Male Endurance Athletes Research Articles

Protein Requirements Are Increased in Endurance-Trained Athletes but Similar between Females and Males during Postexercise Recovery.

This study aimed to determine the daily protein requirements of female and male endurance athletes in a home-based setting using noninvasive stable isotope methodology (i.e., indicator amino acid oxidation). Eight males (30 ± 3 yr; 78.6 ± 10.5 kg; 75.6 ± 7.5 mL·kgFFM-1·min-1; mean ± SD) and seven females (30 ± 4 yr; 57.7 ± 5.0 kg; 77.5 ± 7.1 mL·kgFFM-1·min-1) during the midluteal phase were studied. After 2 d of controlled diet (1.4 gprotein·kg-1·d-1) and training (10 and 5 km run·d-1, respectively), participants completed a 20-km run before an at-home indicator amino acid oxidation trial testing a suboptimal, a moderate, and an excess (i.e., 0.2, 1.2, and 2.0 g·kg-1·d-1, respectively) protein intake. Protein was consumed as a crystalline amino acid mixture containing [1-13C]phenylalanine to examine whole-body phenylalanine flux and phenylalanine oxidation (PheOx; the reciprocal of whole-body protein synthesis) through breath and urine sample collection. A modified biphasic linear regression determined the breakpoint in PheOx for each participant to generate an estimated average intake that would maximize whole-body protein synthesis for each sex. PheOx was different (P < 0.01) between all protein intakes with no effect of sex (P = 0.63). Using a modified three-point curve resulted in a breakpoint that was not different (P = 0.94) between males and females (1.60 and 1.61 g·kg-1·d-1, respectively). The recommended intake (i.e., upper 95% confidence interval) was estimated to be 1.81 and 1.89 g·kg-1·d-1 for males and females, respectively. Our findings indicate that endurance athletes consuming a daily protein intake toward the upper end of current consensus recommendations (~1.85 g·kg-1·d-1) will maximize whole-body protein synthesis during postexercise recovery regardless of sex.

Ten-year mortality among older male recreational endurance athletes in the Birkebeiner Aging Study in comparison with older men from the Tromsø Study.

Physical activity (PA) is associated with reduced mortality. However, whether there is an added benefit of long-term endurance training is unclear. Thus, we aimed to examine 10-year mortality in older male endurance athletes compared with an older male general population. Male athletes (n = 503) participating in an annual long-distance ski race (median years of participation: 14, range: 1-53) from the Norwegian Birkebeiner Aging study (BiAS), and non-athletic men (n = 1867) attending the sixth Tromsø Study (Tromsø6) aged ≥65 years were included. Associations with endurance sport practice and joint exposures of endurance sport practice and self-reported leisure-time PA with all-cause mortality were examined. We analyzed the data with Cox proportional hazard models and regression standardization. After 10 years (median: 10.4, range: 0.5-11.1) the mortality rate was lower in athletes (hazard ratio (HR) 0.34, 95% confidence interval (CI): 0.24-0.49) compared with non-athletes, corresponding to a 15% (95% CI: 12-19%) absolute risk reduction associated with endurance sport practice. In joint analyses categorized according to PA and endurance sport practice, we observed an inverse dose-response relationship with mortality (p < 0.001). Compared to inactive non-athletes, PA was associated with lower mortality in both active non-athletes and athletes. However, the observed benefit among participants reporting moderate-to-vigorous PA was larger in athletes (HR: 0.21, 95% CI: 0.14-0.32) than non-athletes (HR: 0.43, 95% CI: 0.31-0.59) (p < 0.01). Endurance sport practice was associated with reduced 10-year mortality, beyond the effect of PA in older men. This study suggests that long-term endurance sport practice maintained into older adulthood promotes longevity.

VO2max prediction based on submaximal cardiorespiratory relationships and body composition in male runners and cyclists: a population study.

