{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:14:14Z","timestamp":1768954454311,"version":"3.49.0"},"reference-count":58,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Structural and functional adaptation of the heart to chronic exercise is dependent on multiple factors, including the volume and type of training, and has direct implications for pre-participation cardiac screening (PPCS). Sailing is a unique multi-training modality sport with limited prior description of cardiac adaptation to training. The aims of this study are (1) to describe electrocardiogram (ECG) changes in sailors, informing PPCS guidelines; (2) to assess structural and functional cardiac changes in sailors; and (3) to examine sex- or discipline-specific cardiac adaptations in sailors. Methods: Seventy elite sailors (33 females) underwent standard ECG and echocardiography. Echocardiographic data were compared to population norms and analysed by sex and sailing discipline based on training type: isometric (IG), pumping (PG), and movement (MG). Results: One sailor presented with abnormal ECG findings (T wave inversion) which warranted further investigation. Primary training-related ECG changes noted were early repolarisation (24%) and sinus bradycardia (30%). The left ventricular volume index was dilated in 18% of all sailors compared to reference values, with similar findings noted on right ventricular parameters for 22% of the study population, although in males only. The impact of predominant training stimulus (IG, PG, MG) did not mediate differences in the structure of any cardiac chambers (p &gt; 0.05). Ejection fraction was lower in the PG (\u03944%, p \u2264 0.001), whereas global longitudinal strain was higher (\u03942%, p = 0.02) compared to MG and IG. Conclusions: Elite-level sailors present with electrical and structural cardiac phenotypes associated with exercise adaptation, with dilation of both left- and right-sided chambers. These data should be considered when interpreting results of PPCS in male and female sailors from different, specific disciplines.<\/jats:p>","DOI":"10.3390\/jcdd13010053","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:27:58Z","timestamp":1768908478000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotyping the Structure and Function of the Heart of Elite Sailors: Implications for Pre-Participation Cardiac Screening"],"prefix":"10.3390","volume":"13","author":[{"given":"Joseph D.","family":"Maxwell","sequence":"first","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Liverpool University NHS Foundation Trust, Mount Vernon Street, Liverpool L7 8XP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca J.","family":"Howard","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"White","sequence":"additional","affiliation":[{"name":"British Sailing Team, Performance Unit, Portland, Liverpool DT5 1FA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5422-2738","authenticated-orcid":false,"given":"Florence","family":"Place","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8176-507X","authenticated-orcid":false,"given":"Obipiseibima","family":"Aggokabo","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9461-9389","authenticated-orcid":false,"given":"Shaun","family":"Robinson","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"Imperial College Healthcare NHS, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille S. L.","family":"Galloway","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"School of Health and Exercise Sciences, University of British Columbia, Okanagan, Kelowna, BC V1V 1V7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob K. K.","family":"Shardey","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Verrinder","sequence":"additional","affiliation":[{"name":"British Sailing Team, Performance Unit, Portland, Liverpool DT5 1FA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith P.","family":"George","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Cooper","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1334-3286","authenticated-orcid":false,"given":"David","family":"Oxborough","sequence":"additional","affiliation":[{"name":"Research Institute of Sports and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool L3 3AF, UK"},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","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. 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