Left Ventricular Mass and Oxygen Uptake in Top Handball Athletes

Abstract

The key challenge in athlete's screening is the distinction between abnormal and normal which is hindered by the fact that the adaptation to sports activity in endurance athletes is different to that in power athletes. Especially cardiomyopathies provoke changes in ECG and echocardiography (echo) at an early stage when clinical symptoms are absent. ECG and echo data and their relationship to fitness peculiar to top handball players have never been described. We studied 291 male first league handball players (32 Olympians/47 national players) (25.3±4.4 years). Check up consisted of ECG, spiroergometry and echocardiography. None had T-wave inversions, 3.1% showed early repolarisation abnormalities in the precordial leads. Sokolow-Lyon voltage criterion for left ventricular hypertrophy was positive in 19.3%. Spiroergometry showed a maximum oxygen uptake (peakVO₂) of 50.3±7.7 ml/min/kg body weight. LVmass was increased in comparison to normal values. There was a correlation between peakVO₂ and LVindex (p<0.001, r=0.341), (LVmass/peak VO₂ p=0.053, r=0.125). A relationship between cardiac dimensions and peakVO₂ could not be confirmed. In professional handball players early repolarisation abnormalities were less frequent and LVmass was increased when compared with soccer players. The need for normal values for different types of sports is crucial to guarantee a proper evaluation of athletes.

Impact of specific training and competition on myocardial structure and function in different age ranges of male handball players

“…For “seniors”, the increase of the cardiac cavity size and parietal hypertrophy realize more important values compared to other categories. These findings are in accordance with those obtained in elite handball [ 8 , 9 ], basketball [ 10 ], soccer players [ 11 , 42 ] and other sports [ 32 , 35 , 38 ].…”

“…Data in different age ranges, which are in norms with the upper limit of physiologic cardiac hypertrophy, in preadolescent athletes [ 30 ], highly trained adolescent [ 26 , 33 ] and highly trained elite athletes [ 34 ], confirm that with age and after regular participation in training and competition, the process of dilatation continues during the athlete's career within the heart by the increase of ventricular chamber size, which starts early in the athlete's career [ 35 ], LA, which is an additional physiological adaptation frequently present in highly trained athletes [ 5 , 8 , 36 ], Ao, which assure an important CO during the effort [ 37 , 38 ], and IVS, PWT and LV mass index, preserving a high level of intensity required by the competition [ 9 , 39 ].…”

“…The impact of different sports on cardiac structure and functioning has been investigated by several authors with highly trained elite athletes [ 5 – 7 ]. Several studies on echocardiographic (Echo) assessment and common electrocardiographic (ECG) findings in several sports activities were conducted in individual disciplines and team sports especially in handball [ 8 , 9 ], basketball [ 10 ], soccer [ 11 ], rugby [ 12 ] and volleyball [ 13 ], leading us to conclude that the structural and functional changes are of an idiosyncratic nature according to the sport discipline and the type of exercise undertaken. However, most of the collected data in these studies conducted with adult athletes have been compared to untrained controls of other sports activities.…”

Cardiorespiratory fitness status of elite handball referees in Hungary

“…To the best of our knowledge, this is the first study examining elite handball referees with cardiopulmonary exercise testing, thus, we could only compare these results with similar measurements of handball players and referees from other sports only. Comparing the results of this study with a report on 291 male elite German handball players, we can state that our referee group had lower maximal aerobic capacity and similar peak lactate levels [ 27 ].…”

Left ventricular function and mechanics in backs and forwards elite rugby union players

“…In mixed sports ( i.e. both aerobic and strength training), such as basketball, handball or American football, several studies reported LV mass of elite athletes close or higher than 115 g.m − ², the upper of normal LV mass (Lang et al, 2015) defined by the American Society of Echocardiography (Abernethy, Choo, & Hutter, 2003; Buuren et al, 2013; Engel, Schwartz, & Homma, 2016).…”