Abstract
Twelve world elite Biathlon (Bia), ten Nordic Cross Country (NCC) and ten ski-mountaineering (Ski-Mo) athletes were evaluated for pronounced echocardiographic physiological cardiac remodeling as a primary aim of our descriptive preliminary report. In this context, sports-related cardiac remodeling was analyzed by performing two-dimensional echocardiography including speckle tracking analysis as left ventricular global longitudinal strain (LV-GLS). A multicenter retrospective analysis of echocardiographic data was performed in 32 elite world winter sports athletes, which were obtained between 2020 and 2021 during the annual medical examination. The matched data of the elite world winter sports athletes (14 women, 18 male athletes, age: 18–35 years) were compared for different echocardiographic parameters. Significant differences could be revealed for left ventricular systolic function (LV-EF, p = 0.0001), left ventricular mass index (LV Mass index, p = 0.0078), left atrial remodeling by left atrial volume index (LAVI, p = 0.0052), and LV-GLS (p = 0.0003) between the three professional winter sports disciplines. This report provides new evidence that resting measures of cardiac structure and function in elite winter sport professionals can identify sport specific remodeling of the left heart, against the background of training schedule and training frequency.
Highlights
Ski mountaineering (Ski-Mo) is one of the most endurant sports imaginable, as it involves the whole body, mostly performed at altitude involving uphill locomotion, representing a high-energy-demanding elite winter sport [1,2,3,4,5,6]
Biathlon (Bia) and Nordic Cross Country (NCC) are different to Ski-Mo, yet not less complex and metabolically demanding in their physiological demands, which have been of interest in previous studies [7,8]
Our sample size was not normally distributed; we evaluated our numerical data group comparisons for ten Ski-Mo athletes, ten NCC athletes, and twelve elite Bia athletes using the analysis of variance testing (ANOVA) and nonparametric testing with post-hoc testing (p < 0.05)
Summary
Ski mountaineering (Ski-Mo) is one of the most endurant sports imaginable, as it involves the whole body, mostly performed at altitude involving uphill locomotion, representing a high-energy-demanding elite winter sport [1,2,3,4,5,6]. The athletic features of these extreme endurance sports should cause pronounced structural and hemodynamical cardiac remodeling of the left heart [9,10,11]. Different training stimuli (dynamic vs static) lead to varying physiological adaptions [13,14] In this context, especially pronounced changes due to left ventricular (LV) and atrial remodeling can be proven in elite endurance athletes [15]. Inherited and acquired cardiovascular abnormalities such as structural components as hypertrophic cardiomyopathies (HCM), arrhythmogenic ventricular cardiomyopathy (AVCM), or myocarditis—detectable via electrocardiographic (ECG) or echocardiographic evaluation—are sometimes difficult to be distinguished from the physiological adaptations observed in the so-called athlete’s heart, especially in athletes performing sports with a high dynamic component [16,17]. Regular standardized echocardiographic evaluation of athletes is essential, which might contribute to the prevention of undesirable cardiac events in young competitive athletes, because sudden cardiac death in athletes is one of the leading causes of mortality in athletes during sport activities [18,19,20,21,22,23,24,25]
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