Long-term athletic training is associated with cardiac changes that have been studied and are commonly described as athlete's heart. Volleyball is a moderate static and high dynamic sport, therefore involving a combination of resistance and endurance training. A commonly used method to investigate endurance capacity is the measurement of the maximal oxygen uptake of the muscles (Vo2 max). In this work we aimed To study the ability of diastolic function measured by echocardiography to reflect changes in endurance as assessed by Vo2 max in response to combined strengthening and endurance training in male volleyball players. Also we tried to differentiate between physiological cardiac hypertrophy occurring in athletes heart and pathological cardiac hypertrophy in hypertrophic cardiomyopathy (HCM).