How Does Cardiac Remodelling Occur in Children in Different Types of Amateur Sports? A Single-Center Study From Türkiye

OBJECTIVE
Regular intense exercise may result in some cardiac remodelling that can be recognized on echocardiographic examinations. Here, the goal was to draw attention to how changes in the heart differ depending on the type of sport and its duration.

METHODS
Participants consisting of children aged 8-18 years (n=241) were divided into 3 groups: beginners, dynamic dominant athletes, and static dominant athletes. Cardiac remodelling types were classified as concentric hypertrophy, eccentric hypertrophy, and concentric remodelling according to increased values of the left ventricular mass and relative wall thickness.

RESULTS
The means of the left ventricular end-diastolic diameters, the z-scores, and the left atrial diameters were significantly lower in the static group than in the dynamic group. Excluding beginners, the most common echocardiographic changes were higher z-score in the interventricular septal dimension in diastole (25.3%), the left atrial diameter in diastole, the left ventricular posterior wall thickness in diastole, the left ventricular end-diastolic diameter, and the left ventricular end-systolic diameter in decreasing order. Except for beginners, the most hypertrophic pattern was eccentric in both dynamic and static groups. In total, 35% of dynamic dominant athletes and 62% of static dominant athletes showed some type of remodeling. Interventricular septum size and left ventricular end-diastolic diameter are related to training period.

CONCLUSION
According to our results, the enlargement of left ventricle and left atrium diameters is evident in dynamic athletes, while left ventricular mass changes are prominent in static athletes. In our opinion, it is important to monitor amateur child athletes with an understanding of these changes.