
Elite endurance athletes, comprising 281 individuals, underwent a study to examine reduced ejection fraction (EF) prevalence, consequences, and genetic factors. Results showed 15.7% with reduced EF, associated with increased ventricular premature beats and lower left ventricular global longitudinal strain. Higher LVESVi-PRS correlated with reduced EF, with male sex and LVESVi-PRS being significant predictors. During follow-up, no athletes developed heart failure or arrhythmias; however, two deaths occurred, one from trauma and one from sudden cardiac death, the latter having a reduced right ventricular EF and high LVESVi-PRS. The study underscores genetic predisposition alongside exercise in understanding cardiac outcomes in elite athletes.
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