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March 14, 2026Scandinavian Journal of Medicine and Science in Sports0 citationsOpen Access

Cerebral Blood and Cerebrospinal Fluid Flow Dynamics in Endurance Athletes: Associations With Aortic Recoil and Heart Rate

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DHDaisuke HoshiMFMarina FukuieTTTsubasa Tomoto

Key Result

Endurance athletes demonstrated aortic recoil of 5.7 cm²·s and lower heart rate of 53 bpm, resulting in greater diastolic cerebral arterial flow volume compared to controls.

Key Points

  • This study investigates how cerebral blood and cerebrospinal fluid flow dynamics are related to cardiovascular parameters in endurance athletes.
  • Compared 15 young male endurance athletes with 19 sedentary male controls.
  • Acquired extra- and intracranial cerebral blood and CSF flow waveforms using CINE phase-contrast MRI.
  • Quantified flow volume and rate across the cardiac cycle and between systolic and diastolic phases.
  • Integrated aortic cross-sectional area changes to assess aortic expansion and recoil.
  • Athletes exhibited higher aortic recoil (5.7 cm²·s vs. 4.1 cm²·s) and higher stroke volume (97 ± 18 mL vs. 82 ± 11 mL).
  • Lower heart rate in athletes (53 ± 6 bpm vs. 67 ± 12 bpm) compared to controls.
  • Diastolic arterial flow volume was greater in athletes, while systolic arterial flow rate was lower.
  • The relationship between lower heart rate and greater diastolic flow volume was mediated by higher aortic recoil.

Structured PICO

Does endurance training alter cerebral blood and cerebrospinal fluid flow dynamics compared to a sedentary lifestyle?

P
Population
34 young males, comprising 15 endurance athletes and 19 age-matched sedentary controls
I
Intervention
Endurance training (endurance athlete status)
C
Comparator
Sedentary lifestyle (age-matched sedentary controls)
O
Outcome
Cerebral blood and cerebrospinal fluid (CSF) flow volume and rate for the full cardiac cycle, systolic, and diastolic phasessurrogate

Endurance athletes demonstrate enhanced aortic recoil that sustains diastolic cerebral arterial flow volume, allowing efficient brain perfusion despite a lower resting heart rate.

Abstract

Endurance training elicits profound cardiovascular adaptations, including lower heart rate (HR), greater stroke volume (SV), and enhanced aortic Windkessel function. This study aimed to investigate cerebral blood and cerebrospinal fluid (CSF) flow dynamics in endurance athletes and their relations with cardiovascular parameters. Fifteen young male endurance athletes were compared with 19 age-matched sedentary male controls. In the resting supine condition, CINE phase-contrast MRI acquired the extra- and intracranial cerebral blood and CSF flow waveforms, as well as HR, SV, and ascending aortic cross-sectional area waveform. Cerebral blood and CSF flow volume (mL/beat) and rate (mL/min) were quantified for the full cardiac cycle and separately for systolic and diastolic phases. Aortic cross-sectional area change was temporally integrated to quantify aortic expansion and recoil. Athletes exhibited higher aortic recoil (5.7 cm2·s 4.1, 7.3 vs. 4.1 cm2·s 2.6, 5.6) and SV (97 ± 18 mL vs. 82 ± 11 mL) and lower HR (53 ± 6 bpm vs. 67 ± 12 bpm) than controls. Total cerebral arterial blood and CSF flow volumes and rates across the full cardiac cycle were similar between groups; however, athletes showed significantly greater diastolic arterial flow volume and lower systolic arterial flow rate. The association between lower HR and greater diastolic arterial flow volume was mediated by higher aortic recoil across all participants. These results suggest that enhanced aortic recoil in endurance athletes sustains diastolic cerebral arterial flow volume across a prolonged cardiac cycle, enabling more efficient brain perfusion with fewer cardiac cycles than sedentary controls.

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Cite This Study

Hoshi et al. (2026) studied this question. Endurance athletes demonstrated aortic recoil of 5.7 cm²·s and lower heart rate of 53 bpm, resulting in greater diastolic cerebral arterial flow volume compared to controls.

synapsesocial.com/papers/69b4fc7fb39f7826a300d70dhttps://doi.org/10.1111/sms.70261
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