our studywas to examine the impact of an increase in volume (across 9-months) in elite rowers on left- and right-sided cardiac structure, function and mechanics. We present the following findings. First, an increased training volume in elite rowers across 9-months resulted in significant structural adaptation of the left ventricle and atrium, with no adaptations observed on the right side. Second, left-sided structural cardiac adaptation was accompanied by an increase in LV twist, but no other left- or right-sided functional adaptations. This highlights the plasticity of the heart for remodelling in response to exercise training, even in elite athletes. Taken together, our results demonstrate cardiac side-, and possibly also sex-specific adaptation, which is relevant for future studies that should acknowledge that cardiac remodelling does not simply follow the same path between and within individuals. After an increase in training volume across 9-months, the left heart of this cohort of elite rowers showed mild structural (eccentric) adaptation with an increased LV twist, whilst there was no significant remodelling in the right heart. This left-sided structural adaptation is in line with several previous longitudinal training studies including