Early detection of exercise-induced cardiac anomalies is key to clinical management for individuals engaged in vigorous exercise training. This study aimed to investigate cardiovascular adaptation in university students engaged in intensive exercise using cardiac magnetic resonance imaging (MRI). For this prospective, single-center study, 50 university students who finished a four-year's intensively endurance training and 23 age- and gender- matched controls received cardiac MRI. Exercised participants were further divided into symptomatic and asymptomatic groups. Left ventricular (LV) volumes and indexed to body surface were calculated. Global peak strains, systolic and diastolic peak strain rates (DSR) were derived from cine images using feature tracking technique. ANOVA analyses were performed. Fifty exercised participants (mean age, 21years ± 1, 43 males, including 21 symptomatic and 29 asymptomatic cases) and 23 normal controls (mean age, 21years ± 2, 20 males) were evaluated. Exercised participants exhibited higher end-diastolic LV volume (76.0ml ± 10.6 vs 63.5ml ± 7.5, P <
0.001), reduced LV ejection fraction (59.9% ± 5.3 vs 63.0% ± 3.2, P = 0.002) and reduced global longitudinal strain (-18.25 ± 3.32 vs -19.85 ± 1.29, P = 0.004) than the normal control did. Symptomatic excised participants showed reduced peak strains compared to both asymptomatic participants and normal controls. Only circumferential DSR was reduced when compared between asymptomatic cases and the controls. In conclusions, highly intensive exercise could result in elevated LV volume and reduced myocardial strains for young university students. Further, reduced myocardial strains were found for those symptomatic cases which remain within non-pathological ranges.