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Funding Acknowledgements South-Eastern Norway Regional Health Authority OnBehalf Center for Cardiological Innovation Background Endurance exercise is closely correlated with physical fitness and the development of the athlete’s heart. The impact of changes in exercise-patterns in young athletes is poorly described. Aims This study aims to explore the impact of endurance training versus non-endurance training on cardiac morphology and physical fitness in young endurance athletes. Methods Forty-eight cross-country skiers were examined at age 12 (12.1 ± 0.2 years) and then again at age 15 (15.3 ± 0.3 years). Echocardiography, including 3D echocardiography, and cardiopulmonary exercise testing was performed in all participants. Self-reported data on weekly hours of endurance and weekly hours of non-endurance training was collected. Results At follow-up, thirty-one (65%) of the endurance athletes were still active and 17 (35%) were not. There was a moderate, positive correlation between weekly hours of endurance-only training and changes in VO2 max from baseline to follow-up (R = 0.55, p &amp;lt; 0.001), but no correlation was found for weekly hours of all types of training (Figure). Weekly hours of endurance-only training also showed moderate, positive correlations with changes in chamber dimensions, including indexed 3D left ventricular (LV) end-diastolic volume (R = 0.45, p &amp;lt; 0.01), 3D LV end-systolic volume (R = 0.35, p &amp;lt; 0.05), right ventricular (RV) end-diastolic area (R = 0.39, p &amp;lt; 0.01) and RV end-systolic area (R = 0.44, p &amp;lt; 0.01). No correlation was found for weekly hours of all types of training. Conclusion Only endurance training is sufficient to induce cardiac remodeling, including dilatation of both ventricles, in highly trained adolescent athletes. Abstract 431 Figure.

431 Impact of endurance training versus non-endurance training on cardiac morphology and physical fitness in highly trained young athletes