{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:43:04Z","timestamp":1780926184382,"version":"3.54.1"},"reference-count":126,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:00:00Z","timestamp":1726272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Athlete\u2019s heart (AH) represents the heart\u2019s remarkable ability to adapt structurally and functionally to prolonged and intensive athletic training. Characterized by increased left ventricular (LV) wall thickness, enlarged cardiac chambers, and augmented cardiac mass, AH typically maintains or enhances systolic and diastolic functions. Despite the positive health implications, these adaptations can obscure the difference between benign physiological changes and early manifestations of cardiac pathologies such as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic cardiomyopathy (ACM). This article reviews the imaging characteristics of AH across various modalities, emphasizing echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography as primary tools for evaluating cardiac function and distinguishing physiological adaptations from pathological conditions. The findings highlight the need for precise diagnostic criteria and advanced imaging techniques to ensure accurate differentiation, preventing misdiagnosis and its associated risks, such as sudden cardiac death (SCD). Understanding these adaptations and employing the appropriate imaging methods are crucial for athletes\u2019 effective management and health optimization.<\/jats:p>","DOI":"10.3390\/jimaging10090230","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T07:36:00Z","timestamp":1726472160000},"page":"230","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Role of Cardiovascular Imaging in the Diagnosis of Athlete\u2019s Heart: Navigating the Shades of Grey"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3979-0609","authenticated-orcid":false,"given":"Nima","family":"Baba Ali","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sogol","family":"Attaripour Esfahani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-9767","authenticated-orcid":false,"given":"Isabel G.","family":"Scalia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5824-8485","authenticated-orcid":false,"given":"Juan M.","family":"Farina","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4695-8436","authenticated-orcid":false,"given":"Milagros","family":"Pereyra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-2990","authenticated-orcid":false,"given":"Timothy","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Lester","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8750-7880","authenticated-orcid":false,"given":"Said","family":"Alsidawi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Steidley","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadi","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1558-4857","authenticated-orcid":false,"given":"Stefano","family":"Palermi","sequence":"additional","affiliation":[{"name":"Public Health Department, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7081-4286","authenticated-orcid":false,"given":"Reza","family":"Arsanjani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.repc.2014.07.010","article-title":"The hearts of competitive athletes: An up-to-date overview of exercise-induced cardiac adaptations","volume":"34","author":"Dores","year":"2015","journal-title":"Rev. Port. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.pcad.2012.01.006","article-title":"Exercise-induced cardiac remodeling","volume":"54","author":"Weiner","year":"2012","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_3","first-page":"6","article-title":"The \u2018Ten Commandments\u2019 for the 2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease","volume":"42","author":"Sharma","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1093\/eurheartj\/ehx532","article-title":"European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: Recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete\u2019s heart","volume":"39","author":"Pelliccia","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12947-023-00319-3","article-title":"Cardiac imaging in athlete\u2019s heart: Current status and future prospects","volume":"21","author":"Zholshybek","year":"2023","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"D\u2019Andrea, A., Sperlongano, S., Russo, V., D\u2019Ascenzi, F., Benfari, G., Renon, F., Palermi, S., Ilardi, F., Giallauria, F., and Limongelli, G. (2021). The Role of Multimodality Imaging in Athlete\u2019s Heart Diagnosis: Current Status and Future Directions. