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Purpose: Intense endurance training leads to increased left ventricular mass, left ventricular end-diastolic and left atrial end-systolic diameters. The sport specific aspects have not been fully investigated in female athletes. The purpose of the present study was to investigate if differences in cardiac dimensions and function could be observed in female elite handball players compared with sedentary controls.Methods: Cross-sectional study of 16 female elite handball players compared with 16 matched sedentary controls. The subjects underwent a 2- and 3-dimensional echocardiography examination. Cardiac dimensions were quantified with M-mode and 2- and 3- dimensional echocardiography volume measurements. Systolic and diastolic left ventricular functions were also evaluated.Results: Mean age was 21 ± 3 years. When adjusted for BSA all cardiac dimensions, except from posterior wall thickness and left ventricular end-systolic dimensions, were significantly (p<0.05) larger in female handball players compared with sedentary controls. No differences between the both groups were seen in systolic function and most of the diastolic parameters.Conclusions: The present investigation suggests that similar cardiac remodeling takes place in female elite handball players as in athletes pursuing endurance sports. Systolic and diastolic functions remain unaltered.