To the Editor: I read with great interest the meta-analysis on athlete’s heart by Pluim et al.1 In the introduction, they quote previous investigations, including the results of a meta-analysis from my group,2 3 and state that “...they have not been able to resolve satisfactorily the question regarding the existence of 2 types of athlete’s heart.” I strongly disagree with this interpretation of our meta-analysis, in which my colleagues and I compared the echocardiographic data from young male runners, strength athletes, and cyclists with their respective matched controls (total, 725 subjects). We firmly concluded that “the development of so-called eccentric or concentric left ventricular hypertrophy according to the type of sports cannot be regarded as an absolute or dichotomous concept because training regimens and sports activities are not exclusively dynamic or static and because the load on the heart is not purely of the volume or the pressure type.”3 We also asserted that “variable static and dynamic components of the training regimens and sports activities lead to different relative adaptations, which are either predominantly eccentric (runners), predominantly concentric (strength athletes), or a balanced combination of the two (cyclists).”2 The conclusions …