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215126"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1152\/japplphysiol.01170.2007","article-title":"Training-specific changes in cardiac structure and function: A prospective and longitudinal assessment of competitive athletes","volume":"104","author":"Baggish","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1136\/bjsports-2015-e8308rep","article-title":"Survival of the fittest: Retrospective cohort study of the longevity of Olympic medallists in the modern era","volume":"49","author":"Clarke","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.mayocp.2014.06.004","article-title":"Elite athletes live longer than the general population: A meta-analysis","volume":"89","author":"Garatachea","year":"2014","journal-title":"Mayo Clin. Proc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1007\/s10554-018-1412-3","article-title":"Myocardial deformation and volume of exercise: A new overlap between pathology and athlete\u2019s heart?","volume":"34","author":"Dores","year":"2018","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/tre.758","article-title":"Sudden cardiac death in athletes","volume":"11","author":"Mannakkara","year":"2020","journal-title":"Trends Urol. Men\u2019s Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.ccl.2007.07.008","article-title":"How to screen athletes for cardiovascular diseases","volume":"25","author":"Corrado","year":"2007","journal-title":"Cardiol. Clin."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/eurheartj\/ehi108","article-title":"Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: Proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology","volume":"26","author":"Corrado","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/j.jacc.2017.01.015","article-title":"International Recommendations for Electrocardiographic Interpretation in Athletes","volume":"69","author":"Sharma","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.jcmg.2008.12.011","article-title":"Athlete\u2019s heart: The potential for multimodality imaging to address the critical remaining questions","volume":"2","author":"Taylor","year":"2009","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.echo.2015.08.002","article-title":"Endurance Exercise-Induced Cardiac Remodeling: Not All Sports Are Created Equal","volume":"28","author":"Wasfy","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.1161\/CIRCULATIONAHA.110.981571","article-title":"Athlete\u2019s heart and cardiovascular care of the athlete: Scientific and clinical update","volume":"123","author":"Baggish","year":"2011","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1249\/01.mss.0000210203.10200.12","article-title":"Left ventricular function immediately following prolonged exercise: A meta-analysis","volume":"38","author":"Middleton","year":"2006","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5915","DOI":"10.1113\/jphysiol.2011.221903","article-title":"Left ventricular remodelling and the athlete\u2019s heart: Time to revisit the Morganroth hypothesis","volume":"589","author":"Haykowsky","year":"2011","journal-title":"J. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"521","DOI":"10.7326\/0003-4819-82-4-521","article-title":"Comparative left ventricular dimensions in trained athletes","volume":"82","author":"Morganroth","year":"1975","journal-title":"Ann. Intern. Med."},{"key":"ref_21","first-page":"1","article-title":"Cardiovascular Adaptations to Exercise Training","volume":"6","author":"Hellsten","year":"2015","journal-title":"Compr. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/j.jacc.2021.08.003","article-title":"Exercise-Induced Cardiovascular Adaptations and Approach to Exercise and Cardiovascular Disease: JACC State of-the-Art Review","volume":"78","author":"Martinez","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1161\/CIRCULATIONAHA.106.613562","article-title":"The heart of trained athletes: Cardiac remodeling and the risks of sports, including sudden death","volume":"114","author":"Maron","year":"2006","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jcmg.2016.03.017","article-title":"RV Remodeling in Olympic Athletes","volume":"10","author":"Pisicchio","year":"2017","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/S0002-9149(02)02210-5","article-title":"Effect of intensive resistance training on isotonic exercise Doppler indexes of left ventricular systolic function","volume":"89","author":"Fisman","year":"2002","journal-title":"Am. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.echo.2020.02.009","article-title":"Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes: A Report from the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Computed Tomography and the Society for Cardiovascular Magnetic Resonance","volume":"33","author":"Baggish","year":"2020","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/BF03086131","article-title":"Cardiac remodelling: Concentric versus eccentric hypertrophy in strength and endurance athletes","volume":"16","author":"Mihl","year":"2008","journal-title":"Neth. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/JSM.0000000000000501","article-title":"Athletic Remodeling in Female College Athletes: The \u201cMorganroth Hypothesis\u201d Revisited","volume":"29","author":"Kooreman","year":"2019","journal-title":"Clin. J. Sport. