An observational study in Athlete Heart, sponsored by University of Avignon. Recruiting at 2 sites in France. Open to participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-01-23.
Sponsored by University of Avignon · Observational
Exercise-induced cardiac remodeling, known as the "athlete's heart," corresponds to morphological and functional adaptations of the left ventricle in response to prolonged physical training. It is characterized in particular by physiological hypertrophy and improved myocardial function.
Intraventricular blood flow interacts with cardiac mechanics. Regional shape (e.g., sphericity, wall curvature) and myocardial deformations guide flow patterns to create an optimal hemodynamic environment. The interaction between these different parameters in the athlete's heart remains insufficiently explored. In this context, 3D echocardiography makes it possible to combine indices derived from fluid dynamics, regional myocardial function, and cardiac geometry, enabling a comprehensive assessment of cardiac performance.
Primary and secondary objectives:
In this context, the aim of this project is to investigate the relationship between intraventricular flow and cardiac mechanics based on combined measurements of intraventricular flow (e.g., vorticity, pressure gradients), regional myocardial function (e.g., myocardial strain), and global/regional LV geometry (e.g., sphericity, wall curvature) in the athlete's heart. Since these parameters are interdependent, analyzing their interaction through the development of new echocardiographic tools based on 4D assessments will enable a comprehensive evaluation of functional improvements in the athlete's heart.
The secondary objectives are to analyze the impact of dyssynchrony on intraventricular flow, to evaluate the influence of primary and secondary deformations on intraventricular flow, and to study cardiac function from an energetic perspective using non-invasive reconstruction of pressure-volume loops for cardiac work estimation.
Methodology:
The study will include 80 endurance athletes (ENT group) and 80 control subjects (CONT group). The main inclusion criteria common to both groups are: men and women aged 18-45 years, with no known heart disease and no cardiovascular risk factors (e.g., body mass index > 30 kg/m², arterial hypertension). Athletes must train at least 10 hours per week for the past 5 years. Control subjects must not engage in more than 3 hours of physical activity per week.
Athletes will be recruited from elite groups of various federations, during local long-distance races, or during clinical evaluations at Montpellier University Hospital (Dr. C. Hédon's department). Control subjects will be recruited in the Avignon area and in the cardiology department of Montpellier University Hospital during routine visits.
Echocardiographic examinations will be performed in the left lateral decubitus position using Vivid systems with 4D probes. 4D and tri-plane acquisitions with color Doppler will allow assessment of cardiac structure and intraventricular flow. Data analysis will be performed using TOMTEC software, and scripts developed in Matlab and RStudio will process information related to shape, mechanical dispersion, and dyssynchrony. Intraventricular hemodynamics will be analyzed in collaboration with the CREATIS laboratory (D. Garcia), particularly through measurements of intraventricular pressure gradients and vorticity indices.
University of Avignon is the lead sponsor of 12 studies on the registry; 5 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Participants in the ENT group will be recruited:
Healthy participants will be recruited in parallel In Avignon and the surrounding area.
Some participants from the CONT or ENT groups will also be recruited in the cardiology department of Dr Hédon at Montpellier University Hospital during a follow-up visit, for example as part of systematic cardiovascular screening. These participants will have undergone a preventive cardiology consultation that revealed no abnormalities or pathology. If these participants meet all inclusion criteria, they may then be included in the study.
Inclusion criteria for athletes:
- Athlete practicing at least 10 hours of endurance training per week for a minimum of 5 years.
Inclusion criteria for controls:
- Individual not training in more than 3 hours of physical activity per week.
