219
Relationships between Cardiac Dimensions, Anthropometric Characteristics and Maximal Aerobic Power (VO2max) in Young Men G. Osborne, L. A. Wolfe, G. W. Burggraf R. Norman School of Physical and Health Education, Queen's University and Division of Cardiology, Queen's University, Kingston, Ontario, Canada
Introduction G. Osborne, L. A. Wolfe, G. W. Burggraf and
R. Norman, Relationships between Cardiac Dimensions, Anthropometric Characteristics and Maximal Aerobic Power (VO2max) in Young Men. Tnt J Sports Med, Vol 13, No3,pp219—224, 1992.
Accepted: September 15, 1991
Echocardiographic dimensions, anthropometric data and maximal oxygen uptake (VO2max) were studied in 26 healthy sedentary male controls (mean age, 22.0 yrs) and 15 male endurance athletes (mean age, 20.3 yrs). Athletes displayed significantly greater mean values
for left ventricular internal dimension at end-diastole
(LVIDd), end-diastolic volume (LVEDV) and left ventricular mass (LVM). Statistically significant positive correlations were observed within the sedentary control group be-
tween left ventricular end-diastolic dimensions (LVIDd, mm and/or LVEDV, cm3) and body height (cm), body weight kg), chest circumference (cm) and body surface area (m ). Left ventricular mass (LVM, g) correlated significantly with lean body mass (kg). Ectomorphic somatotype rating (Ecto) correlated negatively with LVEDV and LVM.
Finally, VO2max (1/mm) correlated significantly with LVIDd, LVEDV and LVM. Multiple linear regression anal-
ysis indicated that the degree of endomorphy (Endo), LVIDd (mm/m2) and chest circumference accounted for 89% of the variance in VO2max (mi/kg/mm) within the athlete group. Endo, Ecto and LVIDd (mm/rn2) accounted for 86% of the variance in VO2max (ml/kg/min) in the control group. This study supports the hypothesis that maximal
aerobic power can be predicted from cardiac and anthropometric measurements. Key words
Echocardiography, anthropometry, maximal oxygen uptake
It is well established that elite male endurance athletes, when compared to sedentary non-athletes, are characterized by a high ectomorphic (lean body build) somatotype
rating (29), a greater maximal aerobic power (VO2max,
mi/kg/mm) and greater values for left ventricular internal dimension during diastole (LVIDd) and left ventricular mass (LVM) as determined by echocardiography (33).
Morganroth and Maron (20) hypothesized
that the enlarged cardiac dimensions exhibited by elite athletes depend on two factors: training intensity and type of physical conditioning. They proposed that strenuous dynamic or isotonic conditioning results in dilation of the left ventricular cavity with no significant alteration in the left ventricular wall thickness (i. e. eccentric cardiac enlargement).
Longitudinal conditioning studies are designed specifically to analyze chronic exercise effects on heart size. Published studies have reported rapid and highly significant enlargement (11), moderate increases (1, 6, 7, 34) and no significant change (23, 25, 30, 31) in echocardiographic cardiac dimensions following short-term conditioning.
Other published studies indicate that factors other than conditioning may play an important role in the cardiac enlargement process. For instance, twin studies (2, 5, 18) have examined the importance of genetic and/or non-training environmental influences on the heart, while others (3, 22, 32)
have observed significant positive correlations between indexes of skeletal and cardiac muscularity.
The present study analyzed the relationships between maximal aerobic power (VO2max), specific anthropometric variables (eg. somatotype, skinfolds, body girths, percent body fat, lean body mass, and body surface area), and echocardiographicallyd etermined cardiac dimensions both in healthy sedentary young men and in successful endurance athletes. It was hypothesized that body dimensions, cardiac dimensions and VO2max are significantly correlated in healthy young men. Methodology
Subject Selection Int.J.SportsMed. 13(1992)219—224 GeorgThieme VerlagStuttgartNewYork
Subjects were 26 healthy, nonsmoking male volunteers (mean age, 22.0 years) from the student population
Downloaded by: Queen's University. Copyrighted material.