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1111\/echo.15066","article-title":"Echocardiographic evaluation of the Athlete\u2019s heart","volume":"38","author":"Albaeni","year":"2021","journal-title":"Echocardiography"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.tcm.2021.06.001","article-title":"Causes of sudden cardiac death in young athletes and non-athletes: Systematic review and meta-analysis: Sudden cardiac death in the young","volume":"32","author":"Valentini","year":"2022","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1515\/jbcpp-2022-0109","article-title":"Limited diagnostic value of questionnaire-based pre-participation screening algorithms: A \u201crisk-exposed\u201d approach to sports activity","volume":"33","author":"Palermi","year":"2022","journal-title":"J. Basic. Clin. Physiol. Pharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"151","DOI":"10.31083\/j.rcm2405151","article-title":"Athlete\u2019s Heart: A Cardiovascular Step-By-Step Multimodality Approach","volume":"24","author":"Palermi","year":"2023","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1093\/eurheartj\/ehw631","article-title":"International recommendations for electrocardiographic interpretation in athletes","volume":"39","author":"Sharma","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1136\/bjsports-2012-092067","article-title":"Electrocardiographic interpretation in athletes: The \u2018Seattle criteria\u2019","volume":"47","author":"Drezner","year":"2013","journal-title":"Br. J. Sports Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1136\/bjsports-2016-097331","article-title":"International criteria for electrocardiographic interpretation in athletes: Consensus statement","volume":"51","author":"Drezner","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/eurheartj\/ehp473","article-title":"Recommendations for interpretation of 12-lead electrocardiogram in the athlete","volume":"31","author":"Corrado","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Vecchiato, M., Ermolao, A., Zanardo, E., Battista, F., Ruvoletto, G., Palermi, S., Quinto, G., Degano, G., Gasperetti, A., and Padalino, M.A. (2023). Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease. Children, 10.","DOI":"10.3390\/children10030521"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ijcard.2022.05.071","article-title":"Molecular genetic testing in athletes: Why and when a position statement from the Italian Society of Sports Cardiology","volume":"364","author":"Castelletti","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1007\/s11886-022-01812-3","article-title":"Echocardiographic Evaluation of the Athlete\u2019s Heart: Focused Review and Update","volume":"24","author":"Lee","year":"2022","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1111\/jce.13715","article-title":"Prognostic significance of noncardiac syncope in the general population: A systematic review and meta-analysis","volume":"29","author":"Ricci","year":"2018","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1177\/2047487320932018","article-title":"The use of cardiac imaging in the evaluation of athletes in the clinical practice: A survey by the Sports Cardiology and Exercise Section of the European Association of Preventive Cardiology and University of Siena, in collaboration with the European Association of Cardiovascular Imaging, the European Heart Rhythm Association and the ESC Working Group on Myocardial and Pericardial Diseases","volume":"28","author":"Anselmi","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_42","first-page":"297","article-title":"Echocardiography in the preparticipation screening: An old topic revisited","volume":"24","author":"Donati","year":"2023","journal-title":"J. Cardiovasc. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s44156-023-00027-8","article-title":"The athlete\u2019s heart: Insights from echocardiography","volume":"10","author":"Flanagan","year":"2023","journal-title":"Echo Res. Pr. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00059-006-2862-2","article-title":"Sports-specific features of athlete\u2019s heart and their relation to echocardiographic parameters","volume":"31","author":"Barbier","year":"2006","journal-title":"Herz"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Unnithan, V.B., Beaumont, A., Rowland, T., George, K., Sculthorpe, N., Lord, R.N., Bakhshi, A., and Oxborough, D. (2022). Left Ventricular Responses during Exercise in Highly Trained Youth Athletes: Echocardiographic Insights on Function and Adaptation. J. Cardiovasc. Dev. Dis., 9.","DOI":"10.3390\/jcdd9120438"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1093\/ehjci\/jeu323","article-title":"The multi-modality cardiac imaging approach to the Athlete\u2019s heart: An expert consensus of the European Association of Cardiovascular Imaging","volume":"16","author":"Galderisi","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1136\/heartjnl-2012-303465","article-title":"Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete\u2019s heart","volume":"99","author":"Utomi","year":"2013","journal-title":"Heart"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e011587","DOI":"10.1161\/CIRCIMAGING.120.011587","article-title":"Female Athlete\u2019s Heart: Sex Effects on Electrical and Structural Remodeling","volume":"13","author":"Biella","year":"2020","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1093\/eurjpc\/zwad023","article-title":"Effects of endurance exercise training on left ventricular structure in healthy adults: A systematic review and meta-analysis","volume":"30","author":"Morrison","year":"2023","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"23","DOI":"10.7326\/0003-4819-130-1-199901050-00005","article-title":"Physiologic left ventricular cavity dilatation in elite athletes","volume":"130","author":"Pelliccia","year":"1999","journal-title":"Ann. Intern. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1161\/01.CIR.101.3.336","article-title":"The athlete\u2019s heart. A meta-analysis of cardiac structure and function","volume":"101","author":"Pluim","year":"2000","journal-title":"Circulation"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.echo.2005.10.005","article-title":"Recommendations for chamber quantification: A report from the American Society of Echocardiography\u2019s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology","volume":"18","author":"Lang","year":"2005","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1161\/CIRCULATIONAHA.109.917211","article-title":"Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes","volume":"121","author":"Rawlins","year":"2010","journal-title":"Circulation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.echo.2010.09.020","article-title":"Left ventricular myocardial velocities and deformation indexes in top-level athletes","volume":"23","author":"Cocchia","year":"2010","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.amjmed.2011.01.009","article-title":"Cardiovascular screening with electrocardiography and echocardiography in collegiate athletes","volume":"124","author":"Magalski","year":"2011","journal-title":"Am. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.echo.2014.09.013","article-title":"Patterns of left ventricular diastolic function in Olympic athletes","volume":"28","author":"Caselli","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1016\/j.echo.2013.07.019","article-title":"Right atrial and ventricular adaptations to training in male Caucasian athletes: An echocardiographic study","volume":"26","author":"Pagourelias","year":"2013","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Hwang, I.C., Choi, D., Choi, Y.J., Ju, L., Kim, M., Hong, J.E., Lee, H.J., Yoon, Y.E., Park, J.B., and Lee, S.P. (2022). Differential diagnosis of common etiologies of left ventricular hypertrophy using a hybrid CNN-LSTM model. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-25467-w"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1055\/s-0035-1555780","article-title":"Atrial Size and Function in Athletes","volume":"36","author":"Gjerdalen","year":"2015","journal-title":"Int. J. Sports Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/j.1600-0838.2006.00538.x","article-title":"Strain rate and tissue tracking imaging in quantitation of left ventricular systolic function in endurance and strength athletes","volume":"17","author":"Poulsen","year":"2007","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/jcecho.jcecho_11_22","article-title":"Myocardial Work Efficiency in Physiologic Left Ventricular Hypertrophy of Power Athletes","volume":"32","author":"Carbone","year":"2022","journal-title":"J. Cardiovasc. Echogr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1249\/JES.0000000000000102","article-title":"The Complex Phenotype of the Athlete\u2019s Heart: Implications for Preparticipation Screening","volume":"45","author":"Brown","year":"2017","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1111\/sms.13656","article-title":"Left ventricular remodeling in elite and sub-elite road cyclists","volume":"30","author":"Brown","year":"2020","journal-title":"Scand J. Med. Sci. Sports"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00421-009-1233-0","article-title":"Diastolic function in healthy humans: Non-invasive assessment and the impact of acute and chronic exercise","volume":"108","author":"George","year":"2010","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1093\/ejechocard\/jer138","article-title":"Right ventricular systolic function assessment: Rank of echocardiographic methods vs. cardiac magnetic resonance imaging","volume":"12","author":"Pavlicek","year":"2011","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.echo.2010.05.010","article-title":"Guidelines for the echocardiographic assessment of the right heart in adults: A report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography","volume":"23","author":"Rudski","year":"2010","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s10554-015-0600-7","article-title":"Increased left atrial size is associated with reduced atrial stiffness and preserved reservoir function in athlete\u2019s heart","volume":"31","author":"Pelliccia","year":"2015","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1093\/ejechocard\/jer137","article-title":"Determinants