Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Innovation and Technology Ministry Hungary - National Research, Development and Innovation Office (Innovációs és Technológiai Minisztérium - Nemzeti Kutatási, Fejlesztési és Innovációs Hivatal Hungary. Introduction Exercise-induced left ventricular hypertrophy (LVH) is widely investigated in adolescent athletes characterized by 2-tiered classification (2TC). Though, the differentiation of normal adaptive changes from pathological LVH can be challenging. 4-tiered classification (4TC) may discriminate better different forms of exercise-induced LVH providing three-dimensional information of the left ventricle (LV). Purpose, methods The main objective of our study was to distinguish alterations between 2TC and 4TC examining 121 adolescent athletes with echocardiography. Moreover, these results were also compared to the matched LV parameters of 114 adult athletes. Results Examining the 4TC allocation representing parameters (LV mass, LV mass/BSA, LV end-diastolic volume/BSA, concentricity) of the adolescent and adult athletes we identified significant differences (p< 0,05) between the different LVH groups and normal geometry, suggesting that the applied classification provides proper group distinguishing power. There were no significant differences between the cumulative training times of the different LVH groups (p >0,05). Furthermore, the BSA corrected LV parameters did not show any correlation with training time. Totally 25 athletes (22%) were reclassified in 4TC into completely different groups, highlighted the 6 athletes (5%) reclassified from normal geometry to concentric LVH and the 11 adolescent (9%) reclassified from normal to eccentric LVH. The reclassifications rate showed similar pattern in adult athletes. Conclusion Based on all these data we assume that training time has no significant impact on the classification. Cardiac remodeling develops already in young age, and further training time has less impact on the adaptive changes. We prefer to apply 4TC in the routine echocardiographic examination of endurance athletes to specify a more sensitive and distinct screening method.