Training intensity influences left ventricular dimensions in young competitive athletes

Abstract

BackgroundIn young athletes, exercise causes changes in the heart that include growth in wall thickness and mass of the left ventricle and expansion of the heart’s chambers. The heart’s function is either preserved or enhanced, but this may change to the opposite over time.ObjectiveThis study aimed to assess structural and functional cardiac adaptations in relation to exercise training time, intensity, and performance in young competitive athletes.MethodsA total of 404 children and adolescents (14.23 ± 2.0 years, 97 females) were enrolled in the Munich Cardiovascular Adaptations in Young Athletes Study (MuCAYA-Study). Eighty-five participants were examined two times a year. Two-dimensional echocardiography was performed to assess left ventricular structure and function. Training time and intensity was measured with the MoMo physical activity questionnaire, maximum aerobic capacity by cardiopulmonary exercise testing, and strength with the handgrip strength test.ResultsMaximum aerobic capacity significantly influenced interventricular septal thickness in diastole. Training intensity significantly influenced left ventricular internal diameter in diastole and systole, and left ventricular mass indexed to body surface area. Within one year, interventricular wall thickness, relative wall thickness and left ventricular mass, indexed to body surface area and height, increased significantly. Training intensity and aerobic capacity contributed to cardiac adaptations in young competitive athletes, as represented by altered structural parameters but preserved cardiac function. Within a year, however, structural changes and a decline in diastolic performance were observed within the longitudinal sub-sample.ConclusionOur results confirm the hypothesis that cardiac adaptations to exercise occur at a young age. Cardiac adaptation in our cohort was influenced by exercise intensity and maximum aerobic capacity.

The effect of long‐term soccer training on left ventricular structure and function in elite male youth soccer players

“…39 Furthermore, decrements in E/A ratio were noted alongside increases in LV chamber size in adolescent athletes tracked over a 10-month period. 12 Unnithan et al, 20 using the same cohort of SP seen in this study demonstrated higher E and E′ during submaximal cycle ergometer exercise compared to CON when exercising at the same relative exercise intensity. These findings support the theory of a diastolic functional reserve for exercise in the SP.…”

“…Evidence to support this latter contention was noted in elite, male endurance cyclists, whereby lower E and E′ velocities were identified compared to sub‐elite and nonathletes at rest supporting the theory of a diastolic functional reserve 39 . Furthermore, decrements in E/A ratio were noted alongside increases in LV chamber size in adolescent athletes tracked over a 10‐month period 12 . Unnithan et al., 20 using the same cohort of SP seen in this study demonstrated higher E and E′ during submaximal cycle ergometer exercise compared to CON when exercising at the same relative exercise intensity.…”

“…The lack of a definitive growth and maturation time point, where cardiac adaptation occurs in pre‐and adolescent athletes suggests that training intensity and volume may be the key stimuli for LV adaptation in youth athletes 12,13 . Based on this assumption, one of the most potent sports to trigger LV structural and functional adaptation in both the short‐ and long‐term is soccer, 14 where match‐play and training exposure is at 85% of maximal heart rate in youth soccer players 15 .…”

“…10,11 The lack of a definitive growth and maturation time point, where cardiac adaptation occurs in pre-and adolescent athletes suggests that training intensity and volume may be the key stimuli for LV adaptation in youth athletes. 12,13 Based on this assumption, one of the most potent sports to trigger LV structural and functional adaptation in both the short-and long-term is soccer, 14 where match-play and training exposure is at 85% of maximal heart rate in youth soccer players. 15 A constellation of cross-sectional studies in both elite male and female preand adolescent soccer players have demonstrated greater chamber size, wall thickness, and larger LV twist and greater diastolic strain rate in the soccer players compared to their recreationally active peers.…”

Electrocardiographic criteria for left ventricular hypertrophy in professional and non-professional athletes

“…Weberruß et al found that a higher aerobic capacity significantly influences the thickness of the septal wall in diastole, as well as a higher training intensity influences the ventricular diameter in systole and diastole. ( Weberruß et al, 2022) With the use of the Cornell criterion it was found that no athlete from both groups present voltage criteria for the presence of LVH, however in a meta-analysis conducted by Zhigang You et al it was found that the LVH detected through this criterion has a higher predictive value in mortality from cardiovascular disease. This criterion was applied to the general population and it was found that 87% of the population had a higher risk for death from all causes, 66% had a higher risk for cardiovascular death and 70% had a higher risk for major cardiovascular events.…”