Myocardial performance during progressive exercise in athletic adolescent males

Purpose: The extent that enhanced ventricular function contributes to superior aerobic fitness of trained athletes is unclear. This study compared cardiovascular responses to progressive cycle exercise in 12 adolescent soccer players and 10 untrained boys with assessment of ventricular inotropic and relaxation properties by Doppler ultrasound techniques. Methods: Resting cardiac dimensions were measured by M-mode echocardiography. Stroke volume was estimated by the Doppler technique, and systolic function by peak aortic flow velocity and ejection flow rate. Diastolic transmitral pressure gradient was assessed by pulse wave peak E-wave velocity, ventricular relaxation properties by tissue Doppler imaging (E' velocity, adjusted for ventricular size), and ventricular filling pressure by E/E' ratio. Results: Size-adjusted cardiac dimensions were significantly greater in the athletes. Peak V[spacing dot above]O2 values for the athletes and nonathletes were 57.4 +/- 4.8 and 44.4 +/- 6.6 mL[middle dot]kg-1[middle dot]min-1, respectively. Maximal cardiac index and stroke index were greater in the athletes (11.10+/- 1.52 vs 9.02 +/- 2.05 L[middle dot]min-1[middle dot]m-2; 59 +/- 8 vs 46 +/- 10 mL[middle dot]m-2). Athletes and nonathletes demonstrated similar maximal peak aortic velocity (231 +/- 20 and 208 +/- 45 cm[middle dot]s-1, respectively) and ejection rate (13.3 +/- 1.0 and 12.5 +/- 2.8 mL[middle dot]s-1[middle dot]cm-2 x 10-2, respectively). No significant group differences were observed in Emax (155 +/- 17 and 149 +/- 23 cm[middle dot]s-1 for athletes and nonathletes, respectively), adjusted E'max (5.9 +/- 1.2 and 5.8 +/- 1.2 cm[middle dot]s-1[middle dot]mm-1 for athletes and nonathletes, respectively), and E/E'max (265 +/- 40 and 262 +/- 56 for athletes and nonathletes, respectively). Conclusions: This study revealed no differences between young trained athletes and nonathletes in myocardial functional responses to progressive exercise, implying that greater aerobic fitness in these athletes reflected volume expansion of the cardiovascular system without contribution of enhanced systolic or diastolic ventricular function. Such findings should be considered limited to the context of young athletes with limited duration of athletic training.