Intensive training is associated with hemodynamic changes that typically induce an enlargement of cardiac chambers, involving not only the ventricles but also the atria. The hearts of competitive athletes are characterized by increases in left and right atrial dimensions that have been interpreted as a physiologic adaptation to training. Conversely, some authors have hypothesized maladaptive remodeling; furthermore, the extent of left atrial dimensional remodeling may overlap atrial dilation observed in patients with cardiac disease, representing a challenge for clinicians. However, studies investigating left and right atrial function in athletes have demonstrated that atrial size is insufficient to provide mechanistic information about the atrium itself, and an increase in atrial size is not intrinsically an expression of atrial dysfunction. The authors critically analyze training-induced atrial remodeling, taking into account not only the assessment of atrial size but also the evaluation of atrial function, suggesting that the characterization of atrial function plays a fundamental role in the evaluation of athlete's heart, being useful to differentiate physiologic remodeling induced by exercise from pathologic changes occurring in cardiac disorders.

强化训练与血液动力学变化相关，血液动力学变化通常会导致心室增大，不仅涉及心室，而且还涉及心房。竞技运动员的心脏的特征是左右心房尺寸的增加，这被认为是对训练的生理适应。相反，一些作者假设适应不良的重塑。此外，左心房重构的程度可能与心脏疾病患者观察到的心房扩张重叠，这对临床医生构成了挑战。但是，研究运动员左，右心房功能的研究表明，心房大小不足以提供有关心房本身的机械信息，并且心房大小的增加本质上不是心房功能障碍的一种表现。