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DOI: 10.1055/s-2004-817857
© Georg Thieme Verlag KG Stuttgart · New York
Relationships between Left Ventricular Morphology, Diastolic Function and Oxygen Carrying Capacity and Maximal Oxygen Uptake in Children
Publication History
Accepted after revision: January 12, 2004
Publication Date:
30 July 2004 (online)
Abstract
Little attention has been paid to children with respect to factors controlling maximal oxygen uptake (V·O2max). This study was therefore specifically designed to examine the potential relationships between cardiac size, diastolic function and O2 carrying capacity with maximal aerobic capacity. Specifically, body size indices (body surface area, lean body mass), resting left ventricular dimensions and filling characteristics, blood haemoglobin concentration as well as V·O2max established during a maximal cycle exercise test were assessed in a large cohort (n = 142) of healthy 10 - 11 year old boys and girls. Results were compared between groups of low (< 50, L), moderate (50 - 60, M) and high (> 60, H) V·O2max (ml · min-1 · kg-1 of lean body mass). Moreover, potential contributors to V·O2max variance were investigated using univariate and multivariate regression analyses over the overall population. The major results show no differences between the 3 groups for all diastolic and systolic function indices as well as blood haemoglobin and systemic vascular resistances (used as an index of afterload). None of these variables emerged from regression analyses as potential predictors of V·O2max. After accounting for body size variation, heart dimensions, and especially left ventricular internal dimensions, differed between H and M and L and were associated with higher cardiac filling and subsequently stroke volume. Strong relationships between V·O2max and heart dimensions were noticed, due primarily but not exclusively to the influence of body size. After adjusting for lean body mass, end-diastolic diameter contributed modestly (8 %) but significantly to V·O2max variance, which is biologically meaningful.
Key words
V·O2max - cardiac size - diastolic function - O2 carrying capacity - children
References
- 1 Basset D, Howley E. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000; 32 70-84
-
2 Belle R, Macek M, Rutenfranz J, Saris W HM.
Health indicators and risk factors of cardiovascular diseases during childhood and adolescence. Rutenfranz J, Mocellin R, Klimt F Children and Exercise XII, International Series on Sport Sciences. Vol. 17. Champaign, Illinois; Human Kinetics 1986: 27-29 - 3 Blimkie C, Cunningham D, Nichol P. Gas transport capacity and echocardiographically determined cardiac size in children. J Appl Physiol. 1980; 49 994-999
- 4 Bouchard C, Malina R, Perusse R. Genetics of Fitness and Physical Performance. Vol. 11. Champaign; Human Kinetics 1997: 246-249
- 5 Colan S D. Mechanics of left ventricular systolic and diastolic function in physiologic hypertrophy of the athlete's heart. Cardiol Clinics. 1992; 10 227-240
- 6 Daniels S R, Kimball T R, Morrison J A, Khoury P, Meyer R A. Indexing left ventricular mass for differences in body size in children and adolescents without cardiovascular disease. Am J Cardiol. 1995; 76 699-701
- 7 Devereux R B, Alonso D R, Lutas E M. et al . Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy. Am J Cardiol. 1986; 57 450-458
- 8 DiBello V, Santoro G, Talarico L. et al . Left ventricular function during exercise in athletes and in sedentary men. Med Sci Sports Exerc. 1996; 28 190-196
- 9 DuBois D, DuBois E F. Nomogramme pour la détermination de la surface cutanée à partir de la taille et du poids. Arch Int Med. 1916; 17 863-871
- 10 Durnin J V, Rahaman M M. The assessment of the amount of fat in the human body from measurements of skinfold thickness. Br J Nutr. 1967; 21 681-689
- 11 Eisenman J C, Katzmarzyk P T, Thériault G, Song T MK, Malina R M, Bouchard C. Cardiac dimensions, physical activity and submaximal working capacity in youth of the Québec Family Study. Eur J Appl Physiol. 2000; 81 40-46
- 12 Eriksson B O, Koch G. Effect of physical training on hemodynamic response during submaximal and maximal exercise in 11 - 13-year-old boys. Acta Physiol Scand. 1973; 87 27-39
- 13 Ginzton L E, Conant R, Brizendine M, Lacks M M. Effect of long-term high intensity aerobic training on left ventricular volume during maximal upright exercise. J Am Coll Cardiol. 1989; 14 364-371
- 14 Gledhill N, Cox D, Jamnik R. Endurance athletes' stroke volume does not plateau: major advantage is diastolic function. Med Sci Sports Exerc. 1994; 26 1116-1121
- 15 Gledhill N, Warbuton D, Jamnik V. Haemoglobin, blood volume, cardiac function and aerobic power. Can J Appl Physiol. 1999; 24 54-65
