Abstract
Background: Women have been reported with smaller cardiac size and blood volume in response to intensive physical training compared to men. However, adaptive cardiac characteristics to exercises have been rarely compared between elite and non-elite female athletes particularly among Asian athletes. Methods: This study included 177 women, aged 18-34 years, under a standard 6-month military training course in Taiwan. In 2020, all attended a 3000-meter run to assess endurance capacity, and 89 were randomly selected to complete a 2-minute push-up test to assess muscular strength. Elite athletes were those whose performance fell one standard deviation above the mean (16%) of each exercise modality. Cardiac characteristics evaluated by a 12-lead electro-cardiography (ECG) and transthoracic echocardiography were compared between elite and non-elite female athletes. Multiple logistic regression analysis was used to determine the predictors of elite female athletes’s cardiac adaptation to endurance versus strength exercise. Results: Compared to non-elite controls, elite female endurance athletes had greater QRS duration (92.12±10.35 ms vs. 87.26±9.89 ms, p =0.01) and higher prevalence of right axis deviation (34.9% vs. 11.1%, p <0.001). There were no differences in any echocardiographic variables, i.e. left ventricular mass index and diastolic function. Greater QRS duration, right axis deviation and lower systolic blood pressure levels were independent predictors of elite endurance athletes [odds ratios (OR) and 95% confidence intervals: 1.05 (1.01-1.09), 2.91 (1.12-7.59) and 0.93 (0.88-0.98), respectively]. In contrast, elite female strength athletes had greater right ventricular outflow tract (RVOT) (28.06±3.57 mm vs. 25.38± 3.61 mm, p =0.007), while demonstrated no differences in ECG variables. Greater RVOT was the only predictor of elite strength athletes [OR: 1.26 (1.05-1.50)]. Conclusions: In physically active Asian women, QRS prolongation and right axis deviation in ECG rather than the heart structure and functional changes characterize the elite endurance athletes. However, the right ventricular outflow enlargement documented in elite strength athletes requires further investigations.
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