Exclusion Criteria for both groups:
Exclusion criteria for athletes:
- Use of substances listed on the prohibited substances list of the French Anti-Doping Agency
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Sedentary controls
Endurance athletes
Left ventricular principal strains
The investigators will assess left ventricular principal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular secondary strains
The investigators will assess left ventricular secondary strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular principal and secondary strain rates
The investigators will assess left ventricular principal and secondary strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strains
The investigators will assess left ventricular global longitudinal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strain rates
The investigators will assess left ventricular global longitudinal strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global circumferential strains
The investigators will assess left ventricular global circumferential strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global circumferential strain rates
The investigators will assess left ventricular global circumferential strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global radial strains
The investigators will assess left ventricular global radial strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global radial strain rates
The investigators will assess left ventricular global radial strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global area strains
The investigators will assess left ventricular global area strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global area strain rates
The investigators will assess left ventricular global area strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Standard deviation of the time-to-peak of left ventricular segmental strains
The investigators will assess standard deviation of the time-to-peak of left ventricular segmental strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Maximum delay
The investigators will assess maximum delay of left ventricular segmentary strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular longitudinal strain delay index
The investigators will assess left ventricular longitudinal strain delay index in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular post systolic strain index
The investigators will assess left ventricular post systolic strain index in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular myocardic work
The investigators will left ventricular myocardic work in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular potential energy
The investigators will assess left ventricular potential energy in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global longitudinal strains
The investigators will assess right ventricular global longitudinal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global longitudinal strain rates
The investigators will assess right ventricular global longitudinal strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global circumferential strains
The investigators will assess right ventricular global circumferential strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global circumferential strain rates
The investigators will assess right ventricular global circumferential strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular principal strains
The investigators will assess right ventricular principal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular secondary strains
The investigators will assess right ventricular secondary strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular principal strain rates
The investigators will assess right ventricular principal strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular secondary strain rates
The investigators will assess right ventricular secondary strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global area strain
The investigators will assess right ventricular global area strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global area strain rates
The investigators will assess right ventricular global area strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial global longitudinal strains
The investigators will assess left atrial global longitudinal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial global longitudinal strain rates
The investigators will assess left atrial global longitudinal strain rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right atrial global longitudinal strains
The investigators will assess right atrial global longitudinal strains in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strains - 2D
The investigators will assess left ventricular global longitudinal strains in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strain rates - 2D
The investigators will assess left ventricular global longitudinal strain rates in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Basal rotation - 2D
The investigators will assess left ventricular basal rotation in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Apical rotation - 2D
The investigators will assess left ventricular apical rotation in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Basal rotation - 3D
The investigators will assess left ventricular basal rotation in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Apical rotation - 3D
The investigators will assess left ventricular apical rotation in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular twist
The investigators will assess left ventricular twist in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular torsion
The investigators will assess left ventricular torsion in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular twisting/untwisting rates - 2D
The investigators will assess left ventricular twisting/untwisting rates in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular torsional rates - 3D
The investigators will assess left ventricular torsional rates in resting conditions using 3D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular basal/apical rotational rates
The investigators will assess left ventricular basal/apical rotational rates in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular circumferential strains - 2D
The investigators will assess regional left ventricular circumferential strains in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular circumferential strain rates - 2D
The investigators will assess left ventricular regional circumferential strain rates in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global myocardial work - 2D
The investigators will assess left ventricular global myocardial work in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular myocardial constructive work - 2D
The investigators will assess left ventricular myocardial constructive work in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular myocardial wasted work - 2D
The investigators will assess left ventricular myocardial wasted work in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular myocardial work efficiency - 2D
The investigators will assess left ventricular myocardial work efficiency in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular longitudinal strains - 2D
The investigators will assess right ventricular longitudinal strains in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular longitudinal strain rates - 2D
The investigators will assess right ventricular longitudinal strain rates in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial longitudinal strain rates - 2D
The investigators will assess left atrial longitudinal strain rate components in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Intraventricular pressure gradient
The investigators will assess intraventricular pressure gradient of the left ventricle in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Vorticity indexes
The investigators will assess left ventricular vorticity indexes in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Kinetic energy of left ventricular flow
The investigators will assess kinetic energy of left ventricular flow in resting conditions using 2D echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular wall thicknesses
The investigators will assess left ventricular wall thicknesses in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular diameters
The investigators will assess left ventricular diameters in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month..
Left ventricular volumes
The investigators will assess left ventricular volumes in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular mass
The investigators will assess left ventricular mass in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular ejection fraction
The investigators will assess left ventricular ejection fraction in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular Tissue Doppler Imaging
The investigators will assess left ventricular myocardial velocities in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular transmitral flow
The investigators will assess left ventricular transmitral flow in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular filling pressure index
The investigators will assess left ventricular filling pressure index in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular outflow tract diameter
The investigators will assess right ventricular outflow tract diameter in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Tricuspid annular plane systolic excursion
The investigators will assess tricuspid annular plane systolic excursion in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular fractional area change
The investigators will assess right ventricular fractional area change in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular ejection fraction
The investigators will assess right ventricular ejection fraction in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month..
Right ventricular Tissue Doppler Imaging
The investigators will assess right ventricular myocardial velocities in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular transtricuspid flow
The investigators will assess right ventricular transtricuspid flow in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular filling pressure gradient
The investigators will assess right ventricular filling pressure gradient in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular systolic pressure
The investigators will assess right ventricular systolic pressure in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial volumes
The investigators will assess left atrial volumes in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right atrial volumes
The investigators will assess right atrial volumes in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Blood pressures
The investigators will assess blood pressures in resting conditions using a tensiometer in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Heart rate
The investigators will assess heart rate in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Stroke volume
The investigators will assess stroke volume in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Cardiac output
The investigators will assess cardiac output in resting conditions using echocardiography in the two groups.
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Started Dec 2025 (actual). Primary completion is estimated for Aug 2027, 20 months after the start.
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University of Avignon