Oxygen uptake (VO2) is one of the most important measures of fitness and critical vital sign. Cardiopulmonary exercise testing (CPET) is a valuable method of assessing fitness in sport and clinical settings. There is a lack of large studies on athletic populations to predict VO2max using somatic or submaximal CPET variables. Thus, this study aimed to: (1) derive prediction models for maximal VO2 (VO2max) based on submaximal exercise variables at anaerobic threshold (AT) or respiratory compensation point (RCP) or only somatic and (2) internally validate provided equations. Four thousand four hundred twenty-four male endurance athletes (EA) underwent maximal symptom-limited CPET on a treadmill (n=3330) or cycle ergometer (n=1094). The cohort was randomly divided between: variables selection (nrunners = 1998; ncyclist = 656), model building (nrunners = 666; ncyclist = 219), and validation (nrunners = 666; ncyclist = 219). Random forest was used to select the most significant variables. Models were derived and internally validated with multiple linear regression. Runners were 36.24±8.45 years; BMI = 23.94 ± 2.43 kg·m-2; VO2max=53.81±6.67 mL·min-1·kg-1. Cyclists were 37.33±9.13 years; BMI = 24.34 ± 2.63 kg·m-2; VO2max=51.74±7.99 mL·min-1·kg-1. VO2 at AT and RCP were the most contributing variables to exercise equations. Body mass and body fat had the highest impact on the somatic equation. Model performance for VO2max based on variables at AT was R2=0.81, at RCP was R2=0.91, at AT and RCP was R2=0.91 and for somatic-only was R2=0.43. Derived prediction models were highly accurate and fairly replicable. Formulae allow for precise estimation of VO2max based on submaximal exercise performance or somatic variables. Presented models are applicable for sport and clinical settling. They are a valuable supplementary method for fitness practitioners to adjust individualised training recommendations. No external funding was received for this work.

Hungry runners - low energy availability in male endurance athletes and its impact on performance and testosterone: mini-review.

Low Energy Availability (LEA) arises from the inability to cover energy needs and requirements of training or normal physiological functions. This value differs from the energy balance, which takes into account the total daily energy intake compared to all the energy expended, regardless of the amount of fat-free mass. Insufficient energy consumption affects recovery, adaptation processes, increases the risk of injury or illness, so all of this can negatively affect performance. This mini-review is written on research articles in Pubmed database related to LEA in endurance-trained men and its impact on performance and testosterone. This article also clarifies the prevalence of LEA in male endurance athletes and its correlation to Relative Energy Deficiency in Sports (RED-S). LEA occurs in male endurance athletes and correlates with decreased testosterone levels, decreased bone density and also Resting Metabolic Rate. In endurance-trained men, there is great potential for the negative consequences of low energy availability. It can also be said that there are possibilities for primary screening, so we recommend regular check-ups of blood markers, body structure and keeping not only training but also dietary records, which can increase awareness of an adequate energy balance.

Young athlete’s growing heart: sex differences in cardiac adaptation to exercise training during adolescence

BackgroundAthlete’s heart is a condition of exercise-induced cardiac remodelling. Adult male endurance athletes more often remodel beyond reference values. The impact of sex on remodelling through adolescence remains unclear. Paediatric...

Microstructural organization of the corpus callosum in young endurance athletes: A global tractography study.

Aerobic exercise training has been shown to improve microstructural organization of the corpus callosum (CC); however, evidence of this topographic effect is limited. To compare the CC microstructural organization between endurance athletes and sedentary adults using a white-matter fiber tractography approach. Diffusion tensor imaging (DTI) and T1-weighted structural data were collected from 15 male young endurance athletes and 16 age- and sex-matched sedentary adults. DTI data were analyzed with a global probabilistic tractography method based on neighborhood anatomical information. Fractional anisotropy (FA) and mean, radial (RD), and axial diffusivities were measured in the eight CC tracts: rostrum, genu, splenium, and body's prefrontal, premotor, central, parietal, and temporal tracts. Cortical thickness of the CC tract endpoints and the CC tract length and volume were also measured. Physical activity level was assessed by metabolic equivalents (METs). The athlete group had an average VO2max of 69.5 ± 3.1 ml/kg/min, which is above 90%ile according to the American College of Sports Medicine guideline. Compared with the sedentary group, the athlete group had higher FA in the CC body's premotor and parietal tracts and the CC splenium. These tracts showed lower RD in the athlete compared with sedentary group. The voxelwise analysis confirmed that the athlete group had higher FA in the CC and other white matter regions than the sedentary group, including the corona radiata, internal capsule, and superior longitudinal fasciculus. Cortical thickness of the CC tract endpoints and the CC tract lengths and volumes were similar between the two groups. Physical activity levels were positively correlated with FA in the CC body's parietal (r = 0.486, p = 0.006) and temporal (r = 0.425, p = 0.017) tracts and the CC splenium (r = 0.408, p = 0.023). Young endurance athletes have higher microstructural organization of the CC tracts connected the sensorimotor and visual cortices than the age- and sex-matched sedentary adults.

