Effects of endurance exercise training on left ventricular structure in healthy adults: a systematic review and meta-analysis

Morrison, Brenda J.; George, Keith; Kreiter, Elizabeth; Dixon, Duncan; Rebello, Lyndon; Massarotto, Raffaele Joseph; Coté, Anita T.

doi:10.1093/eurjpc/zwad023

Cited by 14 publications

(7 citation statements)

References 103 publications

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“…These types of athletes represent those with the greatest degree of cardiac adaptation [ 4 ] and hence our findings of predominantly normal geometry are important when understanding the magnitude of adaption. A recent meta-analysis explored the impact of endurance training on LVM, demonstrating greater values compared to non-athletic controls [ 22 ]. These data provide further insight alongside the data presented here, that although LVM increases with athletic training, eccentric and more so concentric geometrical adaptation is relatively rare in young MES athletes.…”

Section: Discussionmentioning

confidence: 99%

“…This has implications related to our physiological understanding of sex on the athlete’s heart suggesting that the association between LV remodelling and body size in an athletic population is different between males and females. It has been documented that the rate and magnitude of adaptation in LVM [ 22 ] and body composition [ 31 ] in response to endurance training differ between males and females. These differences have been related to both testosterone [ 32 ] and oestrogen levels with data on post-menopausal women being insightful highlighting increased LVM compared to pre-menopause [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Allometric scaling for left ventricular mass and geometry in male and female athletes of mixed and endurance sports

Oxborough,

McDerment,

George

et al. 2024

Echo Res Pract

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Background The athlete’s heart (AH) defines the phenotypical changes that occur in response to chronic exercise training. Echocardiographic assessment of the AH is used to calculate LV mass (LVM) and determine chamber geometry. This is, however, interpreted using standard linear (ratiometric) scaling to body surface area (BSA) whereas allometric scaling is now widely recommended. This study (1) determined whether ratiometric scaling of LVM to BSA (LVMiratio) provides a size-independent index in young and veteran athletes of mixed and endurance sports (MES), and (2) calculated size-independent beta exponents for allometrically derived (LVMiallo) to BSA and (3) describes the physiological range of LVMiallo and the classifications of LV geometry. Methods 1373 MES athletes consisting of young (< 35 years old) (males n = 699 and females n = 127) and veteran (> 35 years old) (males n = 327 and females n = 220) were included in the study. LVMiratio was calculated as per standard scaling and sex-specific LVMiallo were derived from the population. Cut-offs were defined and geometry was classified according to the new exponents and relative wall thickness. Results LVMiratio did not produce a size independent index. When tested across the age range the following indexes LVMi/BSA0.7663 and LVMi/BSA0.52, for males and females respectively, were size independent (r = 0.012; P = 0.7 and r = 0.003; P = 0.920). Physiological cut-offs for LVMiallo were 135 g/(m2)0.7663 in male athletes and 121 g/(m2)0.52 in female athletes. Concentric remodelling / hypertrophy was present in 3% and 0% of young male and female athletes and 24% and 17% of veteran male and female athletes, respectively. Eccentric hypertrophy was observed in 8% and 6% of young male and female athletes and 9% and 11% of veteran male and female athletes, respectively. Conclusion In a large cohort of young and veteran male and female MES athletes, LVMiratio to BSA is not size independent. Sex-specific LVMiallo to BSA with LVMi/BSA0.77 and LVMi/BSA0.52 for male and female athletes respectively can be applied across the age-range. Population-based cut-offs of LVMiallo provided a physiological range demonstrating a predominance for normal geometry in all athlete groups with a greater percentage of concentric remodelling/hypertrophy occurring in veteran male and female athletes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Allometric scaling for left ventricular mass and geometry in male and female athletes of mixed and endurance sports

Oxborough,

McDerment,

George

et al. 2024

Echo Res Pract

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“…Sex-specific differences in cardiac structure and function have been observed in response to endurance training. In a recent meta-analysis, left ventricular (LV) mass indexed to body surface area was found to be similarly augmented following endurance training in both sexes (10). However, while both males and females showed augmented LV cavity size, an increase in LV wall thickness was observed in males only (10).…”

Section: Introductionmentioning

confidence: 99%

“…In a recent meta-analysis, left ventricular (LV) mass indexed to body surface area was found to be similarly augmented following endurance training in both sexes (10). However, while both males and females showed augmented LV cavity size, an increase in LV wall thickness was observed in males only (10). Further, endurance training induced LV end-diastolic volume appears to increase to a greater extent in males compared to females with LV stroke volume enhanced only in males (11).…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Ventricular-Vascular Interactions Associated with Aerobic Capacity

