Study highlights gender-related differences in athletes’ hearts

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A new study to be featured at the ESC Congress 2015 (29 August–2 September, London, UK) will reveal how exercise has a different effect on men and women’s hearts. The study about gender differences in athletes’ hearts highlights the importance of understanding how women’s hearts work, and that what looks normal in men could reveal problems in women.

Researchers from St George’s University of London, UK, conducted a study in 1,082 healthy, elite, white athletes, including 41% females between 21 and 27, who underwent electrocardiogram (ECG) and echocardiogram as part of their heart assessment. Sports were divided into static, dynamic or mixed and their effects on the size and shape of the heart were assessed.

Authors observed that female athletes participating in dynamic sport showed predominantly eccentric hypertrophy, an increase in the size of the heart, a common and benign effect in male athletes. In women, this may be a sign for hypertrophic cardiomyopathy, or a thickening of the heart muscle which is a leading cause of death in athletes.

“The physiological alteration when exercising is different in men than women. In men, both the heart walls thicken and heart cavity size increases, while in women it is mainly the heart cavities that get bigger. If the walls of a woman’s heart thicken in a similar fashion to a male, this could be cause for concern: either that they have hypertrophic cardiomyopathy, a heart muscle’s fault that often triggers sudden death in young sportsmen, or that they might be using anabolic drugs,” said Sanjay Sharma, professor of inherited cardiac diseases in sports cardiology at St George’s, University Hospital in London.

Men who exercise regularly grow a bigger heart muscle as a result of body building hormone testosterone’s action. Women do not produce much of this hormone, so sport usually does not have the effect of increasing their heart wall thickness much more than that of sedentary women.

The study suggests that any growth in a woman’s heart wall thickness-beyond the usual limits for a sedentary woman-may be a warning sign for hypertrophic cardiomyopathy, and underlines the importance of understanding gender anatomic differences.

“This study was conducted in over 400 women, which is huge, and it brings very relevant results, as data on gender specific heart geometry in athletes was lacking. Women seem to adapt slightly differently to that kind of exercise than men,” Sharma said.

The number of women suffering from cardiovascular diseases is on the increase. In the UK alone, 1 million women now suffer from cardiovascular disease, compared to 1.6 million men. This is a consequence of increasingly similar lifestyles, with notably long stressful working days, alcohol consumption, smoking and unhealthy diets.

Sudden death is still much more common in men than women, but things may change as more and more women now engage in sports long practiced by men alone.

“An increasing number of competitive athletes are women. They engage in sports they have never done before: football, rugby, boxing, etc. So it is now even more important that we understand the way women’s hearts work,” Sharma concluded.

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