Longitudinal Association of Peak Oxygen Uptake with Vascular and Cardiac Structure and Function in German Paediatric Athletes

Aims: This study aims to investigate the longitudinal associations between changes in maximal cardiorespiratory fitness (CRF) and vascular/cardiac structure and function in paediatric athletes. Methods: 142 paediatric athletes with data for baseline and a one-year follow-up from the Munich Cardiovascular Adaptation in Young Athletes (MuCAYA) study (mean [SD] age at baseline: 14.0 [2.9] years; 17 girls) were included. Parameters for CRF were VO 2peak (L/min), relative VO 2peak (ml/min/kg), and maximum (watts) and relative power output (watts/kg). We applied linear mixed-effect models for repeated measures to examine the prospective associations between the one-year progression of CRF with the progression of vascular and cardiac parameters. Results: One-year progression in VO 2peak was associated with increases in central systolic blood pressure (SBP) and aortic pulse wave velocity (PWV), while a one-year progression in maximum physical performance was associated with increases in central SBP, aortic PWV, and carotid intima-media thickness (cIMT). A one-year VO 2peak progression was associated with a decrease in ejection fraction and an increase in left ventricular end-diastolic dimension (LVIDd), and internal dimension (LVIDs), interventricular septal thickness (IVSd), LV posterior wall thickness (LVPWd), left ventricular mass (LVM), LVM to body surface area (BSA, LVM/BSA), and LVM/height 2.7 . Maximum power output progression was further associated with decreases in ejection fraction but increases in LVIDd, LVIDs, IVSd, LVPWd, LVM, LVM/BSA, and LVM/height 2.7 . Conclusion: We demonstrate the paradoxical relationships between increased CRF and increased cardiovascular parameters in paediatric athletes, suggesting that vascular and cardiac functional and structural physiologic remodelling may be present in adolescent athletes.