of echocardiographic left atrial volume: Implications for normalcy","volume":"12","author":"Nistri","year":"2011","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"29","DOI":"10.21037\/cdt.2017.06.08","article-title":"Left atrial function: Evaluation by strain analysis","volume":"8","author":"Gan","year":"2018","journal-title":"Cardiovasc. Diagn Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/clc.23180","article-title":"Left atrial function in elite athletes: A meta-analysis of two-dimensional speckle tracking echocardiographic studies","volume":"42","author":"Cuspidi","year":"2019","journal-title":"Clin. Cardiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.jacc.2005.04.052","article-title":"Prevalence and clinical significance of left atrial remodeling in competitive athletes","volume":"46","author":"Pelliccia","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1177\/2047487319894882","article-title":"Aortic root remodelling in competitive athletes","volume":"27","author":"Abuli","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1007\/s11547-021-01411-2","article-title":"Advanced cardiac imaging in athlete\u2019s heart: Unravelling the grey zone between physiologic adaptation and pathology","volume":"126","author":"Palmisano","year":"2021","journal-title":"Radiol. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1001\/jamacardio.2020.0054","article-title":"Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes","volume":"5","author":"Churchill","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"365404","DOI":"10.1155\/2014\/365404","article-title":"Role of cardiac magnetic resonance in the evaluation of dilated cardiomyopathy: Diagnostic contribution and prognostic significance","volume":"2014","author":"Francone","year":"2014","journal-title":"ISRN Radiol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Palermi, S., Sperlongano, S., Mandoli, G.E., Pastore, M.C., Lisi, M., Benfari, G., Ilardi, F., Malagoli, A., Russo, V., and Ciampi, Q. (2023). Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges. J. Clin. Med., 12.","DOI":"10.3390\/jcm12247678"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1136\/heartjnl-2019-316147","article-title":"Differentiation between athlete\u2019s heart and dilated cardiomyopathy in athletic individuals","volume":"106","author":"Millar","year":"2020","journal-title":"Heart"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Szabo, L., Brunetti, G., Cipriani, A., Juhasz, V., Graziano, F., Hirschberg, K., Dohy, Z., Balla, D., Drobni, Z., and Perazzolo Marra, M. (2022). Certainties and Uncertainties of Cardiac Magnetic Resonance Imaging in Athletes. J. Cardiovasc. Dev. Dis., 9.","DOI":"10.3390\/jcdd9100361"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1055\/s-0033-1350130","article-title":"Detection of cardiovascular disease in elite athletes using cardiac magnetic resonance imaging","volume":"185","author":"Mangold","year":"2013","journal-title":"Rofo"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1016\/j.jcmg.2018.09.021","article-title":"Cardiac Magnetic Resonance Normal Reference Values of Biventricular Size and Function in Male Athlete\u2019s Heart","volume":"12","author":"Anselmi","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.jcmg.2013.06.003","article-title":"Cardiac imaging and stress testing asymptomatic athletes to identify those at risk of sudden cardiac death","volume":"6","author":"Baggish","year":"2013","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1002\/clc.23360","article-title":"Myocardial fibrosis in athletes-Current perspective","volume":"43","author":"Malek","year":"2020","journal-title":"Clin. Cardiol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s11936-018-0679-y","article-title":"The Role of Cardiovascular Magnetic Resonance in Sports Cardiology; Current Utility and Future Perspectives","volume":"20","author":"Androulakis","year":"2018","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1007\/s12265-020-10022-7","article-title":"Cardiovascular Magnetic Resonance and Sport Cardiology: A Growing Role in Clinical Dilemmas","volume":"13","author":"Maestrini","year":"2020","journal-title":"J. Cardiovasc. Transl. Res."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jcmg.2017.11.016","article-title":"The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Highly Trained Athletes","volume":"11","author":"Gati","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11936-020-0802-8","article-title":"Cardiac Imaging in the Athlete: Shrinking the \u201cGray Zone\u201d","volume":"22","author":"Caruso","year":"2020","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1002\/jmri.20949","article-title":"Coronary magnetic resonance angiography","volume":"26","author":"Stuber","year":"2007","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s10554-018-1478-y","article-title":"Cardiac magnetic resonance based deformation imaging: Role of feature tracking in athletes with suspected arrhythmogenic right ventricular cardiomyopathy","volume":"35","author":"Czimbalmos","year":"2019","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1080\/02640414.2018.1499392","article-title":"Right ventricular function in elite male athletes meeting the structural echocardiographic task force criteria for arrhythmogenic right ventricular cardiomyopathy","volume":"37","author":"Qasem","year":"2019","journal-title":"J. Sports Sci."