Concentric left ventricular (LV) hypertrophy and asymmetric septal hypertrophy have both been described in weight lifters, but diastolic filling, which is abnormal in pathologically hypertrophied ventricles, has not been investigated in such subjects. Accordingly, pulsed Doppler examination of LV inflow, M-mode and 2-dimensional echocardiography were performed in 16 competitive weight lifters and 10 age-matched male control subjects. Peak and mean filling rates were determined in milliliters per second as the product of the cross-sectional area of the mitral anulus and the Doppler-derived peak early and mean transmitral inflow velocities, respectively. Rapid filling index was defined as peak filling rate divided by mean filling rate. Flow velocity integrals of the early and atrial diastolic filling phases were also measured. LV end-diastolic volume and ejection fraction were measured using 2-dimensional echocardiography. Weight lifters had significantly higher LV end-diastolic volume (181 +/- 50 vs 136 +/- 40 ml, p less than 0.05) and dimension (5.6 +/- 0.6 vs 5.1 +/- 0.5 cm, p less than 0.05), and posterior wall thickness (0.9 +/- 0.2 vs 0.8 +/- 0.1, p less than 0.05); however, after correction for body surface area there was no significant difference in these values. Weight lifters had significantly higher LV mass (241 +/- 70 vs 165 +/- 29, p less than 0.02) and LV mass index (114 +/- 29 vs 87 +/- 15 g/m2, p less than 0.05). There was no significant difference between the weight lifters and control subjects in rapid filling index, early to late integral ratio or ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)