Age- and Sex-Differences in Cardiac Characteristics Determined by Echocardiography in Masters Athletes.

Background: Cardiac function and morphology are known to differ between men and women. Sex differences seen with echocardiography have not been studied systematically in masters athletes.

Purpose: To evaluate sex differences in cardiac structure, function and left ventricular (LV) systolic global longitudinal strain among masters athletes.

Methods: This cross-sectional study comprises of 163 masters athletes ( = 109, 60 ± 12 years; = 55, 57 ± 12 years, range 36-91 years) who participated at the 23rd World Masters Athletics Championship held in Málaga, Spain. All athletes underwent state-of-the-art echocardiography including cardiac function, morphology, strain and hemodynamic assessment.

Results: Left ventricular mass was higher in male than in female athletes (174 ± 44 vs. 141 ± 36 , < 0.01) due to greater end-diastolic intraventricular septal, LV posterior wall and LV basal diameter. However, LV mass index did not differ between the groups. End-diastolic LV volume and right ventricular area, both indexed to body-surface-area, were greater in men than in women (52.8 ± 11.0 vs. 46.1 ± 8.5 ml/m, < 0.01, 9.5 ± 2.4 vs. 8.1 ± 1.7 cm/m, < 0.01). In contrast, women had higher LV systolic global longitudinal strain (-20.2 ± 2.6 vs. -18.8 ± 2.6%, < 0.01) and LV outflow tract flow velocity (75.1 ± 11.1 vs. 71.2 ± 11.1 cm/s, = 0.04). Systolic and diastolic blood pressure, LV ejection fraction, and stroke volume index were not different between sexes.

Conclusion: Cardiac sex differences are present even among masters athletes. Lifelong exercise training does not appear to exasperate morphological difference to a point of cardiac risk or dysfunction in both male and female athletes.