Risk of atrial fibrillation and stroke among older men exposed to prolonged endurance sport practice: a 10-year follow-up. The Birkebeiner Ageing Study and the Tromsø Study

AimsEndurance sport practice is associated with a high prevalence of atrial fibrillation (AF), which increases the risk of stroke in the general population. However, stroke risk in endurance athletes with...

Exercise blood pressure changes and aortic dilatation in male Masters endurance athletes.

With aging, aortic dilatation represents a primary risk factor for acute aortic syndromes.1 Among endurance-trained Masters athletes, clinically relevant aortic dilatation, defined by a diameter at the aortic root (AR) or ascending aorta ≥40 mm, is also common.2 Whether this phenotype represents adaptive vascular remodelling, akin to the ‘athlete’s heart’, vs. a manifestation of overuse pathology is uncertain. We sought to analyse the association between changes in exercise blood pressure (BP) and AR size in a cross-sectional cohort of male Masters endurance athletes. We hypothesized that an increased systolic BP (SBP) response to exercise would be associated with larger AR size. Subjects were taken from a developing registry of healthy Masters endurance athletes recruited from the Atlanta Track Club (Atlanta, GA, USA), a regional running organization, created to study cardiovascular risk in Masters athletes. Fasting blood work and maximal-effort treadmill cardiopulmonary exercise testing (CPET) were obtained on all athletes. Exercise history was self-reported and estimated as weekly metabolic equivalents of task (MET).3 Athletes without established diabetes, hypertension, or coronary artery disease and normal resting and exercise ECG proceeded with trans-thoracic echocardiography and vascular applanation tonometry [carotid-femoral pulse wave velocity (PWV), SphygmoCor, Atcor Medical].

Using Predictive Modeling Technique to Assess Core Temperature Adaptations from Heart Rate, Sweat Rate, and Thermal Sensation in Heat Acclimatization and Heat Acclimation.

Assessing the adaptation of rectal temperature (Trec) is critical following heat acclimatization (HAz) and heat acclimation (HA) because it is associated with exercise performance and safety; however, more feasible and valid methods need to be identified. The purpose of this study was to predict adaptations in Trec from heart rate (HR), sweat rate (SR), and thermal sensation (TS) using predictive modeling techniques. Twenty-five male endurance athletes (age, 36 ± 12 y; VO2max, 57.5 ± 7.0 mL⋅kg−1⋅min−1) completed three trials consisting of 60 min running at 59.3 ± 1.7% vVO2max in a hot environment. During trials, the highest HR and TS, SR, and Trec at the end of trials were recorded. Following a baseline trial, participants performed HAz followed by a post-HAz trial and then completed five days HA, followed by a post-HA trial. A decision tree indicated cut-points of HR (<−13 bpm), SR (>0.3 L·h−1), and TS (≤−0.5) to predict lower Trec. When two or three variables met cut-points, the probability of accuracy of showing lower Trec was 95.7%. Greater adaptations in Trec were observed when two or three variables met cut-points (−0.71 ± 0.50 °C) compared to one (−0.13 ± 0.36 °C, p < 0.001) or zero (0.0 3 ± 0.38 °C, p < 0.001). Specificity was 0.96 when two or three variables met cut-points to predict lower Trec. These results suggest using heart rate, sweat rate, and thermal sensation adaptations to indicate that the adaptations in Trec is beneficial following heat adaptations, especially in field settings, as a practical and noninvasive method.

