Teen Athletes’ Complex Heart Changes Due to Intense Sports

The cardiovascular system of adolescent athletes may adapt to greater cardiorespiratory fitness by augmenting blood pressure, arterial stiffness, and heart growth, according to a study jointly conducted by the Technical University of Munich and the University of Eastern Finland. The study’s findings were published in the American Journal of Physiology-Heart and Circulatory Physiology.

Cardiovascular Impact of Competitive Sports on Teenagers

The long-term cardiovascular effects of participating in intense and competitive sports among teenagers have been under-researched, mainly due to the rarity of clinical endpoints and diseases in this demographic.

The MuCAYA Study on Pediatric Athletes

In this study, 142 pediatric athletes from the Munich Cardiovascular Adaptation in Young Athletes (MuCAYA) study were observed during their sports clinic assessments at the Technical University of Munich in Germany for one year. These athletes underwent comprehensive aerobic fitness evaluations, including a gas-analyzed bicycle ergometer fitness test, an echocardiography of cardiac structure and function, and vascular assessments of arterial stiffness, central systolic blood pressure, and carotid intima-media thickness.

These pediatric athletes demonstrated high aerobic fitness levels, which increased over the year. However, this increase was paradoxically associated with a rise in cardiac mass or ventricular hypertrophy, central blood pressure, arterial stiffness, and carotid intima-media thickness. These changes are often deemed detrimental to cardiovascular health. For example, excessive heart enlargement is considered a risk factor for cardiac failure in adulthood. Adjustments for age, sex, and body mass index did not significantly alter these findings.

“Our study shows that highly active children and adolescents benefit from increased endurance and fitness. However, their cardiovascular system adapts in ways that we do not fully understand yet, which may have long-term effects on blood pressure, vascular stiffness, and heart structure. These findings underscore the importance of studying these physiological adaptations in greater detail to support the health of physically active children and adolescents optimally,” said Dr. Lisa Baumgartner, the study’s lead author from the Technical University of Munich, Germany.

The Importance of Monitoring Young Athletes

The study’s findings underscore the necessity for careful monitoring of young athletes. Despite the many benefits children and adolescents derive from sports, intensive training can strain the cardiovascular system. Thus, regular medical supervision and check-ups become critical to identify potential risks early, allowing young athletes to enjoy the benefits of sports without jeopardizing their long-term heart health, adds Dr. Renate Oberhoffer, Chair and Professor of Preventive Paediatrics at the Technical University of Munich in Germany.

Senior author of the study, Andrew Agbaje, a physician and associate professor (docent) of clinical epidemiology and child health at the University of Eastern Finland, supports these findings, noting that they align with his previous research on British non-athlete youth. He emphasizes the need for increased attention to the cardiovascular system’s adaptability to strenuous exercise, as elite adult athletes have been shown to be at a higher risk of cardiac and vascular heart diseases.

The Deutsche Stiftung für Herzforschung e.V., grant number F06/18, financially supported this German study.