A widely accepted principle in sport cardiology is that the pattern of LV hypertrophy that occurs with athletic training is related to the type of exercise performed. This principle is based largely on the nearly four-decade-old seminal echocardiographic study by Morganroth et al who reported that the increased LV mass in highly trained (collegiate or world class) male long distance runners or swimmers compared with age-matched and sex-matched non-athlete controls was primarily due to increased LV end-diastolic volume with little or no increase in LV wall thickness (eccentric LV hypertrophy pattern).1 In contrast, the increased LV mass in highly trained wrestlers and shot-putters was solely due to an increased LV wall thickness as LV end-diastolic volume was normal (concentric LV hypertrophy pattern).1 Based on the divergent LV remodelling patterns observed, Morganroth et al1 ,2 hypothesised that the haemodynamic burden (volume overload) associated with endurance exercise training (ET) may be similar to that which occurs in patients with …