Background .– The cardiac consequences of extensive athletic activity in men over the age of 50 years are unknown.

Aims .– We intend to describe the remodelling that occur due to intensive athletic activity in men ≥ 50 years of age.

Methods .– We conducted a prospective analysis of 21 athletes ≥ 50 years of age. Fifteen sedentary healthy controls and ten patients diagnosed with a left ventricular hypertrophy who were all over the age of 50. All subjects underwent a resting and a sub-maximal exercise echocardiography in order to measure left ventricular systolic and diastolic functions.

Results .– Left ventricular (LV) volumes, which were similar at rest in the three groups, were higher in the athletes during exercise ( P < 0.01). Systolic ejection volumes and longitudinal global left ventricular strains were greater at rest in healthy subjects (athletes and controls) in comparison to those in LVH-patients ( P < 0.01). During exercise, the increase in longitudinal strain was higher in athletes than in the two other groups ( P < 0.05). Concerning left ventricular relaxation, septal e’- and lateral e’-waves were higher both at rest and during exercise in the group of healthy subjects in comparison to those in patients ( P < 0.05).

Conclusion .– Distinguishing physiology from pathology is challenging at rest, particularly in the elderly. However, exercise stress echocardiography helps. Only the changes in shape and in the longitudinal LV systolic function during exercise are significantly different between athletes and controls or LVH-subjects.