TABLE 1.
Cardiovascular remodeling in peripubertal child athletes
| Study | Number of athletes/sport | Age range | Evaluation technique | Pubertal status described | Conclusions and effect of exercise | Reference |
|---|---|---|---|---|---|---|
| Rowland | 14 competitive swimmers; matched active nontrained controls | 8.8‐13.5 y (mean 11) | ECG/Echocardiogram | Yes | Lower resting heart rates and LV volume overload in athletes | Pediatrics 1987;79(5):800‐804 |
| Telford | 85 trained child athletes (mixed) compared with skeletal age matched controls | 11‐12 y | Echocardiogram | No | No difference in ventricular dimensions or mass | J Sports Sci 1988;6:49‐57 |
| Rowland | 10 male runners, matched with active, nontrained controls | 11‐13 y | ECG/Echocardiogram/Metabolic exercise testing | yes–described as prepubertal | No clinically significant differences in ECG or LV mass and wall thickness | Int J SportsMed 1994;15;515‐519 |
| Ozer | 82 swimmers with mean 32 months swim training; 41 sedentary control group | 7‐14 y (mean 11.2) | Echocardiography | No | Athletes had increased LV dimensions, wall thickness, aortic root size and LV mass compared to controls | Jpn Heart J 1994 |
| Rowland | 7 competitive cyclists compared with control group. | 11.9 y |
Metabolic exercise testing Echocardiography |
No | Maximal stroke volume determines VO2 max. Lower resting heart rate and higher stroke volume than controls. | Med Sci Sports Exerc 2000;32(4):747‐52 |
| Obert | 29 boys and girls. 3 months aerobic training/detraining for 2 months (nonexercised control group 26) | 10‐11 y | Echocardiography | No | LV internal dimensions increased 4.6% and wall thickness decreased (10.7%) returned to normal after detraining. Heart rate slowed with training. No change in systolic function with training or detraining. | Int J Sports Med 2001;22(2):90‐96 |
| Triposkiadis | 25 elite swimmers 12‐14 h training per week compared with sedentary controls | 11.5 y |
Heart rate variability (HRV) Echocardiography |
No | Increased vagal dominance, LV and LA dimensions increased. No change in wall thickness or HRV | Eur J Clin Invest 2002;32:16‐23 |
| Nottin | 12 boy cyclists, 11 untrained controls; 10 adult cyclists and 13 sedentary adults | 11–13 y (adults 20‐26 y) | Echocardiography | Yes; Tanner stages. Post pubertal boys excluded. | Increased LV relaxation in adult and child cyclists but no LV hypertrophy in children | Med Sci Sports Med 2004;36(9);1507‐1513 |
| Ayabakan | 22 male pubertal swimmers compared with 21 age‐matched, sedentary controls. Mean 10 h training per week. | 11 y |
Echocardiography Including tissue Doppler imaging |
Yes (described as prepubertal) | No differences in tissue Doppler but increased concentric LV wall thickness in athletes compared to controls. No change in diastolic dimensions. | Cardiol in Young 2006;16:61‐66. |
| Rowland | 7 girls, 7 boys trained swimmers (5 h/week Prone swim simulation. Compared to nontrained controls | 12 y (=/− 0.5 y) |
Metabolic exercise testing Exercise Echocardiography |
No | No rise in stroke volume during exercise implying peripheral factors (increased filling) and heart rate are main determinants of cardiac output on exercise. Minor increase in LV diastolic dimension and mass in trained group. | J Sci Med Sport 2009;12:266‐272 |
| Zdravkovic | 94 highly trained male footballers | 12.85 +/− 0.84 y | Echocardiography | No | Significant increase in LV dimensions, aortic root and LA size | J Sci Sports Med 2010;13:602‐606 |
| Koch | 342 elite athletes at Sports Schools. Multiple disciplines | 10‐15 y‐old | ECG/ echocardiogram | No |
LV upper limits described Age 11: boys 10 mm, girls 9 Age 13: boys/girls 10 mm Age 15: boys 11 mm/girls 10 mm. No ECG gender differences |
Eur J Prev Cardiol 2014;21(6):774‐781 |
| Binnetoglu | 140 athletes; 6 Sports minimum 3 h per week for 2 y, sedentary controls | 10‐16 y | ECG/echocardiogram including strain imaging | No | Normal systolic and diastolic indices in athletes. 16% concentric remodeling; 28% eccentric remodeling. Strain lower in athletes. Myocardial deformation more evident in mixed sports participants. | Pediatr Cardiol 2014;35:126‐139 |
| Agrebi | Elite male national handball players; male. 3 groups of 12 | Mean age 12/16/25 y | ECG/echocardiogram | No | Chamber dilatation occurred in younger athletes but less hypertrophy compared to older athletes. | PLoS ONE 2015;10(12):e0143609. doi:10.1371/journal.pone.0143609 |
| Calo | 2261Caucasian male soccer players | Mean age 12.4 y | ECG/Echocardiogram | No | Anterior T wave inversion (>2 leads) associated with cardiac disease in 4.8%: T wave inversion (inferolateral leads) associated with disease in 60% | Heart 2015;101;193–200 |
Note: Reproduced with permission from Reference 40.