{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:18:36Z","timestamp":1793085516339,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This cross-sectional study aimed to quantify fitness-specific three-dimensional echocardiographic (3DE) reference values categorized by V\u0307O2peak to characterize the \u2018recreational athlete\u2019s heart\u2019 and its sex-specific adaptations across different fitness levels. Furthermore, sex-specific association with V\u0307O2peak was analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 291 healthy participants (mean \u00b1 SD age: 27 \u00b1 4 years; 44% female) regularly engaging in physical activity were included. Echocardiography was performed with Philips EPIQCVx ultrasound systems to assess 3DE left ventricular (LV), right ventricular (RV), and left atrial (LA) volumes, functional measures, LV mass, and ratios. Cardio-pulmonary exercise testing assessed V\u0307O2peak (females: 48 \u00b1 6, males: 54 \u00b1 8\u2005mL\/min\/kg), stratifying participants into three fitness groups: low (L), moderate (M), and high (H) exercise capacity. Both sexes showed increases in 3DE end-diastolic volume with fitness [LVEDV\/m\u00b2, median (10th\u201390th percentile)]: females: L 73 (61\u201383), M 80 (71\u201390), and H 88 (80\u2013104); males: L 82 (70\u201397), M 89 (76\u2013101), and H 99 (89\u2013114) mL\/m\u00b2; with similar trends in RV and LA volumes, LV mass, and stroke volumes. The LV\/RV volume (1.1 \u00b1 0.1) and LV\/LA volume (females: 2.8 \u00b1 0.4, males: 2.9 \u00b1 0.4) ratio and ejection fraction values did not change across fitness levels, whereas LV mass\/volume ratio decreased slightly with increasing fitness without relevant sex differences [L 0.96 (0.87\u20131.05), M 0.91 (0.83\u20130.98), and H 0.87 (0.80\u20130.93) g\/mL].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study establishes sex- and fitness-specific 3DE reference values categorized by V\u0307O2peak, characterizing the recreational athlete\u2019s heart. The V\u0307O\u2082peak-associated enlargement was sex-independent; however, at a given V\u0307O\u2082peak, men exhibited greater remodelling than women. These results bridge the gap between untrained and elite athletes\u2019 hearts and may enhance 3DE evaluation of recreational athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf758","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:05:09Z","timestamp":1764335109000},"page":"1379-1388","source":"Crossref","is-referenced-by-count":2,"title":["The recreational athlete\u2019s heart: sex-specific three-dimensional echocardiographic reference values in relation to VO\u2082peak"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-2048","authenticated-orcid":false,"given":"Theresa","family":"Hofbauer","sequence":"first","affiliation":[{"name":"Department for Sports Medicine, Exercise Physiology and Prevention, Center for Sport Science and University Sports, University of Vienna , Auf der Schmelz 6, Vienna 1150 ,","place":["Austria"]},{"name":"Vienna Doctoral School of Pharmaceutical, Nutritional and Sports Science, University of Vienna , Josef-Holaubek-Platz 2, Vienna 1090 ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3398-0442","authenticated-orcid":false,"given":"Stefan","family":"Heber","sequence":"additional","affiliation":[{"name":"Department for Sports Medicine, Exercise Physiology and Prevention, Center for Sport Science and University Sports, University of Vienna , Auf der Schmelz 6, Vienna 1150 ,","place":["Austria"]},{"name":"Institute of Physiology, Center for Physiology and Pharmacology, Medical University of Vienna , Schwarzspanierstra\u00dfe 17A, Vienna 1090 ,","place":["Austria"]},{"name":"Clinical Department of Internal Medicine II\u2014Cardiology, Nephrology, Intensive Care Medicine, University Clinic Wiener Neustadt , Corvinusring 3-5, Wiener Neustadt 2700 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