Groundbreaking research into changes to the heart of women athletes will set a new standard for female heart healthcare, researchers have said.

Until now, changes to the heart as a result of intensive training had only been measured in men. But a large-scale five-year investigation by a team of Amsterdam UMC scientists in collaboration with sports organisation NOC*NSF has now shown that the physical changes are far from the same in women.

Male athletes develop a thicker heart muscle and larger ventricles whereas women show only wider ventricles, the researchers said.

“A woman is not a small version of a man,” sports cardiologist at Amsterdam UMC Harals Jorstad told broadcaster NOS.  Jorstad’s study, the first in the world to be carried out in such detail, involved the monitoring of the hearts of over 600 male and female top athletes over a period of five years.

Some 170 women participated, who were all subjected to regular scans, MRI scans, electrocardiograms, and ultrasounds.

The research not only found differences between male and female hearts but also between the effects of different sports on the heart. “Female endurance athletes, such as cyclists, had the largest ventricles and the most heart muscle mass, more than, for instance, gymnasts,” researcher Maarten van Diepens said., “That shows the way the heart adapts, partly as a result of the type of stress,” he said.

Male top athletes are more often in the news because of heart problems than women. “In women, heart problems, like arrhythmia, have never been well researched. We know they are less prevalent among young women and female top athletes. Men are nine times more likely to die during a strenuous activity than women,” Jorstad said.

Gender-specific knowledge is important, particularly now that women are taking great strides. “Women are improving faster in their sport compared to men. Marathon world records are constantly broken, for instance,” Van Diepen said. “More is being asked from the female heart than ever, more than we knew it could cope with. Now, for the first time, we have a modern standard for women,” he said.

Female water polo player Vivian Sevenich, who participated in the study, said she was “surprised’ at the lack of knowledge about the female heart. “It’s a bit disappointing in this day and age,” she said.

Jorstad will continue his research to include an explanation as to why the female heart behaves differently from the male. “Do women train differently? Are hormones a factor? What will happen to their hearts in the years after their career? You want to know if you will pay a price in later life,” he said.

The results of the study will also be used to help women who are not top athletes but who do train intensively. “Thanks to this study, we will be better able to support them and protect them from heart problems,” Jorstad said.