Central autonomic network alterations in male endurance athletes

Physical exercise causes marked adjustments in brain function and the cardiovascular system. Brain regions of the so-called central autonomic network (CAN) are likely to show exercise-related alterations due to their involvement in cardiac control, yet exercise-induced CAN changes remain unclear. Here we investigate the effects of intensive exercise on brain regions involved in cardiac autonomic regulation using resting-state functional connectivity (rsFC). We explored rsFC of six core regions within CAN, namely ventromedial prefrontal cortex, dorsolateral anterior cingulate cortex, left/right amygdala, and left/right anterior insula, in 20 endurance athletes and 21 non-athletes. We showed that athletes had enhanced rsFC within CAN and sensorimotor areas compared to non-athletes. Likewise, we identified two networks with increased rsFC encompassing autonomic and motor-related areas using network-based statistics analysis. In addition, rsFC displayed an inverse relationship with heart rate, where the stronger rsFC in athletes correlates with their slower heart rate. Despite this significant relationship, mediation analysis revealed that heart rate is a weak mediator of the effect of intensive physical training on rsFC. Our findings prove that physical exercise enhances brain connectivity in central autonomic and sensorimotor networks and highlight the close link between brain and heart.

Cardiac remodelling in adolescent athletes – sex differences progress through adolescence

Abstract Background Cardiac remodelling beyond reference values is well-known in adult athlete's heart. Male endurance athletes are more prone to develop cardiac chambers and wall thickness above reference values. Cardiac remodelling is also described in adolescent athletes, but considered to be moderate compared to adults. However, few studies evaluate adolescent athlete's heart by paediatric echocardiographic reference values. Current paediatric reference values are sex-unspecific and do not include exercise data. The impact of sex and exercise on remodelling in adolescent athlete's heart remains unclear. Purpose We aimed to study the development of cardiac remodelling and potential sex differences in adolescent athletes. We hypothesized that male adolescent athletes would display greater degree of remodelling compared to female adolescent athletes. Methods Male (M) and female (F) adolescent cross-country skiers were recruited in a longitudinal cohort study. They were examined with echocardiography at age 12, 15 and 18. Data on exercise was collected at all examinations. We evaluated echocardiographic parameters by paediatric reference values (Z-score: number of standard deviations above estimated mean in the given body surface area). Echocardiographic measures were considered above upper reference value if Z-score was ≥2. Results Seventy-six athletes were examined at age 12 (48 M, 28 F), 48 at age 15 (34 M, 14 F) and 34 at age 18 (23 M, 11 F). Although Z-scores were within reference values at age 12 (Table 1), a subset of athletes displayed Z-scores ≥2 for end-diastolic intraventricular septum diameter (IVSd, M 13/48=27%, F 5/28=18%) and left ventricular posterior wall thickness (LVPWd, M 6/48=13%, F 2/28=14%). The male group demonstrated enlarged left ventricular mass (LVM) from age 15 (Figure 1). Males had greater left ventricular end-diastolic volume (LV EDV) from age 12. Additional sex differences were evident from age 15 for IVSd, LVPWd and LVM (Table 1). There was no sex difference in exercise hours. Both groups had normal myocardial function through the study period. Conclusion Cardiac remodelling beyond reference values was observed in athletes of both sexes from early adolescent age. Sex differences were evident from age 12 with further progression. Pathological values for LVM were more frequent in males. These findings suggest that sex differences in exercise-induced cardiac remodelling is more prominent in adolescents than previously reported. Sex and exercise history should be considered in questions of pathology. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): The South-Eastern Norway Regional Health AuthorityCentre for Children and Youth Sport, Norwegian School of Sport Sciences

The Effect of Four Weeks of Long-Term Endurance Training with and Without Propolis Supplementation on Serum Levels of Betatrophin/ANGPTL8 in Male Athletes

