Phenotyping the Structure and Function of the Heart of Elite Sailors: Implications for Pre-Participation Cardiac Screening

Maxwell, JD, Howard, LJ, White, I, Place, F ORCID: 0009-0005-5422-2738, Aggokabo, O ORCID: 0000-0001-8176-507X, Robinson, S ORCID: 0000-0001-9461-9389, Galloway, CSL, Shardey, JKK, Verrinder, C, George, KP ORCID: 0000-0002-5119-6651, Cooper, R ORCID: 0000-0001-7482-828X and Oxborough, D ORCID: 0000-0002-1334-3286 (2026) Phenotyping the Structure and Function of the Heart of Elite Sailors: Implications for Pre-Participation Cardiac Screening. Journal of Cardiovascular Development and Disease, 13 (1). p. 53. ISSN 2308-3425

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Abstract

Background: Structural and functional adaptation of the heart to chronic exercise is dependent on multiple factors, including the volume and type of training, and has direct implications for pre-participation cardiac screening (PPCS). Sailing is a unique multi-training modality sport with limited prior description of cardiac adaptation to training. The aims of this study are (1) to describe electrocardiogram (ECG) changes in sailors, informing PPCS guidelines; (2) to assess structural and functional cardiac changes in sailors; and (3) to examine sex- or discipline-specific cardiac adaptations in sailors. Methods: Seventy elite sailors (33 females) underwent standard ECG and echocardiography. Echocardiographic data were compared to population norms and analysed by sex and sailing discipline based on training type: isometric (IG), pumping (PG), and movement (MG). Results: One sailor presented with abnormal ECG findings (T wave inversion) which warranted further investigation. Primary training-related ECG changes noted were early repolarisation (24%) and sinus bradycardia (30%). The left ventricular volume index was dilated in 18% of all sailors compared to reference values, with similar findings noted on right ventricular parameters for 22% of the study population, although in males only. The impact of predominant training stimulus (IG, PG, MG) did not mediate differences in the structure of any cardiac chambers (p > 0.05). Ejection fraction was lower in the PG (Δ4%, p ≤ 0.001), whereas global longitudinal strain was higher (Δ2%, p = 0.02) compared to MG and IG.

Conclusions: Elite-level sailors present with electrical and structural cardiac phenotypes associated with exercise adaptation, with dilation of both left- and right-sided chambers. These data should be considered when interpreting results of PPCS in male and female sailors from different, specific disciplines.

Item Type:	Article
Uncontrolled Keywords:	32 Biomedical and Clinical Sciences; 3201 Cardiovascular Medicine and Haematology; Heart Disease; Physical Activity; Women's Health; Cardiovascular; Clinical Research; Cardiovascular; 3201 Cardiovascular medicine and haematology
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions:	Sport and Exercise Sciences
Publisher:	MDPI AG
Date of acceptance:	27 December 2025
Date of first compliant Open Access:	28 January 2026
Date Deposited:	28 Jan 2026 09:45
Last Modified:	28 Jan 2026 09:45
DOI or ID number:	10.3390/jcdd13010053
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27982

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