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Background: Regular exercise induces an increase of cardiac mass. It is an “Adaptative, Reversible and Physiological”hypertrophy whose Left Ventricle (LV) morphology can be concentric or eccentric due to the type of practiced sport. No long term data are available for soccer players. Aim of study was to follow-up by echocardiography the impact of physical training on the heart morphology in a group of soccer players for at least five years.Method: Since January 1993 to December 2005, 220 ACF Fiorentina soccer players, matched with a sedentary control group, were yearly followed by 2D echo-exam. They were regularly trained for 11 months a year, for at least 2 hours for 5 times in a week and they played a match on Sunday. In July, athletes made a stage of 3 weeks of 2 training sessions including 3 hours. 46 athletes had a 5 years echo-follow up with a complete evaluation of the aortic dimensions at root (AOr), LVDD (LV diastolic diameter), LVSD (LV systolic diameter), IVS (interventricular septum), PW (posterior wall) thickness, LVMi (Left Ventricular Mass index) and EF.Results: In athletes LV dimensions and LVMi were significantly higher than sedentary controls (123,45 vs 94,36 gr/m2 respectively). After five years follow-up, athletes didn't show modifications of cardiac dimensions: LVDD changes slightly from 52.00 to 52.90 mm; LVSD increased from 31.58 to 32.33 mm, LVMi from 120.77 to 121.45 gr/m2. No significant increase of AOr was observed (from 27.39 mm to 31.64 mm).Conclusions: In regularly trained athletes LV dimensions and LVMi are normally to the upper limits of normal range. After 5 years, all the cardiac dimensions were the same in size. Regular exercise induces a mild LV hypertrophy. The increase of LV chamber can be therefore considered a normal adaptative consequence to exercise.