How Does Cardiac Remodeling Occur in Children Playing Different Types of Amateur Sports? A Single-Center Study from Türkiye

OBJECTIVE
Regular intense exercise may result in cardiac remodeling, which can be identified through echocardiographic examinations. This study aims to highlight how cardiac changes vary based on the type and duration of sports participation.


METHOD
The study included children aged 8-18 years (n = 241), who were divided into three groups: beginners, dynamic dominant athletes, and static dominant athletes. Cardiac remodeling was categorized into concentric hypertrophy, eccentric hypertrophy, and concentric remodeling based on increased values of left ventricular mass and relative wall thickness.


RESULTS
Mean left ventricular end-diastolic diameters, z-scores, and left atrial diameters were significantly lower in the static group compared to the dynamic group. Among participants, excluding beginners, most common echocardiographic change was an increased z-score in the interventricular septal dimension during diastole (25.3%), followed by an increase in the left atrial diameter in diastole, left ventricular posterior wall thickness in diastole, left ventricular end-diastolic diameter, and left ventricular end-systolic diameter. In both dynamic and static groups, excluding beginners, the most prevalent hypertrophic pattern was eccentric hypertrophy. Overall, 35% of dynamic dominant athletes and 62% of static dominant athletes exhibited some form of remodeling. Additionally, interventricular septum size and left ventricular end-diastolic diameter were associated with the training period.


CONCLUSION
Our findings indicate that enlargement of the left ventricle and left atrium diameters is more pronounced in dynamic athletes, whereas changes in left ventricular mass are more prominent in static athletes. We believe that monitoring amateur child athletes with an understanding of these changes is important.