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Analysed MR imaging parameters in the whole study cohort included morphology, functional parameters and late gadolinium enhancement (LGE). Mean left-ventricular enddiastolic volume index (LVEDVI) was high in athletes (105\u00a0ml\/m<jats:sup>2<\/jats:sup>) but significantly lower compared to DCM (132\u00a0ml\/m<jats:sup>2<\/jats:sup>; p\u2009=\u20090.001). Mean LV ejection fraction (EF) was 61% in athletes, below normal in 7 (18%) athletes vs. EF 29% in DCM, below normal in 46 (96%) patients (p\u2009&lt;\u20090.0001). Mean RV-EF was 54% in athletes vs. 60% in HCM, 46% in ARVC, and 41% in DCM (p\u2009&lt;\u20090.0001). Mean interventricular myocardial thickness was 10\u00a0mm in athletes vs. 12\u00a0mm in HCM (p\u2009=\u20090.0005), 9\u00a0mm in ARVC, and 9\u00a0mm in DCM. LGE was present in 1 (5%) athlete, 8 (57%) HCM, 10 (56%) ARVC, and 21 (44%) DCM patients (p\u2009&lt;\u20090.0001). Healthy athletes\u2019 hearts are characterized by both hypertrophy and dilation, low EF of both ventricles at rest, and increased interventricular septal thickness with a low prevalence of LGE. Differentiation of athlete\u2019s heart from other non-ischemic cardiomyopathies in MRI can be challenging due to a significant overlap of characteristics also seen in HCM, ARVC, and DCM.<\/jats:p>","DOI":"10.1007\/s10554-021-02280-6","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T11:02:50Z","timestamp":1621594970000},"page":"2501-2515","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Cardiac MRI findings to differentiate athlete's heart from hypertrophic (HCM), arrhythmogenic right ventricular (ARVC) and dilated (DCM) cardiomyopathy"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-7585","authenticated-orcid":false,"given":"J.","family":"K\u00fcbler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-4202","authenticated-orcid":false,"given":"C.","family":"Burgstahler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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