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Purpose: Although several echocardiographic studies have investigated the role of training in male athletes, few data are available regarding female athlete's heart and most are limited to cross-sectional studies. The aim of our longitudinal study is to assess by Doppler tissue imaging (DTI) the variations in diastolic properties and to determine the adaptations of left atrium (LA) after 4 months of training program in professional female volleyball players.Methods: Twenty-five elite female volleyball players were enrolled. Echocardiographic analysis was performed at baseline (after 2 months of detraining) and after 4 months of training. All athletes were evaluated at the same stage of their training program. We analyzed by 2D speckle tracking echocardiography LA longitudinal deformation dynamics at baseline and after 4 months. Global peak atrial longitudinal strain (PALS) and global peak atrial contraction strain (PACS) were obtained off-line (software EchoPac, GE, USA).Results: Two participant were excluded because of musculoskeletal injury and withdrawal from training program>10 days. A final population of 23 female athletes was analyzed. LA mean volume index significantly increased after 4 months of training (24.0±3.6 ml/m2 vs 26.7±6.9 ml/m2, p=0.0003). Although global PALS and global PACS showed a trend toward lower values after 4 months of training, no significant differences were observed. Higher e' peak (p=0.03), lower a' peak (p=0.01), and greater e'/a' ratio (p=0.0007) were observed after 4 months of training. E/e' ratio did not differ during the study period (p=0.87).Conclusions: Our study demonstrates that a 4-months training program in competitive female volleyball players is associated with a phenomenon of LA remodeling and with a slight improvement in myocardial properties as assessed by DTI analysis. Interestingly, LA enlargement in female athletes is not associated with increased filling pressures.