https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum des Saarlandes Innere Medizin III - Kardiologie, Angiologie und internistische Intensivmedizin Homburg/Saar, Deutschland; 2O. Schäfer, Internal medicine and sports medicine Quierschied, Deutschland
Background:
Professional cycling is a complex sport. Within a professional cycling team, riders with different functions can be distinguished: allrounders, climbers with a focus on uphill stages, and sprinters. These types of riders differ not only in their physical abilities and performance data, but also in their training. Sprinters have a higher proportion of strength component in their training due to the need for rapid acceleration and explosive power. Our aim was to investigate patterns of LV hypertrophy and functional parameters in specialised subtypes of elite world-class cyclists, including Tour de France winners and Olympic medallists.
Methods:
Transthoracic echocardiography was performed in world-class elite cyclists (n=106) as part of their routine care using a portable ultrasound device (GE Vivid iq, M5Sc probe) following current guidelines. All athletes were exercising six times per week for a total of 15 to 25 hours and were categorized based on their training focus and team role (all-rounders: n=66, climbers: n=25 and sprinters: n=15). Left ventricular mass was determined using the Devereux equation and indexed to body surface area (LVMI). Left ventricular hypertrophy (LVH) was defined as LVMI ≥116 g/m2. Echocardiographic threshold for increased LV concentricity was 9.1 g/ml2/3 and for increased left ventricular enddiastolic volume (LVEDV)/BSA 76 ml/m2.
Results:
Physical characteristics differed between cyclist categories, with climbers having the lowest mean body weight and height and sprinters having the highest mean body weight (allrounder: 73±6kg and 183±6cm, climbers: 64±4kg and 178±5cm, sprinters: 78±4kg and 181±6cm). Among allrounders, 46% were diagnosed with concentric dilated LVH, 40% with eccentric dilated LVH, 11% with concentric non-dilated LVH, 2% with eccentric non-dilated LVH and 2% had normal geometry. Among climbers, 42% were classified as having concentric dilated LVH, 42% as having eccentric dilated LVH, 12 % as concentric non-dilated LVH and 4% as eccentric non-dilated LVH. Among sprinters, 53% had concentric dilated LVH, 40% eccentric dilated LVH and 7% concentric non-dilated LVH. Although the proportion of concentric dilated LVH was numerically higher in the sprinter group, no significant difference was found between subtypes (p=0.97). No significant differences in functional parameters such as diastolic function, ejection fraction, longitudinal strain or myocardial work was detected.
Conclusions:
Although world cyclist riders differ in their race performance based on their training specialisation, no differences in LV remodelling and function were detected between all-rounders, climbers and sprinters.
Figure 1: Four-tier LV geometry classification distribution for different specialized subtypes of elite cyclists. (LVMI: left ventricular mass index, LVEDVI: left ventricular end diastolic volume index, LVH: left ventricular hypertrophy)
Figure 1: Four-tier LV geometry classification distribution for different specialized subtypes of elite cyclists. (LVMI: left ventricular mass index, LVEDVI: left ventricular end diastolic volume index, LVH: left ventricular hypertrophy)