Wrestler's Heart: Cardiac Remodeling in World Wrestling Entertainment Athletes

Journal of the American Heart Association, Volume 15, Issue 12 , June 16, 2026. BackgroundEvidence on cardiac adaptation in elite wrestlers remains limited.

This study assessed electrical and structural cardiac remodeling in elite wrestlers, with particular focus on sex‐specific differences.MethodsElite World Wrestling Entertainment athletes undergoing electrocardiographic and echocardiographic evaluation during routine cardiovascular screening were included. Left ventricular (LV) geometry was classified according to relative wall thickness and LV mass on the basis of international recommendations.

This was a retrospective analysis of prospectively acquired data.ResultsThe cohort included 68 athletes (mean age, 28±6 years; 47 [69%] men), with similar weekly training volume between sexes (11.6±5 h/wk). No athlete reported performance‐enhancing drug use, although 1 admitted high‐energy drink consumption.

Electrocardiographic abnormalities were observed in 2 athletes (3%). Women showed smaller absolute LV end‐diastolic diameter (46±4 versus 52±5 mm,P<0.001), but greater indexed LV dimensions (27±3 versus 25±3 mm/m2,P=0.003).

Two female athletes had LV ejection fraction <50%. Right ventricular enlargement was observed in 23% of men and 14% of women (P=0.52), without sex differences in right ventricular fractional area change (39±6% versus 40±6%,P=0.42).