{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:57:59Z","timestamp":1760057879779,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Regular exercise is known to induce cardiovascular adaptations collectively referred to as \u201cathlete\u2019s heart\u201d. While previous research has explored the morphological and functional cardiac adaptations in athletes, the relationship between vitamin D (25-hydroxyvitamin D [25(OH)D]) levels and echocardiographic parameters remains underexplored. This study aims to assess the association between 25(OH)D levels and structural and functional cardiac parameters using electrocardiographic (ECG) and echocardiographic evaluations in athletes. Materials and Methods: This case\u2013control study included 93 male athletes, categorized into professional (n = 68) and recreational (n = 25) groups. Professional athletes were further divided into football (n = 19), weightlifting (n = 22), and running (n = 27) subgroups. Serum 25(OH)D levels were measured using high-performance liquid chromatography\u2013tandem mass spectrometry (LC-MS\/MS). Standard 12-lead ECG and transthoracic echocardiography were performed to assess cardiac structure and function. Data were analyzed using statistical tests that were appropriate for normal and non-normal distributions, with a significance level set at p &lt; 0.05. Results: Athletes exhibited higher left ventricular interventricular septum (IVS) thickness and left ventricular posterior wall thickness (LVPWd) compared to the control group. Significant differences in diastolic function parameters, including early (E) and late (A) diastolic filling velocities and the E\/A ratio, were observed among athlete subgroups. The weightlifting group showed lower end-systolic diameter (ESD) values than the football group. However, no statistically significant relationship was found between 25(OH)D levels and echocardiographic diastolic parameters. While more than half of the athletes had insufficient 25(OH)D levels (&lt;30 ng\/mL), their average values were higher than those reported in previous studies. Conclusions: This study demonstrates that 25(OH)D levels do not significantly influence echocardiographic diastolic parameters in athletes. However, notable differences in structural and functional cardiac findings were observed among different sports disciplines. These findings contribute to the understanding of cardiac adaptations in athletes and suggest that 25(OH)D may not play a crucial role in diastolic function. Further research is needed to explore the long-term effects of vitamin D on athletic cardiac performance.<\/jats:p>","DOI":"10.3390\/medicina61030407","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T06:15:33Z","timestamp":1740550533000},"page":"407","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D Deficiency Does Not Impair Diastolic Function in Elite Athletes"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0815-6494","authenticated-orcid":false,"given":"\u00d6mer","family":"\u00d6zkan","sequence":"first","affiliation":[{"name":"Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3038-3829","authenticated-orcid":false,"given":"\u0130dris","family":"Yakut","sequence":"additional","affiliation":[{"name":"Sincan Training and Research Hospital, 06949 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcrhan","family":"D\u00f6nmez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Sports Medicine, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9486-3541","authenticated-orcid":false,"given":"Feza","family":"Korkusuz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Sports Medicine, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1249\/01.MSS.0000115224.88514.3A","article-title":"American College of Sports Medicine position stand. Exercise and hypertension","volume":"36","author":"Pescatello","year":"2004","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1159\/000541166","article-title":"Physical Activity, Cardiorespiratory Fitness, and Atherosclerotic Cardiovascular Disease: Part 2","volume":"12","author":"Franklin","year":"2024","journal-title":"Pulse"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9935971","DOI":"10.1155\/2024\/9935971","article-title":"Enhancing Awareness of Physical Activity Guidelines among Saudi College Students: The 150 Minutes Program","volume":"2024","author":"Alshehri","year":"2024","journal-title":"Adv. Public Health"},{"key":"ref_4","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. Pract."},{"key":"ref_5","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_6","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1136\/heart.89.12.1455","article-title":"Athlete\u2019s heart","volume":"89","author":"Fagard","year":"2003","journal-title":"Heart"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1152\/jappl.1985.58.3.785","article-title":"Arterial blood pressure response to heavy resistance exercise","volume":"58","author":"MacDougall","year":"1985","journal-title":"J. Appl. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S0735-1097(86)80282-0","article-title":"Structural features of the athlete heart as defined by echocardiography","volume":"7","author":"Maron","year":"1986","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","first-page":"e49734","article-title":"Vitamin D and Cardiovascular Diseases: An Update","volume":"15","author":"Haider","year":"2023","journal-title":"Cureus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/2047487313518473","article-title":"Severely vitamin D-deficient athletes present smaller hearts than sufficient athletes","volume":"22","author":"Allison","year":"2015","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2410426","DOI":"10.1080\/15502783.2024.2410426","article-title":"Association of vitamin D deficiency with post-exercise hypotension and arterial stiffness following prolonged endurance exercise in healthy young men","volume":"21","author":"Chen","year":"2024","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/0002-9149(86)90771-X","article-title":"Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings","volume":"57","author":"Devereux","year":"1986","journal-title":"Am. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.amjcard.2006.05.040","article-title":"Two-Dimensional Echocardiographic Methods for Assessment of Left Atrial Volume","volume":"98","author":"Ujino","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/j.jacc.2005.02.015","article-title":"Task Force 8: Classification of sports","volume":"45","author":"Mitchell","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s40798-024-00783-9","article-title":"Cardiac Structure and Function of Elite Australian Jockeys Compared to the General Population: An Observational Cross-Sectional Study","volume":"10","author":"Farley","year":"2024","journal-title":"Sports Med.-Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4250\/jcu.2014.22.4.196","article-title":"Endurance and Strength Athlete\u2019s Heart: Analysis of Myocardial Deformation by Speckle Tracking Echocardiography","volume":"22","author":"Santoro","year":"2014","journal-title":"J. Cardiovasc. Ultrasound"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/JSM.0b013e3181f207f2","article-title":"High Prevalence of Vitamin D Insufficiency in Athletes and Dancers","volume":"20","author":"Constantini","year":"2010","journal-title":"Clin. J. Sport. Med."},{"key":"ref_18","first-page":"e22","article-title":"Prevalence of vitamin D deficiency in high-level athletics athletes","volume":"59","author":"Edouard","year":"2016","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_19","first-page":"22","article-title":"Vitamin D deficiency in athletes: Laboratory, clinical and field integration","volume":"29","author":"Ip","year":"2022","journal-title":"Asia-Pac. J. Sports Med. Arthrosc. Rehabil. Technol."},{"key":"ref_20","first-page":"219","article-title":"Comparison of vitamin D sufficiency between indoor and outdoor elite male collegiate athletes","volume":"83","author":"Kawashima","year":"2021","journal-title":"Nagoya J. Med. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1136\/hrt.52.2.124","article-title":"Cardiac structure and function in cyclists and runners. Comparative echocardiographic study","volume":"52","author":"Fagard","year":"1984","journal-title":"Br. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ashikaga, K., Manabe, T., Tomori, A., Endo, N., and Kamahara, K. (2025). Differences in athlete\u2019s left ventricular morphology by sex and sports discipline categories in elite Japanese athletes. Phys. Sportsmed., 1\u201310.","DOI":"10.1080\/00913847.2025.2463320"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1540-8175.2007.00367.x","article-title":"Alterations in left ventricular structure and diastolic function in professional football players: Assessment by tissue Doppler imaging and left ventricular flow propagation velocity","volume":"24","author":"Tumuklu","year":"2007","journal-title":"Echocardiography"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/S0002-9149(99)00918-2","article-title":"Effects of 16 weeks of resistance training on left ventricular morphology and systolic function in healthy men >60 years of age","volume":"85","author":"Haykowsky","year":"2000","journal-title":"Am. J. Cardiol."},{"key":"ref_25","first-page":"772","article-title":"Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: Comparative Cross-Sectional Study","volume":"111","author":"Silva","year":"2018","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ijcard.2004.11.022","article-title":"The effect of resistance training on left ventricular function and structure of patients with chronic heart failure","volume":"105","author":"Levinger","year":"2005","journal-title":"Int. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1476-7120-9-27","article-title":"The effect of exercise training on left ventricular function in young elite athletes","volume":"9","author":"Stefani","year":"2011","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.12659\/MSM.883829","article-title":"Doppler echocardiography in athletes from different sports","volume":"19","author":"Moro","year":"2013","journal-title":"Med. Sci. Monit."},{"key":"ref_29","first-page":"151","article-title":"Echocardiographic parameters in athletes of different sports","volume":"7","author":"Venckunas","year":"2008","journal-title":"J. Sports Sci. Med."},{"key":"ref_30","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_31","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.ahj.2010.03.036","article-title":"Left atrial volume index in highly trained athletes","volume":"159","author":"Riegler","year":"2010","journal-title":"Am. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1093\/eurheartj\/ehp040","article-title":"Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes","volume":"30","author":"Teske","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/BF00241657","article-title":"Cardiac anatomy and diastolic filling in professional road cyclists","volume":"67","author":"Missault","year":"1993","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1556\/APhysiol.98.2011.3.5","article-title":"Relationship between the heart rate and E\/A ratio in athletic and non-athletic males","volume":"98","author":"Kneffel","year":"2011","journal-title":"Acta Physiol. Hung."},{"key":"ref_35","first-page":"758","article-title":"Vitamin D levels and other biochemical parameters of mineral bone disorders and their association with diastolic dysfunction and left ventricular mass in young nondiabetic adult patients with chronic kidney disease","volume":"28","author":"Sonkar","year":"2017","journal-title":"Saudi J. Kidney Dis. Transpl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e000011","DOI":"10.1136\/openhrt-2013-000011","article-title":"Vitamin D levels and left ventricular diastolic function","volume":"1","author":"Pandit","year":"2014","journal-title":"Open Heart"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1809944","article-title":"Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease","volume":"380","author":"Manson","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1177\/1479164115621667","article-title":"A randomised controlled trial evaluating the impact of targeted vitamin D supplementation on endothelial function in type 2 diabetes mellitus: The DIMENSION trial","volume":"13","author":"Dalan","year":"2016","journal-title":"Diab. Vasc. Dis. Res."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Gholami, F., Moradi, G., Zareei, B., Rasouli, M.A., Nikkhoo, B., Roshani, D., and Ghaderi, E. (2019). The association between circulating 25-hydroxyvitamin D and cardiovascular diseases: A meta-analysis of prospective cohort studies. BMC Cardiovasc. Disord., 19.","DOI":"10.1186\/s12872-019-1236-7"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"23259671231220371","DOI":"10.1177\/23259671231220371","article-title":"Effects of Vitamin D Supplementation in Elite Athletes: A Systematic Review","volume":"12","author":"Wyatt","year":"2024","journal-title":"Orthop. J. Sports Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s40279-017-0841-9","article-title":"Vitamin D and the Athlete: Current Perspectives and New Challenges","volume":"48","author":"Owens","year":"2018","journal-title":"Sports Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1007\/s00421-020-04421-6","article-title":"Association of 25-hydroxy vitamin D level with the blood pressure response to a maximum exercise test among professional indoor athletes","volume":"120","author":"Bauer","year":"2020","journal-title":"Eur. J. Appl. Physiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/407\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:42:47Z","timestamp":1760028167000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/407"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030407"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030407","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,2,26]]}}}