Background: Betatrophin/angiopoietin-like protein (ANGPTL8) is defined as an adipokine that regulates blood glucose and triglyceride levels. Objectives: This study aimed to evaluate the effect of propolis supplementation for the first time on serum levels of the hormone betatrophin, as a drug target in the treatment of dyslipidemia, in male endurance athletes for four weeks. Methods: 44 male athletes with an average age of 22 ± 3 years, a height of 177.5 ± 6.5 cm, and a weight of 76 ± 6 kg were selected in Qazvin. They were randomly divided into four groups: Supplementation, placebo, physical activity, and control. The supplementation and placebo groups received two 500 mg tablets of propolis and cellulose (in terms of shape and color, are similar to the original supplement and have no properties, flavor, and aroma) once after lunch and once after dinner, respectively. The drug treatment lasted for four weeks. The athletes' weight and serum levels of betatrophin were measured at the beginning and the end of 4 weeks of treatment. The ELISA method was used to assess the serum concentration of betatrophin. Analyzes were performed by the ANCOVA method. Results: The results showed that the long-term endurance training plus propolis supplementation would result in significant changes in the betatrophin serum levels and weight in participants (P = 0.001), but in the athletes without supplementation, these changes were not significant (P &gt; 0.05). Conclusions: The results indicated that betatrophin serum levels in endurance athletes are increased by propolis supplementation, and their weight is decreased.

Genetic polymorphisms of muscular fitness in young healthy men.

The effects of genetic polymorphisms on muscle structure and function remain elusive. The present study tested for possible associations of 16 polymorphisms (across ten candidate genes) with fittness and skeletal muscle phenotypes in 17- to 37-year-old healthy Caucasian male endurance (n = 86), power/strength (n = 75) and team athletes (n = 60), and non-athletes (n = 218). Skeletal muscle function was measured with eight performance tests covering multiple aspects of muscular fitness. Along with body mass and height, the upper arm and limb girths, and maximal oxygen uptake were measured. Genotyping was conducted on DNA extracted from blood. Of the 16 polymorphisms studied, nine (spanning seven candidate genes and four gene families/signalling pathways) were independently associated with at least one skeletal muscle fitness measure (size or function, or both) measure and explained up to 4.1% of its variation. Five of the studied polymorphisms (activin- and adreno-receptors, as well as myosine light chain kinase 1) in a group of one to three combined with body height, age and/or group explained up to 20.4% of the variation of muscle function. ACVR1B (rs2854464) contributed 2.0-3.6% to explain up to 14.6% of limb proximal girths. The G allele (genotypes AG and GG) of the ACVR1B (rs2854464) polymorphism was significantly overrepresented among team (60.4%) and power (62.0%) athletes compared to controls (52.3%) and endurance athletes (39.2%), and G allele was also most consistently/frequently associated with muscle size and power. Overall, the investigated polymorphisms determined up to 4.1% of the variability of muscular fitness in healthy young humans.

Performance and Submaximal Adaptations to Additional Speed-Endurance Training Vs. Continuous Moderate-Intensity Aerobic Training in Male Endurance Athletes.

We examined performance and submaximal adaptations to additional treadmill-based speed-endurance training (SET) vs. continuous moderate-intensity aerobic training (MIT) twice / week. Twenty-two male endurance athletes were tested before and after 10-week SET (6-12 × 30-s sprints separated by 3-min rest intervals) and MIT (2040 min continuous running at ~70% maximal oxygen uptake [V̇O2max]). The SET group attained greater acute heart rate (HR) and blood lactate responses than the MIT group (d = 0.86–0.91). The SET group improved performance in a time-to-exhaustion trial, V̇O2max, and lactate threshold (d = 0.50–0.73), whereas no training-induced changes were observed in the MIT group. Additionally, the SET group reduced oxygen uptake, mean HR and improved running economy (d = 0.53–0.86) during running at 10 and 12 km·h-1. Additional SET imposes greater physiological demands than MIT resulting in superior performance adaptations and reduced energy cost in endurance athletes.

Effects of a 6-wk Sprint Interval Training Protocol at Different Altitudes on Circulating Extracellular Vesicles.

