The impact of sex, age and training on biventricular cardiac adaptation in healthy adult and adolescent athletes: Cardiac magnetic resonance imaging study

Ibolya Csecs, Csilla Czimbalmos, Attila Toth, Zsofia Dohy, Imre F. Suhai, Liliana Szabo, Attila Kovacs, Balint Lakatos, Nora Sydo, Mobin Kheirkhahan, David Peritz, Orsolya Kiss, B. Merkely, Hajnalka Vago

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aims: Physiological cardiac adaptation in athletes is influenced by multiple factors. This study aimed to investigate the impact of sex, age, body size, sports type and training volume on cardiac adaptation in healthy athletes with cardiac magnetic resonance imaging. Methods: A total of 327 athletes (242 male) were studied (adults ≥18 years old; adolescents 14–18 years old). Left and right ventricular ejection fractions, end-diastolic volume, end-systolic volume, stroke volumes and masses were measured. Left ventricular end-diastolic volume/left ventricular mass, right ventricular end-diastolic volume/right ventricular mass and derived right/left ventricular ratios were determined to study balanced ventricular adaptation. Athletes were categorised as skill, power, mixed and endurance athletes. Results: Male athletes had higher left and right ventricular volumes and masses in both adult (n = 215 (145 male); 24 ± 5 years old) and adolescent (n = 112 (97 male); 16 ± 1 years old) groups compared with women (all P < 0.05). In adults, male sex, age, body surface area, weekly training hours, mixed and endurance sports correlated with higher ventricular volumes and masses (all P < 0.05); and a combination of age, sex, training hours, endurance and mixed sports explained 30% of the variance of the left ventricular end-diastolic volume index (r = 0.30), right ventricular end-diastolic volume index (r = 0.34), right ventricular mass index (r = 0.30); and as much as 53% of the left ventricular mass index (r = 0.53) (all P < 0.0001). In adolescents, positive correlations were found between training hours and left ventricular hypertrophy (r = 0.39, P < 0.0001), and biventricular dilation (left ventricular end-diastolic volume r = 0.34, P = 0.0008; right ventricular end-diastolic volume r = 0.36, P = 0.0004). In adolescents, age and body surface area did not correlate with cardiac magnetic resonance parameters. Conclusion: There are significant sex differences in the physiological adaptation of adult and adolescent athlete’s heart; and male sex, higher training volume and endurance sports are major determinants of sports adaptation in adults.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Athletes
Stroke Volume
Magnetic Resonance Imaging
Sports
Physiological Adaptation
Body Surface Area
Cardiac Volume
Body Size
Left Ventricular Hypertrophy
Sex Characteristics
Dilatation
Magnetic Resonance Spectroscopy

Keywords

  • athlete’s heart
  • cardiac hypertrophy
  • Cardiac magnetic resonance imaging
  • exercise
  • remodelling
  • sex

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

Cite this

The impact of sex, age and training on biventricular cardiac adaptation in healthy adult and adolescent athletes : Cardiac magnetic resonance imaging study. / Csecs, Ibolya; Czimbalmos, Csilla; Toth, Attila; Dohy, Zsofia; Suhai, Imre F.; Szabo, Liliana; Kovacs, Attila; Lakatos, Balint; Sydo, Nora; Kheirkhahan, Mobin; Peritz, David; Kiss, Orsolya; Merkely, B.; Vago, Hajnalka.

In: European Journal of Preventive Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Csecs, Ibolya ; Czimbalmos, Csilla ; Toth, Attila ; Dohy, Zsofia ; Suhai, Imre F. ; Szabo, Liliana ; Kovacs, Attila ; Lakatos, Balint ; Sydo, Nora ; Kheirkhahan, Mobin ; Peritz, David ; Kiss, Orsolya ; Merkely, B. ; Vago, Hajnalka. / The impact of sex, age and training on biventricular cardiac adaptation in healthy adult and adolescent athletes : Cardiac magnetic resonance imaging study. In: European Journal of Preventive Cardiology. 2019.
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abstract = "Aims: Physiological cardiac adaptation in athletes is influenced by multiple factors. This study aimed to investigate the impact of sex, age, body size, sports type and training volume on cardiac adaptation in healthy athletes with cardiac magnetic resonance imaging. Methods: A total of 327 athletes (242 male) were studied (adults ≥18 years old; adolescents 14–18 years old). Left and right ventricular ejection fractions, end-diastolic volume, end-systolic volume, stroke volumes and masses were measured. Left ventricular end-diastolic volume/left ventricular mass, right ventricular end-diastolic volume/right ventricular mass and derived right/left ventricular ratios were determined to study balanced ventricular adaptation. Athletes were categorised as skill, power, mixed and endurance athletes. Results: Male athletes had higher left and right ventricular volumes and masses in both adult (n = 215 (145 male); 24 ± 5 years old) and adolescent (n = 112 (97 male); 16 ± 1 years old) groups compared with women (all P < 0.05). In adults, male sex, age, body surface area, weekly training hours, mixed and endurance sports correlated with higher ventricular volumes and masses (all P < 0.05); and a combination of age, sex, training hours, endurance and mixed sports explained 30{\%} of the variance of the left ventricular end-diastolic volume index (r = 0.30), right ventricular end-diastolic volume index (r = 0.34), right ventricular mass index (r = 0.30); and as much as 53{\%} of the left ventricular mass index (r = 0.53) (all P < 0.0001). In adolescents, positive correlations were found between training hours and left ventricular hypertrophy (r = 0.39, P < 0.0001), and biventricular dilation (left ventricular end-diastolic volume r = 0.34, P = 0.0008; right ventricular end-diastolic volume r = 0.36, P = 0.0004). In adolescents, age and body surface area did not correlate with cardiac magnetic resonance parameters. Conclusion: There are significant sex differences in the physiological adaptation of adult and adolescent athlete’s heart; and male sex, higher training volume and endurance sports are major determinants of sports adaptation in adults.",
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author = "Ibolya Csecs and Csilla Czimbalmos and Attila Toth and Zsofia Dohy and Suhai, {Imre F.} and Liliana Szabo and Attila Kovacs and Balint Lakatos and Nora Sydo and Mobin Kheirkhahan and David Peritz and Orsolya Kiss and B. Merkely and Hajnalka Vago",
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T2 - Cardiac magnetic resonance imaging study

