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Purpose. The aim of the present study was to see if a threefold difference in LA volume in elite football players would lead to any reduction in LA systolic deformation by two-dimensional (2D) strain, increased filling pressure, which is associated with large LA volumes, or other adaptations of the athlete's heart.Methods: From our database of 595 football players the 30 football players with respectively the largest and smallest LA end systolic volumes (LAESV) were defined. LV enddiastolic (LVEDV) and stroke volume (SV) were measured by 2D echo. Transmitral early- (E) and atrial- (A) peak velocities were measured. Early diastolic peak velocity at the septal and lateral part of the mitral valve were calculated by tissue velocity imaging and averaged (E'). E/A-ratio and E/E' were calculated. 2D strain analysis was performed on LA loops from four chamber view. Average of 6 segments of “strain” were calculated and defined as LA global strain.To adjust for chamber size LA global strain was divided by LAESV. All volumes were divided by body surface area (BSA).Results:There were no significant differences in age, BSA, body mass index, systolic- or diastolic blood pressure, or A, E/A-ratio, E' or E/E' between the groups. LA volume correlated significantly to: SV; R=0.7 (p<0.001), LVEDV; R=0.7 (p<0.001), and HR; R=-0.5, p<0.001). See table for other results.Conclusions: The atheletes with large LA volumes did not show any reduction in LA global 2D strain or increased LV filling pressure as compared to those with small LA volumes, which indicates this to be a physiological adaption to training. Although the increase in SV and LVEDV did not correspond to the considerable increase in LAESV, we consider the strong association between LAESV vs. HR, SV and LVEDV to add further evidence to this notion.