Morrison

Mittermaier

Lester

et al. 2023

Preprint

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Background: Aerobic capacity as measured by peak oxygen uptake (VO2peak), is related to functional capacity and is a strong independent predictor of all-cause and disease-specific mortality. Lifelong exercise is associated with reduced central arterial and ventricular stiffness, potential mechanisms that may underpin cardiovascular health benefits as a result of endurance training. The purpose of this study was to evaluate sex-specific ventricular-vascular interactions associated with VO2peak in healthy males and females. Methods: Sixty-eight males and females (35 10 years) characterized as recreational exercisers to highly trained endurance athletes, and free of chronic disease underwent a cycle ergometer test to exhaustion to assess aerobic capacity (VO2peak). Resting arterial compliance and echocardiographic evaluation of left ventricular (LV) function were measured. Results: VO2peak was similar between groups (54 6 vs. 50 7). LV mass indexed to body surface area (LVMI) was higher (110 20 vs. 94 18, p=0.001) and longitudinal diastolic strain rate was lower (1.6 0.3 vs. 1.4 0.2, p=0.005) in males. Linear regression analysis revealed LVMI and longitudinal diastolic strain rate were significantly associated with VO2peak (r2=0.32, p=0.001) in males, while in females LVMI and large artery compliance were the key factors influencing VO2peak (r2=0.61, p<0.001). Conclusion: These findings reveal that in females much of the variance in VO2peak can be attributed to ventricular and vascular adaptations, whereas in males, cardiac factors of structure and function accounted for the majority of this variance. The substantive central vascular adaptations to exercise observed in females in this study further validates engagement in endurance training to prevent age-related arterial stiffening in women.

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“…An exploratory analysis found that Q̇ peak increased in male but not female participants 11 , however the study was not designed using procedures deemed best practice for making sex-based comparisons 12 . Meta-analyses based on endurance training studies lasting 2–52 weeks have demonstrated greater changes in V̇O 2peak and cardiac remodelling in male compared to female participants 13 – 15 , but data regarding the potential effect of SIT are more limited. A recent review highlighted the lack of studies and conflicting evidence regarding potential sex-based differences in Q̇ peak trainability following SIT and the need for work to address this question using best practice research designs 16 .…”

Section: Introductionmentioning

confidence: 99%

Biological sex does not influence the peak cardiac output response to twelve weeks of sprint interval training

Bostad,

Williams,

Van Berkel

et al. 2023

Sci Rep

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Sprint interval training (SIT) increases peak oxygen uptake (V̇O2peak) but the mechanistic basis is unclear. We have reported that 12 wk of SIT increased V̇O2peak and peak cardiac output (Q̇peak) and the changes in these variables were correlated. An exploratory analysis suggested that Q̇peak increased in males but not females. The present study incorporated best practices to examine the potential influence of biological sex on the Q̇peak response to SIT. Male and female participants (n = 10 each; 21 ± 4 y) performed 33 ± 2 sessions of SIT over 12 wk. Each 10-min session involved 3 × 20-s ‘all-out’ sprints on an ergometer. V̇O2peak increased after SIT (3.16 ± 1.0 vs. 2.89 ± 1.0 L/min, η2p = 0.53, p < 0.001) with no sex × time interaction (p = 0.61). Q̇peak was unchanged after training (15.2 ± 3.3 vs. 15.1 ± 3.0 L/min, p = 0.85), in contrast to our previous study. The peak estimated arteriovenous oxygen difference increased after training (204 ± 30 vs. 187 ± 36 ml/L, p = 0.006). There was no effect of training or sex on measures of endothelial function. We conclude that 12 wk of SIT increases V̇O2peak but the mechanistic basis remains unclear. The capacity of inert gas rebreathing to assess changes in Q̇peak may be limited and invasive studies that use more direct measures are needed.

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Effects of endurance exercise training on left ventricular structure in healthy adults: a systematic review and meta-analysis

Cited by 14 publications

References 103 publications

Allometric scaling for left ventricular mass and geometry in male and female athletes of mixed and endurance sports

Allometric scaling for left ventricular mass and geometry in male and female athletes of mixed and endurance sports

Sex Differences in Ventricular-Vascular Interactions Associated with Aerobic Capacity

Biological sex does not influence the peak cardiac output response to twelve weeks of sprint interval training

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