- 16 Huonker M, Köning D, Keul J. Assessment of left ventricular dimensions and functions in athletes and sedentary subjects at rest and during exercise using echocardiography, Doppler sonography and radionuclide ventriculography. Int J Sports Med. 1996; 17 S173-S179
- 17 Jensen-Urstadt M, Bouvier F, Nejat M, Saltin B, Brodin L A. Left ventricular function in endurance runners during exercise. Acta Physiol Scand. 1998; 164 167-172
- 18 Koch G. Muscle blood flow in prepubertal boys. Medicine Sport. 1978; 11 39-46
- 19 Krip B, Gledhill N, Jamnik V, Warburton D. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc. 1997; 29 1469-1476
- 20 Levy W C, Cerqueira M D, Abrass I B, Schwartz R S, Stratton J R. Endurance exercise training augments diastolic filling at rest and during exercise in healthy young and older men. Circulation. 1993; 88 116-126
- 21 Lewis J F, Kuo L C, Nelson J G, Limacher M C, Quinones M A. Doppler echocardiographic determination of stroke volume and cardiac output: clinical validation of two new methods using the apical window. Circulation. 1984; 70 425-431
- 22 Matsuda M, Sugishita Y, Koseki S, Ito I, Akatsuka T, Takamatsu K. Effect of exercise on left ventricular diastolic filling in athletes and nonathletes. J Appl Physiol. 1983; 55 323-328
- 23 Medved R, Fabecic-Sabadi V, Medved V. Echocardiographic findings in children participating in swimming training. Int J Sports Med. 1986; 7 94-99
- 24 Nixon J V, Wright A R, Porter T R, Roy V, Arrowood J A. Effects of exercise on LV diastolic performance in trained athletes. Am J Cardiol. 1991; 68 945-949
- 25 Nottin S, Vinet A, Stecken F, N'Guyen L D, Ounissi F, Lecoq A M, Obert P. Central and peripheral cardiovascular adaptations to exercise in endurance-trained children. Acta Physiol Scand. 2002; 175 85-92
- 26 Obert P, Stecken F, Courteix D, Lecoq A M, Guenon P. Effect of long-term intensive endurance training on left ventricular structure and diastolic function in prepubertal children. Int J Sports Med. 1998; 19 149-154
- 27 Obert P, Mandigout S, Vinet A, N'Guyen L D, Stecken F, Courteix D. Effect of aerobic training and detraining on left ventricular dimensions and diastolic function in prepubertal boys and girls. Int J Sports Med. 2001; 22 90-96
- 28 Obert P, Mandigout S, Nottin S, Vinet A, N'Guyen L D, Lecoq A M. Cardiovascular response to endurance training in children: effect of gender. Eur J Clin Invest. 2003; 33 199-208
- 29 Oyen E M, Schuster S, Brode P E. Dynamic exercise echocardiography of the left ventricle in physically trained children compared to untrained healthy children. Int J Cardiol. 1990; 29 29-33
- 30 Ozer S, Cil E, Baltaci G, Ergun N, Ozme S. Left ventricular structure and function by echocardiography in childhood swimmers. Jpn Heart J. 1994; 35 300-306
- 31 Pathe M, Laurenceau J L, Baron B, Marchand X, Rocha P, Zannier D, Kahn J C. Influence of preload changes on the filling function of the left heart ventricle studied by Doppler echocardiography. Arch Mal Coeur Vaiss. 1990; 83 2061-2066
- 32 Rowland T, Goff D, Popowski B, DeLuca P, Ferrone L. Cardiac responses to exercise in child distance runners. Int J Sports Med. 1998; 19 385-390
- 33 Rowland T, Wehnert M, Miller K. Cardiac responses to exercise in competitive child cyclists. Med Sci Sports Exerc. 2000; 32 747-752
- 34 Rowland T, Goff D, Martel L, Ferrone L. Influence of cardiac functional capacity on gender differences in maximal oxygen uptake in children. Chest. 2000; 117 629-635
- 35 Rowland T W, Unninthan V B, Macfarlane N G, Gibson N G, Paton J Y. Clinical manifestations of the “athlete's heart” in prepubertal male runners. Int J Sports Med. 1994; 8 515-519
- 36 Sahn D J, DeMaria A, Kisslo J, Weyman G. Recommendations regarding quantitation in M-mode echocardiographic measurements. Circulation. 1978; 58 1072-1083
- 37 Senior D G, Waters K L, Cassidy M, Crucitti T, Shapiro H, Riba A L. Effect of aerobic training on left ventricular diastolic filling. Conn Med. 1989; 53 67-70
- 38 Triposkiadis F, Ghiokas S, Skoularigis I, Kotsakis A, Giannakoulis I, Thanopoulos V. Cardiac adaptation to intensive training in prepubertal swimmers. Eur J Clin Invest. 2002; 32 16-23
- 39 Vanoverschelde J L, Essamri B, Vanbutsele R, D'Hont A M, Cosyns J R, Detry J MR, Melin J A. Contribution of ventricular diastolic function to exercise capacity in normal subjects. J Appl Physiol. 1993; 74 2225-2233
- 40 Vinet A, Mandigout S, Nottin S, N'Guyen L D, Lecoq A M, Couteix D, Obert P. Influence of body composition, hemoglobin concentration, cardiac size and function on gender differences in maximal oxygen uptake in prepubertal children. Chest. 2003; 124 1494-1499
- 41 Zahka K G. Report of the second Task Force on blood pressure control in children. Md Med J. 1987; 36 323-325
Prof. P. Obert
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