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Fogante, M., Agliata, G., Basile, M.C., Compagnucci, P., Volpato, G., Falanga, U., Stronati, G., Guerra, F., Vignale, D., and Esposito, A. (2021). Cardiac Imaging in Athlete\u2019s Heart: The Role of the Radiologist. Medicina, 57.","DOI":"10.3390\/medicina57050455"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.clinimag.2021.03.001","article-title":"Cardiac-CT with the newest CT scanners: An incoming screening tool for competitive athletes?","volume":"78","author":"Savino","year":"2021","journal-title":"Clin. Imaging"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1161\/CIRCULATIONAHA.106.178458","article-title":"Assessment of coronary artery disease by cardiac computed tomography: A scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology","volume":"114","author":"Budoff","year":"2006","journal-title":"Circulation"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1161\/CIRCULATIONAHA.122.061173","article-title":"Exercise Volume Versus Intensity and the Progression of Coronary Atherosclerosis in Middle-Aged and Older Athletes: Findings From the MARC-2 Study","volume":"147","author":"Aengevaeren","year":"2023","journal-title":"Circulation"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"486","DOI":"10.4329\/wjr.v6.i7.486","article-title":"Nuclear imaging in detection and monitoring of cardiotoxicity","volume":"6","author":"Gargiulo","year":"2014","journal-title":"World J. Radiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jcmg.2022.12.015","article-title":"Myocardial Perfusion PET for the Detection and Reporting of Coronary Microvascular Dysfunction: A JACC: Cardiovascular Imaging Expert Panel Statement","volume":"16","author":"Schindler","year":"2023","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.echo.2022.03.012","article-title":"Recommendations for Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy: An Update from the American Society of Echocardiography, in Collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography","volume":"35","author":"Nagueh","year":"2022","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s12350-018-1298-4","article-title":"Is there a role for cardiac positron emission tomography in hypertrophic cardiomyopathy?","volume":"26","author":"Bravo","year":"2019","journal-title":"J. Nucl. Cardiol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1161\/CIRCULATIONAHA.109.915009","article-title":"Cardiac positron emission tomogra phy\/computed tomography imaging accurately detects anatomically and functionally significant coronary artery disease","volume":"122","author":"Kajander","year":"2010","journal-title":"Circulation"},{"key":"ref_100","unstructured":"Al Moudi, M., Sun, Z., and Lenzo, N. (2011). Diagnostic value of SPECT, PETand PET\/CT in the diagnosis of coronary artery disease: A systematic review. Biomed. Imaging Interv. J., 7."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.csm.2022.02.005","article-title":"Differentiating Physiology from Pathology: The Gray Zones of the Athlete\u2019s Heart","volume":"41","author":"Danielian","year":"2022","journal-title":"Clin. Sports Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.hlc.2018.04.297","article-title":"Differentiating Athlete\u2019s Heart From Cardiomyopathies\u2014The Left Side","volume":"27","author":"Brosnan","year":"2018","journal-title":"Heart Lung Circ."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.pcad.2020.07.004","article-title":"Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis","volume":"63","author":"Wundersitz","year":"2020","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jacc.2004.02.057","article-title":"Serial left ventricular adaptations in world-class professional cyclists: Implications for disease screening and follow-up","volume":"44","author":"Abergel","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.cjca.2015.11.025","article-title":"Differentiating Exercise-Induced Cardiac Adaptations From Cardiac Pathology: The \u201cGrey Zone\u201d of Clinical Uncertainty","volume":"32","author":"Kim","year":"2016","journal-title":"Can. J. Cardiol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s12574-017-0338-4","article-title":"Exercise stress echocardiography in hypertrophic cardiomyopathy","volume":"15","author":"Suzuki","year":"2017","journal-title":"J. Echocardiogr."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e15141","DOI":"10.14814\/phy2.15141","article-title":"Cardiac structure and function in elite female athletes: A systematic review and meta-analysis","volume":"9","author":"Bryde","year":"2021","journal-title":"Physiol. Rep."