Longitudinal association of peak oxygen uptake with vascular and cardiac structure and function in German pediatric athletes.

This study aims to investigate the longitudinal associations between changes in maximal cardiorespiratory fitness (CRF) and vascular/cardiac structure and function in pediatric athletes. One hundred and forty-two pediatric athletes with data for baseline and a 1-year follow-up from the Munich Cardiovascular Adaptation in Young Athletes (MuCAYA) study [mean (SD) age at baseline: 14.0 (2.9) yr; 17 girls] were included. Parameters for CRF were peak oxygen uptake (V̇o) (L/min), relative V̇o (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 1-year progression of CRF with the progression of vascular and cardiac parameters. One-year progression in V̇o was associated with increases in central systolic blood pressure (SBP) and aortic pulse wave velocity (PWV), and a 1-year progression in maximum physical performance was associated with increases in central SBP, aortic PWV, and carotid intima-media thickness (cIMT). A 1-year V̇o 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 indexed to body surface area (BSA, LVM/BSA), and LVM/height. 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. We demonstrate the paradoxical relationships between increased CRF and increased cardiovascular parameters in pediatric athletes, suggesting that vascular and cardiac functional and structural physiologic remodeling may be present in adolescent athletes. Previous research has suggested that cardiorespiratory fitness in nonathlete youth is an independent marker for detecting altered cardiovascular and metabolic health. However, there is limited longitudinal evidence, especially in pediatric athletes, regarding the relationship between cardiorespiratory fitness and cardiovascular outcomes. We showed that a 1-year increase in peak oxygen uptake and maximum power output was associated with increased central systolic blood pressure, arterial stiffness, carotid thickness, and cardiac mass, suggestive of cardiovascular remodeling among pediatric athletes.