Abstract
220 mt. J. Sports Med. 13(1992)
G. Osborne, L. A. Wolfe, G. W. Burggraf R. Norman
two years.
Each subject participated in three laboratory sessions. The initial visit included a complete explanation of
the equipment and testing protocol. An informed consent form was read and signed by each individual at this time. Medical screening procedures involved completion of a PARQ Health Questionnaire, measurement of resting blood pres-
sure and a recording of a resting 12-lead electrocardiogram (physician interpreted). Finally, during this visit, all anthropometric data were collected as described below. The second session took place at Hotel Dieu Hospital (Kingston, Ontario), and involved the assessment of resting cardiac dimensions by echocardiography. The final session involved the de-
Echocardiographic Measurements Left ventricular echocardiograms were obtained by an experienced technician, with subjects in the resting state, head tilted up at 30 degrees and in the left lateral decubitus position. Measurements were obtained using a Hewlett-Packard model HP77020 two-dimensional imaging system, 2.25 MHz phased array transducer, and a Honeywell strip chart recorder. To avoid respiratory variability, tracings were recorded at the end of normal expiration. The left ventricle was observed in the standard parasternal two-dimension long axis plane. M-mode recordings (paper speed, 50 mm/sec.) were derived from a cursor line crossing the left ventricle at or just below the tips of the mitral valve leaflets. M-mode recordings were analyzed by an in-
dependent experienced reader without the knowledge of the subjects' identities or group allocations, and in accordance with the Penn convention (9). Basic measurements, expressed to the nearest mm, were the following: left ventricular internal dimension at end-diastole (LVIDd); left ventricular internal dimension at end-systole (LVIDs); posterior wall thickness at end-diastole (PWT); thickness of the interventricular septum at end-diastole (ST).
termination of their VO2max.
The R wave peak of a simultaneously recorded electrocardiogram was used as the reference point for end-diastolic measurements. LVIDs was taken as the minimum sepa-
Anthropometric Measurements Body height (cm) and body weight (kg) were determined. Body surface area (m2) was calculated from the height and weight measurements using the Dubois-Meeh formula. Skinfold sites were assessed using Harpenden calipers and included the triceps, biceps, subscapular, iliac and medial calf skinfolds. Girth measurements included the chest (after normal expiration), the abdomen, the hip, the right biceps (when fully contracted) and the right calf (when in a relaxed state with the leg bent at 90 degrees). Humerus and femur biepicondylar diameters were measured using Harpenden anthropometers. Somatotype was evaluated using the data described above and the Heath-Carter rating method (17).
Body density (Db) was determined via hydro-
static weighing, where: Db = (body weightwater density)/[body
weight — (underwater
weight + (water
den-
sityresidual volume))]. In this regard, vital capacity of the lung (VC) was determined using a Cavitron Model SC-20 spirometer and residual lung volume estimated as 0.24 VC. Percentage body fat was calculated from body density (Db) using the formula of Brozek: % Fat 4.570/Db —4.142. Lean body mass was calculated as total body weight minus fat weight.
Maximal Exercise Testing Maximal aerobic power (VO2max) was determined using the Bruce treadmill protocol and a Beckman Metabolic Measurement Cart. Heart rate was determined electrocardiographically. Criteria for attainment of maximal oxygen uptake were levelling off of VO2max despite an increase in work rate, or attainment of age-predicted maximal heart rate (220 beats/minute — age) and a respiratory exchange ratio greaterthan 1.1.