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1111\/jch.12977","article-title":"Left ventricular hypertrophy in athletes and hypertensive patients","volume":"19","author":"Lovic","year":"2017","journal-title":"J. Clin. Hypertens."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"3A","DOI":"10.1177\/14732300050330S102","article-title":"Left ventricular hypertrophy--the problem and possible solutions","volume":"33","author":"Gosse","year":"2005","journal-title":"J. Int. Med. Res."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1016\/S0735-1097(02)02270-2","article-title":"Physiologic limits of left ventricular hypertrophy in elite junior athletes: Relevance to differential diagnosis of athlete\u2019s heart and hypertrophic cardiomyopathy","volume":"40","author":"Sharma","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/HCO.0000000000000203","article-title":"Differentiating the athlete\u2019s heart from hypertrophic cardiomyopathy","volume":"30","author":"Wasfy","year":"2015","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e003312","DOI":"10.1161\/CIRCIMAGING.115.003312","article-title":"Hypertrophic Cardiomyopathy, Athlete\u2019s Heart, or Both: A Case of Hypertrophic Cardiomyopathy Regression","volume":"8","author":"Kebed","year":"2015","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jcmg.2020.07.039","article-title":"Cardiac Phenotypes and Markers of Adverse Outcome in Elite Athletes With Ventricular Arrhythmias","volume":"14","author":"Lie","year":"2021","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1161\/CIRCULATIONAHA.108.840827","article-title":"Diagnosis of arrhythmogenic right ventricular cardiomyopathy\/dysplasia: Proposed modification of the task force criteria","volume":"121","author":"Marcus","year":"2010","journal-title":"Circulation"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Androulakis, E., and Perone, F. (2023). Multimodality Cardiac Imaging in Young and Veteran Athletes: Updates on Atrial Function Assessment, Arrhythmia Predisposition and Pathology Discrimination. J. Clin. Med., 12.","DOI":"10.3390\/jcm12030797"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.jcmg.2018.04.031","article-title":"Diagnostic Differentiation Between Arrhythmogenic Cardiomyopathy and Athlete\u2019s Heart by Using Imaging","volume":"11","author":"Solari","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.hlc.2018.04.300","article-title":"Differentiating Athlete\u2019s Heart from Cardiomyopathies-The Right Side","volume":"27","author":"Prior","year":"2018","journal-title":"Heart Lung Circ."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s10741-021-10128-3","article-title":"Ventricular non-compaction review","volume":"27","author":"Srivastava","year":"2022","journal-title":"Heart Fail. Rev."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.ijcard.2015.04.140","article-title":"Left ventricular non-compaction and hypertrabeculation in the athlete: Distinguishing between pathology and physiology","volume":"190","author":"Pelliccia","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/eurjpc\/zwae008","article-title":"Unlocking the potential of artificial intelligence in sports cardiology: Does it have a role in evaluating athlete\u2019s heart?","volume":"31","author":"Palermi","year":"2024","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Smaranda, A.M., Dr\u0103goiu, T.S., Caramoci, A., Afetelor, A.A., Ionescu, A.M., and B\u0103d\u0103r\u0103u, I.A. (2024). Artificial Intelligence in Sports Medicine: Reshaping Electrocardiogram Analysis for Athlete Safety-A Narrative Review. Sports, 12.","DOI":"10.3390\/sports12060144"},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Barry, T., Farina, J.M., Chao, C.J., Ayoub, C., Jeong, J., Patel, B.N., Banerjee, I., and Arsanjani, R. (2023). The Role of Artificial Intelligence in Echocardiography. J. Imaging, 9.","DOI":"10.3390\/jimaging9020050"},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Bellfield, R.A.A., Ortega-Martorell, S., Lip, G.Y.H., Oxborough, D., and Olier, I. (2022). The Athlete\u2019s Heart and Machine Learning: A Review of Current Implementations and Gaps for Future Research. J. Cardiovasc. Dev. Dis., 9.","DOI":"10.3390\/jcdd9110382"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1016\/j.jacc.2016.08.062","article-title":"Machine-Learning Algorithms to Automate Morphological and Functional Assessments in 2D Echocardiography","volume":"68","author":"Narula","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1016\/S2589-7500(20)30267-3","article-title":"Diagnosis and risk stratification in hypertrophic cardiomyopathy using machine learning wall thickness measurement: A comparison with human test-retest performance","volume":"3","author":"Augusto","year":"2021","journal-title":"Lancet Digit. Health"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"101792","DOI":"10.1016\/j.media.2020.101792","article-title":"Handling confounding variables in statistical shape analysis-application to cardiac remodelling","volume":"65","author":"Bernardino","year":"2020","journal-title":"Med. 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