ASSOCIATION OF ATHLETE’S HEART WITH AEROBIC CAPACITY AND FUNCTIONAL EXERCISE PERFORMANCE IN COMPETITIVE ATHLETES

Abstract

Background: Long-term participation in competitive sports induces physiological cardiovascular adaptations collectively referred to as the athlete’s heart. Although these adaptations are well recognized, their relationship with aerobic capacity and functional exercise performance is clinically important, particularly in sports and cardiopulmonary physiotherapy. Objective: To investigate the association of athlete’s heart with aerobic capacity and functional exercise performance in competitive athletes, with particular emphasis on echocardiographic indices, VO₂peak, exercise tolerance, heart-rate response, and post-exercise recovery. Methods: A cross-sectional observational analysis was structured for 80 competitive athletes. Cardiac adaptation was evaluated using echocardiographic parameters, including left ventricular mass index (LVMI), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF). Aerobic capacity and functional exercise performance were evaluated using VO₂peak, peak workload, exercise duration, resting and peak heart rate, one-minute heart-rate recovery (HRR1), Borg Rating of Perceived Exertion, dyspnea, and training characteristics. Pearson’s correlation and multiple linear regression analyses were used, with statistical significance set at p < .05. Results: The mean VO₂peak was 49.06 ± 4.85 mL·kg⁻¹·min⁻¹. LVEDV showed a strong positive correlation with VO₂peak (r = .605, p < .001), while LVMI demonstrated a moderate positive correlation (r = .444, p < .001). LVEF was not significantly associated with VO₂peak (p = .242). VO₂peak was significantly associated with peak workload (r = .670), exercise duration (r = .629), HRR1 (r = .444), resting heart rate (r = −.499), and weekly training duration (r = .434), all p < .001.   The regression model explained 51.0% of the variance in VO₂peak (R² = .510), with LVEDV emerging as the strongest independent predictor (β = .469, p < .001), followed by weekly training hours (β = .264, p = .003) and LVMI (β = .242, p = .009). Conclusion: Physiological cardiac remodeling appears to be closely associated with aerobic capacity and functional exercise performance in competitive athletes. Greater LVEDV and LVMI were associated with higher VO₂peak, while superior aerobic capacity was accompanied by greater workload, longer exercise duration, improved heart-rate recovery, and lower resting heart rate. These findings support an integrated assessment of cardiac morphology, CPET-derived aerobic capacity, and physiotherapy-related functional measures when evaluating competitive athletes.