To the Editor We read the recent article by Pelliccia and colleagues1 with great interest. The authors are to be commended for conducting this study in a large sample (N = 252) of Paralympic athletes. One of the main findings was that cardiac remodeling in Paralympic athletes differed by disability (ie, spinal cord injury [SCI] and non-SCI) and sport discipline (endurance and nonendurance). Herein, we discuss pertinent consideration for individuals with SCI, who account for 44% of the cohort.