This study aimed to investigate the modulation of circulating exosome-like extracellular vesicles (ELVs) after 6 wk of sprint interval training (SIT) at sea level and at 2000, 3000, and 4000 m. Thirty trained endurance male athletes (18-35 yr) participated in a 6-wk SIT program (30-s all-out sprint, 4-min 30-s recovery; 4-9 repetitions, 2 sessions per week) at sea level ( n = 8), 2000 m (fraction of inspired oxygen (F io2 ) 0.167, n = 8), 3000 m (F io2 0.145, n = 7), or 4000 m (F io2 0.13, n = 7). Venous blood samples were taken before and after the training period. Plasma ELVs were isolated by size exclusion chromatography, counted by nanoparticle tracking analysis, and characterized according to international standards. Candidate ELV microRNAs (miRNAs) were quantified by real-time polymerase chain reaction. When the three hypoxic groups were analyzed separately, only very minor differences could be detected in the levels of circulating particles, ELV markers, or miRNA. However, the levels of circulating particles increased (+262%) after training when the three hypoxic groups were pooled, and tended to increase at sea level (+65%), with no difference between these two groups. A trend to an increase was observed for the two ELV markers, TSG101 (+65%) and HSP60 (+441%), at sea level, but not in hypoxia. Training also seemed to decrease the abundance of miR-23a-3p and to increase the abundance of miR-21-5p in hypoxia but not at sea level. A 6-wk SIT program tended to increase the basal levels of circulating ELVs when performed at sea level but not in hypoxia. In contrast, ELV miRNA cargo seemed to be modulated in hypoxic conditions only. Further research should explore the potential differences in the origin of ELVs between normoxic and local and systemic hypoxic conditions.

Interleukin-6, undercarboxylated osteocalcin, and brain-derived neurotrophic factor responses to single and repeated sessions of high-intensity interval exercise

ObjectivesThe purpose of this study was to compare the effects of a single session of high-intensity interval exercise (HIIE) with 2 consecutive HIIEs, separated by 3 h of recovery, on plasma interleukin-6 (IL-6), undercarboxylated osteocalcin (ucOC), and brain-derived neurotrophic factor (BDNF) responses. MethodsTwenty male recreational endurance athletes completed two HIIE trials in a randomized crossover design: a single session of HIIE on the single exercise day (HIIE-S) and two sessions of HIIE 3 h apart on the double exercise day (HIIE-D). The HIIE protocol consisted of 10 × 1 min cycling at 100 % of peak oxygen uptake, with 75 s of low-intensity cycling at 60 W. Blood samples were collected to analyze IL-6, ucOC, and BDNF levels before and immediately after HIIE on the HIIE-S and before and immediately after the second HIIE on the HIIE-D. ResultsBoth HIIE interventions significantly increased (p < 0.001) plasma IL-6 (HIIE-S 33.90 % vs HIIE-D 31.04 %; p = 0.64), ucOC (HIIE-S 37.18 % vs HIIE-D 39.54 %; p = 0.85), and BDNF levels (HIIE-S 236.01 % vs HIIE-D 216.68 %; p = 0.69), with no group effect. ConclusionsOur results demonstrate that performing two consecutive HIIEs on the same day with a 3-h rest results in similar changes in plasma levels of IL-6, BDNF, and ucOC compared with a single session of HIIE.

Flavanol-Rich Cocoa Supplementation Inhibits Mitochondrial Biogenesis Triggered by Exercise.

The potential role of cocoa supplementation in an exercise context remains unclear. We describe the effects of flavanol-rich cocoa supplementation during training on exercise performance and mitochondrial biogenesis. Forty-two male endurance athletes at the beginning of the training season received either 5 g of cocoa (425 mg of flavanols) or maltodextrin (control) daily for 10 weeks. Two different doses of cocoa (equivalent to 5 g and 15 g per day of cocoa for a 70 kg person) were tested in a mouse exercise training study. In the athletes, while both groups had improved exercise performance, the maximal aerobic speed increased only in the control group. A mitochondrial DNA analysis revealed that the control group responded to training by increasing the mitochondrial load whereas the cocoa group showed no increase. Oxidative stress was lower in the cocoa group than in the control group, together with lower interleukin-6 levels. In the muscle of mice receiving cocoa, we corroborated an inhibition of mitochondrial biogenesis, which might be mediated by the decrease in the expression of nuclear factor erythroid-2-related factor 2. Our study shows that supplementation with flavanol-rich cocoa during the training period inhibits mitochondrial biogenesis adaptation through the inhibition of reactive oxygen species generation without impacting exercise performance.

Cardiac Events in World-Class Athletes: An Internet-Based Study.

