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July 4, 2026Journal of Cardiovascular Development and DiseaseOpen Access

Higher exercise levels and LVH in elite athletes are linked to ~69% greater autonomic control.

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Why the study?

Does a composite index of autonomic control (ANSI) correlate with training load and left ventricular hypertrophy in elite athletes?

Population

330 elite athletes

Comparison

High level of combined static/dynamic exercise vs Low level of combined static/dynamic exercise

Design

Cross-sectional

Key result

A composite index of autonomic control (ANSI) progressively increased with higher exercise levels and left ventricular hypertrophy in elite athletes (LOW: 38.2% vs HIGH-LVH[+]: 64.4%; p<0.001).

Authors

GOGianluigi OggionniGBGiuseppina BernardelliMMMara Malacarne

Discussion

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Overview

Subgroup HRV patterns in athletes remain hypothesis-generating; leaves open any role in training guidance or screening.

Key Points

  • This research aims to explore how exercise training influences cardiac regulation and left ventricular hypertrophy in elite athletes through an autonomic control index.
  • Observational study of 330 elite athletes categorized by static/dynamic exercise levels and left ventricular hypertrophy presence.
  • Utilized a composite index of autonomic nervous system control to assess cardiac adaptation.
  • Analyzed differences in autonomic control among athlete groups with varying training loads and cardiac remodeling.
  • The composite index showed a progressive increase among different athlete groups (LOW: 38.2%, HIGH-LVH [−]: 52.1%, HIGH-LVH [+]: 64.4%, p < 0.001).
  • Significant differences in autonomic control were observed among all groups (p < 0.001).
  • In the HIGH group, the index had the strongest association with left ventricular hypertrophy and the highest explanatory power among autonomic variables.

Study Design

Type

Observational (n=330)

Structured PICO

Does a composite index of autonomic control (ANSI) correlate with training load and left ventricular hypertrophy in elite athletes?

P
Population
330 elite athletes evaluated for cardiac adaptation to high-volume training using a composite index of autonomic nervous system control.
E
Exposure
High level of combined static/dynamic exercise (with or without left ventricular hypertrophy)
C
Comparator
Low level of combined static/dynamic exercise
O
Outcome
Composite index of autonomic nervous system control (ANSI)surrogate

Main Result

Absolute Event Rate: 64.4% vs 38.2%

p-value: p=<0.001

A composite index of autonomic control (ANSI) can differentiate elite athletes based on cardiac remodeling and training workloads, suggesting utility for autonomic nervous system evaluation in sports cardiology.

Cite This Study

Oggionni et al. (2026) conducted an observational in Athlete's heart / Left ventricular hypertrophy (n=330). High level of combined static/dynamic exercise vs. Low level of combined static/dynamic exercise was evaluated on Composite index of ANS control (ANSI) (p=<0.001). A composite index of autonomic control (ANSI) progressively increased with higher exercise levels and left ventricular hypertrophy in elite athletes (LOW: 38.2% vs HIGH-LVH[+]: 64.4%; p<0.001).

synapsesocial.com/papers/6a48a3cb89561a0c2d78d85ahttps://doi.org/10.3390/jcdd13070304
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left ventricular efficiency in endurance athletes2026
  2. 2Association Between Cardiorespiratory Fitness and a Composite Index of Cardiac Autonomic Control: Potential Implications for Exercise Training Evaluation2026
  3. 3Left ventricular end-diastolic volume as a new indexation method in athletes with aortic dilatation: a cardiac MRI study2026
  4. 4Sex differences in cardiac adaptation and training patterns in elite cyclists2026
  5. 5Structural features of the athlete heart as defined by echocardiography1986 · 515 citations