The Athlete's Heart - Male vs. Female

The heart is arguably the most important muscle in the body.  It is the unit responsible for providing every part of the body with oxygen.  For this reason, it is of utmost importance to keep the heart healthy and strong.  This is done through exercise – particularly cardiovascular exercise.  Participating in cardio - at least 150 minutes of moderate intensity cardio per week - helps the heart grow strong and become more efficient at pumping blood throughout the body.

Although a stronger heart is the end result of cardiovascular exercise in all people, a recent study was just released that says there is a difference between male hearts and female hearts and the way they respond to endurance training.

There are a few things that can happen when the heart begins adjusting to the demands of long-distance cardiovascular activity.  Each event centers around the relative wall thickness (thickness of the heart wall) and the left ventricular mass (weight of the bottom left chamber of the heart that pumps out oxygenated blood).

In male endurance athletes, it is more common to see “concentric hypertrophy” or “concentric remodeling.”  Concentric hypertrophy means there is an increased left ventricular mass and an increased relative wall thickness. Remodeling means the left ventricular mass is normal but there is an increased relative wall thickness. However, if these events were to be seen in female athletes, it is highly probable that they are suffering from an impairment of the cardiac muscle called hypertrophic cardiomyopathy, which could cause complications.

Instead, female athletes have a higher probability of experiencing “eccentric hypertrophy,” meaning an increase in left ventricular mass and a normal relative wall thickness.

It is interesting to see the difference between the adaptation of male and female hearts to sustained cardiovascular activity.  Unfortunately, there is not a lot of research available on female endurance athletes.  With the results of this study, it is likely that more research will be done to determine why this physiologic difference exists and how it pertains to training.


Dr. David Carfagno is a Board Certified Internist and Sports Physician, who trained at the Cleveland Clinic Foundation.


Finocchiaro G, Papadakis M, Dhutia H, et al. Effect of gender and sporting discipline on left ventricular adaptation to exercise. European Society of Cardiology 2015 Congress; August 31, 2015; London, UK. Abstract 2967.