Left ventricular function during exercise in trained pre‐adolescent soccer players

Abstract

It is unclear, what the underlying cardiovascular mechanisms are that give rise to the high level of aerobic fitness seen in youth soccer players. The aim of the study was to evaluate global and regional markers of systolic and diastolic function in a group of pre-adolescent soccer players during an incremental exercise test. Twenty-two, male soccer players (SP) from two professional soccer clubs (age: 12.0 ± 0.3 years) volunteered for the study. Fifteen recreationally active boys (CON), of similar age (age: 11.7 ± 0.2 years) were also recruited. All boys underwent a cycle ergometer test to exhaustion. Cardiac dimensions were determined using M-mode echocardiography. During submaximal and maximal exercise, continuous-wave Doppler ultrasound techniques were used to derive stroke volume (SVIndex). Tissue-Doppler imaging was used to quantify systolic (S'adj) and diastolic function (E; E'adj and E/E') at rest and both submaximal and maximal exercise intensities. Speckle tracking echocardiography was used to determine peak longitudinal ε at submaximal exercise intensities. SP demonstrated significantly (P ≤ 0.05) greater peak VO values than CON (SP: 48.0 ± 5.0 vs CON: 40.1 ± 7.5 mL/kg/min). Allometrically scaled to body surface area left ventricular end-diastolic volume (LVEDV) was larger (P ≤ 0.05) in the SP (51.3 ± 9.0) compared to CON (44.6 ± 5.8 mL·BSA ). At the same relative, submaximal exercise intensities, the SP demonstrated greater SVIndex, cardiac output (QIndex), and E. No differences were noted for peak longitudinal ε during submaximal exercise. Factors that augment pre-load and LV volume appear to determine the superior aerobic fitness seen in the soccer players.

Superior cardiac mechanics without structural adaptations in pre-adolescent soccer players

“…16 have been reported previously. 7 Linear LV dimensions were scaled to BSA 0.5 , LV mass to height 2.7 and volumes to BSA 1.5 . 18 Concentricity was calculated as LVM divided by allometrically scaled LVEDV (LVEDV 0.667 ).…”

“…20 Peak mitral inflow velocities and pulsed wave tissue Doppler imaging (TDI) were assessed as previously reported. 7 E/E' was calculated as an estimate of LV filling pressure 21 from the average of septal and lateral E'.…”

“…[4][5][6] Our group recently documented LV structure and function in highly-trained pre-adolescent athletes, with a particular focus on conventional indices of LV function. 7 Speckle tracking echocardiography (STE) comprehensively assesses LV mechanics by quantifying deformation in the longitudinal, circumferential and radial planes, as well as rotation and twist. 8,9 Studies using STE to compare young athletes with age-matched controls have been conflicting, [10][11][12] likely due to variations in maturity status, the sex of the athletes, and disparate sports being studied.…”

The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence

“…In contrast, TPR reduced stepwise. Since functional cardiovascular changes pave the way for potential cardiac structural adaptation, our finding perhaps provides an early indication of a physiologically adapted cardiovascular system in those with high fitness. Indeed, previous studies in athletic youth reveal differential LV structure (volume overload) and function, as result of training status and fitness .…”

Pre-participation screening in young elite athletes: Towards a new algorithm?

“…In pre-pubertal athletes, even intense and regular physical training does not largely affect the size or mass of the left ventricle, as measured by two-dimensional echocardiography or magnetic resonance imaging (MRI). 3 The current advanced echocardiographic techniques and MRI have begun to clarify the mechanism involved in adaptive processes in pre-pubertal athletes. They may help to differentiate between the physiological adaptation to exercise and early stages of cardiomyopathies.…”