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Introduction: Recent observations of left ventricularremodeling in highly trained male athletes have identified increasedtrabeculation within the myocardium below the region of the papillarymuscle. It is uncertain whetherthis phenomenon represents physiological adaptation or reflects the presence ofmorphological mild manifestation of isolated left ventricular non-compaction(ILVNC). This study sought to identify the prevalence of hypertrabeculation between female athletes and healthy non-athletic controls.Methods: Between 2002 and 2011, 239 female athletes (mean age 20.1 ±5.6 years; 90% Caucasian) underwent cardiac evaluation including 12-ECG and echocardiography. Echocardiograms wereanalysed in accordance with ESC guidelines. Hypetrabeculation were defined as more than 3 localised protrusions of the ventricular wall ≥3mm in thickness associated with intertrabecular recesses. The results were compared with 139 healthy non-athletic females (64% Caucasian) of similar age.Results: There was no difference in mean age between female athletes and female controls. Female controls had a larger BSA (1.84±0.33m2 vs 1.67 ±0.0.35 m2;p<0.0001). Athletes demonstrated a higher prevalence of LV hypertrabeculation compared with non-athletic healthy female controls (n=45; 18.8% vs n=6; 4.8%;p0.0001). 7 out of 23 black athletes (30%) exhibited hypertrabeculation compared with 38 out of 216 white athletes (17%); p = <0.05. None of the female athletes with hypertrabeculation demonstrated enlargement of LV diastolic dimension or objective features of LV systolic or diastolic dysfunction compared with female athletes without hypertrabeculation. The mean LVDd was 47.48mm ± 4.8mm vs48.13mm ± 4.4mm; p:0375. The Fractional shortening was 0.37 ±0.44 vs 0.37 ± 0.74; p:0.510. The S' was 8.96± 1.76 vs 8.92 ± 1.78; p: 0.921. The E' was 15.7 ± 2.82 vs 16.09 ± 2.61; p: 0.574.The E/A ratio was 2.25 ± 0.79 vs 2.27 ± 0.82; p:0.09). None of the athletes with hypertrabeculation fulfilled diagnostic criteria for ILVNC.Conclusion: Female athletes exhibited a significantly higher frequency of LV hypertrabeculation compared with controls. Hypertrabeculation were more prevalent in black athletes compared to white athletes. None of the athletes exhibited abnormal LV dimension or markers of systolic and diastolic dysfunction.