This study aimed at assessing the prevalence of adverse cardiac events, as identified in the media, in world-class athletes according to their sex and sports discipline. All female and male athletes from 30 individual Olympic sports who ranked in the international yearly top 10 between 2006 and 2018 were included. The name of each of them was associated in a Google search with selected key terms related to heart disease and/or acute cardiac events after their inclusion date. Global and sex-specific adverse cardiac event hazard function λ were calculated for each sport. Global and sex-specific prevalences of cardiac events were calculated, then compared (Fisher's exact test) between all sports. From the 2471 athletes included, 15 cases of cardiac events (prevalence of 0.61%) were reported; 2 sudden cardiac deaths (0.08%) occurred in male athletes. The other events were related to arrhythmic events ( n = 13), mainly supraventricular arrhythmias ( n = 9). All surviving athletes were able to continue their career, mostly after ablation procedure. Male endurance athletes accounted for seven events, among which three events occurred among short-distance triathletes. Events among women were comparatively rare ( n = 4), and all were observed among short-distance triathletes. A relatively unexpected high prevalence of cardiac events in endurance elite athletes was observed as compared with other sports, mainly, in short-distance male and female triathletes. This raises the question of particular cardiovascular constraints in this discipline and underlines the urge of international longitudinal follow-up studies in these kinds of athletes.

Training and coaching of female vs. male endurance athletes on their road to gold. Perceptions among successful elite athlete coaches

This scientific short report investigated how successful male coaches perceive gender differences in training characteristics and coaching practice among medal-winning endurance athletes. Ten male Norwegian coaches with a track record of coaching both female and male endurance world-class athletes (total of 269 Olympic, World and European Championship medals) participated in semi-structured interviews. Inductive thematic analysis revealed that all coaches mainly adjusted their key training and coaching principles to the individual athlete, rather than gender. A coach-driven and athlete-centered individualization process was essential to create trust, mutual understanding, and optimal training content. Potential gender/sex differences were perceived in four main themes: sport-specific competition demands, physiological, psychological and interpersonal factors (e.g., gender of the coach). In this context, all coaches described how training and coaching of female athletes differs from that of men, thus considering male athletes as the reference group and male physiology and psychology as the norm. Furthermore, societal factors such as a male-dominant sports culture and underlying gender stereotypes were suggested as amplifiers of gender differences. Accordingly, our report highlights the need for female perspectives in elite sports and invites further in-depth investigations of the identified gender/sex differences within the respective disciplines of training science, physiology, psychology and sociology. Key Words: Coaching, Endurance Training, Gender Differences, Sex Difference, Training Science

Right Heart Structure and Function in Lifelong Recreational Endurance Athletes with and without Paroxysmal Atrial Fibrillation

Healthy young athletes adapt to the increased demands of endurance exercise with symmetric cardiac remodeling. Male veteran endurance athletes have an increased risk for atrial fibrillation (AF), and some athletes seem susceptible to changes mimicking arrhythmogenic cardiomyopathy. Intense exercise puts a disproportionate hemodynamic load on the right-sided heart chambers. Despite this, data describing right heart structure and function in older veteran athletes are scarce. The aim of this study was to investigate structural and functional characteristics of the right heart in veteran athletes with and without AF to contribute to the understanding of exercise-induced cardiac remodeling in this group. Three hundred two male participants, of whom 151 were veteran skiers (62 with paroxysmal AF) and 151 were control subjects from the general population (62 with paroxysmal AF), underwent echocardiographic examinations in sinus rhythm to evaluate right atrial (RA) and right ventricular (RV) structure and function. While 87 of the participants had never exercised regularly, 50, 43, and 122 men had practiced regular endurance exercise for 1 to 20, 20 to 40, and >40years, respectively. RA volume and RV size increased with cumulative years of exercise (P<.001), with a disproportionate increase in RV size compared with left ventricular (LV) size, regardless of AF status (P<.001). RA and RV function assessed by strain remained similar despite lifelong exposure to endurance exercise. AF was associated with reduced RA strain irrespective of exposure to exercise (P<.001). RA and RV sizes and RV/LV ratio showed a dose-response relationship with cumulative years of endurance exercise, whereas RA and RV function did not, indicating that increasing RV/LV ratio may represent a physiologic adaptation to prolonged endurance exercise. AF was associated with reduced RA function, regardless of exposure to exercise, suggesting that RA functional parameters are more closely linked to AF than RA size in veteran athletes.