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The current literature provides a compelling overview of the available methods that target the interrelation of prolonged exercise with cardiac structure and function. However, this data stems from scientific studies that included mostly male athletes. Despite the growing participation of females in competitive sport meetings, little is known about the long-term cardiac effects of repetitive training in this population. There are several factors\u2014biochemical, physiological and psychological, that determine sex-dependent cardiac response. Herein, the aim of this review was to compare cardiac adaptation to endurance exercise in male and female athletes with the use of electrocardiographic, echocardiographic, and biochemical examination, to determine the sex-specific phenotypes, and to improve the healthcare providers\u2019 awareness of cardiac remodeling in athletes. Finally, we discuss the possible exercise-induced alternations that should arouse suspicion of pathology and be further evaluated. <\/jats:p>","DOI":"10.1152\/ajpheart.00756.2023","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T14:44:00Z","timestamp":1708699440000},"page":"H1065-H1079","update-policy":"https:\/\/doi.org\/10.1152\/aps-crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Differences in cardiac adaptation to exercise in male and female athletes assessed by noninvasive techniques: a state-of-the-art review"],"prefix":"10.1152","volume":"326","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3845-3083","authenticated-orcid":false,"given":"Zofia","family":"Lasocka-Koriat","sequence":"first","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gda\u0144sk, Gda\u0144sk, Poland"},{"name":"First Department of Cardiology, Medical University of Gda\u0144sk, Gda\u0144sk, 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