Athlete HeartCARDIO-3DNCT07363993
Interaction Between Intraventricular Flow and Cardiac Mechanics Using 3D Echocardiography in Athletes and Sedentary Subjects
An observational study of Athlete Heart, run by University of Avignon at 2 sites in France.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 to 45 yearsHealthy volunteers can take part
- Conditions the study is for
- Athlete Heart
- How many people
- 160 participants
- Where
- 2 sitesFrance
- Study dates
- 1 Dec 2025to 31 Aug 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- Healthy volunteers accepted
- Adult
Study population: Participants in the ENT group will be recruited: * At Montpellier University Hospital, in the cardiology department of Dr Hédon, during a follow-up visit. * At various national training centers of the French Triathlon Federation and the French Athletics Federation; * During local long-distance events (e.g., long-distance triathlons, ultramarathons), with assessments carried out at the time of race bib collection. 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.
Who may be able to join
- Athlete practicing at least 10 hours of endurance training per week for a minimum of 5 years.
- Individual not training in more than 3 hours of physical activity per week.
Who cannot join
- History of known heart disease;
- Current cardiac rhythm disorder;
- Individual with one or more cardiovascular risk factors (smoking, diabetes, hypertension, body mass index > 30 kg/m²);
- Individual in a period of relative exclusion in relation to another protocol, or for whom the annual maximum compensation amount of €4,500 has been reached;
- Individual not affiliated with a social security system, or not benefiting from such a system;
- Pregnant or breastfeeding woman; patient unable to give informed consent; protected adults; vulnerable persons;
- Individual deprived of liberty by judicial or administrative decision.
- Use of substances listed on the prohibited substances list of the French Anti-Doping Agency
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
France2 sites, 2 recruiting
- Recruiting
LaPEC
Avignon, 84000
Claire CM Claire Maufrais, PhD, PhD, +33682949447, claire.maufrais@univ-avignon.fr
- Recruiting
CHU Montpellier
Montpellier, 34000
Christophe Hédon Dr Christophe Hédon, 0033677586814, c-hedon@chu-montpellier.fr
About this study
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.
Read more
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.
- Conditions
- Athlete Heart
- Keywords
- regional myocardial function, intraventricular flow, cardiac geometry, echo-3D, athlete's heart
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Controls | Sedentary controls | |
| Athletes | Endurance athletes |
What is being measured
The primary outcome is the main question the study is designed to answer.
Left ventricular principal strains
The investigators will assess left ventricular principal strains in resting conditions using 3D echocardiography in the two groups.
Measured: From date of enrollment until the date of evaluation, assessed up to 1 month.
Secondary outcomes (74)
Left ventricular secondary strains
The investigators will assess left ventricular secondary strains in resting conditions using 3D echocardiography in the two groups.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: From date of enrollment until the date of evaluation, assessed up to 1 month.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jan 2026
- Study start1 Dec 2025
- Primary completion31 Aug 2027 (estimated)
- Study completion31 Aug 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Athlete HeartStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 160 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Avignon
- Sponsor type
- University, hospital or other
- Collaborators
- CHU Arnaud de Villeneuve MONTPELLIER
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07363993
- Sponsor's protocol ID
- AU-112025-CM
- Other IDs
- LAPEC/2025/CARDIO-3D
- Acronym
- CARDIO-3D
- Status last verified
- Jan 2026
- First submitted
- 8 Jan 2026
- Last updated
- 23 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Interaction Between Intraventricular Flow and Cardiac Mechanics Using 3D Echocardiography in Athletes and Sedentary Subjects
- ClinicalTrials.gov ID
- NCT07363993
- Acronym / sponsor ID
- CARDIO-3D / AU-112025-CM
- Conditions
- Athlete Heart
- Keywords
- regional myocardial function, intraventricular flow, cardiac geometry, echo-3D, athlete's heart
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 160 participants (estimated)
- Lead sponsor
- University of AvignonUniversity, hospital or other
- Collaborators
- CHU Arnaud de Villeneuve MONTPELLIER
- Study start
- 1 Dec 2025 (actual)
- Primary completion
- 31 Aug 2027 (estimated)
- Study completion
- 31 Aug 2027 (estimated)
- First posted
- 23 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Controls | – | –Sedentary controls |
| Athletes | – | –Endurance athletes |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
- Study population
- Participants in the ENT group will be recruited: * At Montpellier University Hospital, in the cardiology department of Dr Hédon, during a follow-up visit. * At various national training centers of the French Triathlon Federation and the French Athletics Federation; * During local long-distance events (e.g., long-distance triathlons, ultramarathons), with assessments carried out at the time of race bib collection. 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.
Key inclusion criteria (2 listed)
- Athlete practicing at least 10 hours of endurance training per week for a minimum of 5 years.
- Individual not training in more than 3 hours of physical activity per week.
Key exclusion criteria (8 listed)
- History of known heart disease;
- Current cardiac rhythm disorder;
- Individual with one or more cardiovascular risk factors (smoking, diabetes, hypertension, body mass index > 30 kg/m²);
- Individual in a period of relative exclusion in relation to another protocol, or for whom the annual maximum compensation amount of €4,500 has been reached;
- Individual not affiliated with a social security system, or not benefiting from such a system;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Left ventricular principal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
The investigators will assess left ventricular principal strains in resting conditions using 3D echocardiography in the two groups.
74 secondary outcomes
Left ventricular secondary strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular principal and secondary strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global circumferential strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global circumferential strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global radial strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global radial strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global area strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global area strain rates
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
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Maximum delay
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular longitudinal strain delay index
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular post systolic strain index
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular myocardic work
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular potential energy
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global longitudinal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global longitudinal strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global circumferential strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global circumferential strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular principal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular secondary strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular principal strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular secondary strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global area strain
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right ventricular global area strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial global longitudinal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left atrial global longitudinal strain rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Right atrial global longitudinal strains
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strains - 2D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular global longitudinal strain rates - 2D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Basal rotation - 2D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Apical rotation - 2D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Basal rotation - 3D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Apical rotation - 3D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular twist
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular torsion
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular twisting/untwisting rates - 2D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular torsional rates - 3D
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Left ventricular basal/apical rotational rates
Time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jan 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Athlete Heart, run by University of Avignon at 2 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 23 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Left ventricular principal strains (time frame: From date of enrollment until the date of evaluation, assessed up to 1 month.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jan 2026; AzTrials last refreshed its copy on 31 Oct 2026.