Key result
Elite male swimmers show better resting cardiac function than water polo players despite similar exercise responses.
Why the study?
Water polo players and artistic swimmers face similar hydrostatic pressures as swimmers but differ in training intensities, postures, and hemodynamic stressors, making the influence of aquatic-sport training on left ventricular adaptation unclear.
Does the type of aquatic sport training (swimming vs water polo vs artistic swimming) influence left ventricular adaptation at rest and during isometric handgrip exercise in elite athletes?
Cross-Sectional (n=90)
No
Does the type of aquatic sport training (swimming vs water polo vs artistic swimming) influence left ventricular adaptation at rest and during isometric handgrip exercise in elite athletes?
Absolute Event Rate: -4% vs -1%
p-value: p=0.11
Elite aquatic athletes exhibit sport- and sex-specific left ventricular functional adaptations, with swimmers showing primarily volume-based adaptations compared to the mixed volume-pressure adaptations of water polo players and unique adaptations in artistic swimmers.
Sport-specific LV adaptations in elite aquatic athletes remain hypothesis-generating; longitudinal studies needed to clarify training effects on function.
Purpose: Elite swimmers (SW) have reduced diastolic function compared to elite runners, possibly as an adaptation to the aquatic training environment. Water polo players (WP) and artistic swimmers (AS) are exposed to the same hydrostatic pressures as SW, but are subject to different training intensities, postures, and hemodynamic stressors. Our purpose was to compare resting and exercising cardiac function in elite SW, WP, and AS, to characterize the influence of training for aquatic-sport on left ventricular (LV) adaptation.Methods: Ninety athletes (SW:20M/17F; WP:21M/9F; AS:23F) at the 2019 FINA World Championships volunteered for resting and stress (3min 30% maximal isometric handgrip) echocardiographic assessment of LV global function and mechanics. Results: Male SW displayed improved resting systolic and diastolic function compared to WP; however, both groups maintained stroke volume under high-pressure handgrip stress (SW:∆-4±12%; WP:∆-1±13%, P=0.11). There were no differences between female SW and WP resting LV function, but SW demonstrated improved function over AS. During isometric handgrip, all female sport athletes maintained stroke volume (SW:∆3±16%; WP:∆-10±11%; AS:∆-2±14%, P=0.46), but WP had improved apical rotation (∆1.7±4.5°), which was reduced in AS (∆-3.1±4.5°) and maintained in SW (∆-0.5±3.8°, P=0.04). Unlike SW and WP, AS displayed a unique maintenance of early filling velocity during handgrip exercise (SW:∆-3.5±14.7cm/s; WP:∆-15.1±10.8cm/s; AS:∆1.5±15.3cm/s, P=0.02).Conclusion: Among male athletes, SW display primarily volume-based functional adaptations distinct from the mixed volume-pressure adaptations of WP; however, both groups can maintain stroke volume with increased afterload. Female SW and WP do not demonstrate sport-specific differences like males, perhaps owing to sex-differences in adaptation, but have greater volume-based adaptations than AS. Lastly, AS display unique functional adaptations, that may be driven by elevated pressures under low-volume conditions.
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Coates et al. (2021) conducted a cross-sectional in Healthy elite aquatic athletes (n=90). Isometric handgrip exercise vs. Rest was evaluated on Percent change in stroke volume during isometric handgrip exercise (male swimmers vs water polo players) (p=0.11). Elite male swimmers displayed improved resting systolic and diastolic function compared to water polo players, but both groups maintained stroke volume during high-pressure isometric handgrip exercise.
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