AU - Csecs, Ibolya

AU - Czimbalmos, Csilla

AU - Toth, Attila

AU - Dohy, Zsofia

AU - Suhai, Imre F.

AU - Szabo, Liliana

AU - Kovacs, Attila

AU - Lakatos, Balint

AU - Sydo, Nora

AU - Kheirkhahan, Mobin

AU - Peritz, David

AU - Kiss, Orsolya

AU - Merkely, B.

AU - Vago, Hajnalka

PY - 2019/1/1

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N2 - Aims: Physiological cardiac adaptation in athletes is influenced by multiple factors. This study aimed to investigate the impact of sex, age, body size, sports type and training volume on cardiac adaptation in healthy athletes with cardiac magnetic resonance imaging. Methods: A total of 327 athletes (242 male) were studied (adults ≥18 years old; adolescents 14–18 years old). Left and right ventricular ejection fractions, end-diastolic volume, end-systolic volume, stroke volumes and masses were measured. Left ventricular end-diastolic volume/left ventricular mass, right ventricular end-diastolic volume/right ventricular mass and derived right/left ventricular ratios were determined to study balanced ventricular adaptation. Athletes were categorised as skill, power, mixed and endurance athletes. Results: Male athletes had higher left and right ventricular volumes and masses in both adult (n = 215 (145 male); 24 ± 5 years old) and adolescent (n = 112 (97 male); 16 ± 1 years old) groups compared with women (all P < 0.05). In adults, male sex, age, body surface area, weekly training hours, mixed and endurance sports correlated with higher ventricular volumes and masses (all P < 0.05); and a combination of age, sex, training hours, endurance and mixed sports explained 30% of the variance of the left ventricular end-diastolic volume index (r = 0.30), right ventricular end-diastolic volume index (r = 0.34), right ventricular mass index (r = 0.30); and as much as 53% of the left ventricular mass index (r = 0.53) (all P < 0.0001). In adolescents, positive correlations were found between training hours and left ventricular hypertrophy (r = 0.39, P < 0.0001), and biventricular dilation (left ventricular end-diastolic volume r = 0.34, P = 0.0008; right ventricular end-diastolic volume r = 0.36, P = 0.0004). In adolescents, age and body surface area did not correlate with cardiac magnetic resonance parameters. Conclusion: There are significant sex differences in the physiological adaptation of adult and adolescent athlete’s heart; and male sex, higher training volume and endurance sports are major determinants of sports adaptation in adults.

AB - Aims: Physiological cardiac adaptation in athletes is influenced by multiple factors. This study aimed to investigate the impact of sex, age, body size, sports type and training volume on cardiac adaptation in healthy athletes with cardiac magnetic resonance imaging. Methods: A total of 327 athletes (242 male) were studied (adults ≥18 years old; adolescents 14–18 years old). Left and right ventricular ejection fractions, end-diastolic volume, end-systolic volume, stroke volumes and masses were measured. Left ventricular end-diastolic volume/left ventricular mass, right ventricular end-diastolic volume/right ventricular mass and derived right/left ventricular ratios were determined to study balanced ventricular adaptation. Athletes were categorised as skill, power, mixed and endurance athletes. Results: Male athletes had higher left and right ventricular volumes and masses in both adult (n = 215 (145 male); 24 ± 5 years old) and adolescent (n = 112 (97 male); 16 ± 1 years old) groups compared with women (all P < 0.05). In adults, male sex, age, body surface area, weekly training hours, mixed and endurance sports correlated with higher ventricular volumes and masses (all P < 0.05); and a combination of age, sex, training hours, endurance and mixed sports explained 30% of the variance of the left ventricular end-diastolic volume index (r = 0.30), right ventricular end-diastolic volume index (r = 0.34), right ventricular mass index (r = 0.30); and as much as 53% of the left ventricular mass index (r = 0.53) (all P < 0.0001). In adolescents, positive correlations were found between training hours and left ventricular hypertrophy (r = 0.39, P < 0.0001), and biventricular dilation (left ventricular end-diastolic volume r = 0.34, P = 0.0008; right ventricular end-diastolic volume r = 0.36, P = 0.0004). In adolescents, age and body surface area did not correlate with cardiac magnetic resonance parameters. Conclusion: There are significant sex differences in the physiological adaptation of adult and adolescent athlete’s heart; and male sex, higher training volume and endurance sports are major determinants of sports adaptation in adults.

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KW - cardiac hypertrophy

KW - Cardiac magnetic resonance imaging

KW - exercise

KW - remodelling

KW - sex

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