ration of the posterior wall and septum during systole. All measurements were the average of 5 heart cycles in held expiration. Left ventricular mass (LVM, g) was estimated using a previously validated (8) regression corrected "cube formula":
LV mass= 1.04 [(LVIDd+PWT+ST)3—LVIDd3]--- 14, when echocardiographic measurements are expressed in cm. A modification of Simpson's Rule (10) was implemented to calculate left ventricular end-diastolic volume (LVEDV). In this regard: LVEDV = (AmL/3) + [(Am + Ap)/2-L/3] + (1/3 Ap-L/3), where: Am = area of the mitral plane determined from 2-D short axis view; Ap area of the papillary muscle plane determined from 2-D short axis view; L = longitudinal diameter of the left ventricle determined from a 2-D long axis view. It was represented as the longest recorded value from either the 2 chamber or the 4 chamber view. It was assumed that the length of each section was one-third the longitudinal diameter of the left ventricle (10). All measurements included the myocardium of the left ventricle. The peak of a simultaneously recorded electrocardiogram was used as the reference point for all two-dimensional measurements. All recordings were analyzed by an independent experienced reader without the knowledge of the subjects' identities or group allocation.
Statistical Analysis VO2max, body dimensions and left ventricular dimensions of the two subject groups were compared using unpaired Student t-statistics. A correlation grid (Pearson product-moment correlation coefficient) was established within the overall nonathietic subject group (n = 26) for relevant experimental variables (VO2max, somatotype ratings, body dimensions and cardiac dimensions). This was utilized to detect any associations which may exist between VO2max, body dimensions and cardiac dimensions. Data from the athletic
Downloaded by: Queen's University. Copyrighted material.
at Queen's University. Most (n = 18) of the subjects had not engaged in any regular fitness conditioning for at least two years prior to the study. Eight additional subjects participated in recreational sports, but none engaged in any type of intensive sports training. A reference group which included 15 successful young male endurance athletes (long-distance runners) were recruited from the Queen's varsity track and cross country team (mean age, 20.3 years). The athletes were evaluated at the end of the cross country running season and had been averaging 50 miles/week of conditioning over the last
mt. I Sports Med. 13(1992) 221
Prediction of 170 2max
Nonathletic Group. Variable
Athletes
Nonathletes
(n=15)
(n=26)
TaWe 2 Cardiac Measurements of the Athletic Group and the Nonathletic Group. Athletes
Variable
Nonathletes
(n=15)
(n=26)
Body Surface
1.89±0.10
1.96±0.17
54±7*
Area (m2)
(1.66—2.02)
(1.75—2.46)
Resting Heart Rate (beats/mm)
66±10
(44—68)
(48—94)
Body Height (cm)
181.6±5.9
179.7±6.1
LVIDd (mm)
55.3±3.7*
52.0±4.4
(167.0—193.7)
(165.8—193.4)
(48.0—61.0)
(43.0—60.0)
Chest Circumference
91.2±4.4
95.3±9.5
26.6±2.1
(82.4—102.0)
(81.5—119.5)
LVIDd (mm/rn2 BSA)
29.3±1.8*
(cm)
25.3—31.4)
22.0—30.6)
Body Weight (kg)
68.6±5.4*
76.3±14.7
LVIDs (mm)
36.0 1.9
34.3 3.5
(58.6—78.2)
(60.5—123.8)
(33.0—41.0)
(29.0—42.0)
Endomorphy Rating
2.5±0.7*
4.8±2.1
9.2±0.8
8.7± 1.0
(1.5—4.0)
(1.5—9.0)
(8.0—10.0)
(7.0—11.0)
Mesomorphy Rating
2.3±0.4
2.8±1.3
8.4±1.1
7.8±1.3
(1.5—3.0)
(0.5—5.5)
(6.0—10.0)
(6.0—10.0)
Ectomorphy Rating
4.0±0.7
2.9±1.4
214±37
178±50
(3.0—5.5)
(0.5—5.0)
(180—303)
(96—296)
Percent Body Fat
10.7±2.2*
18.3±6.4
91±24
(7.8—33.8)
LVM (g/m2 BSA)
113±18*
(6.2—14.8)
(79—153)
(52—147)
Lean body Mass (kg)
61.2±4.2
61.7±8.5
LVEDV (cm3)
349±40*
283±52
(54.5—68.6)
(50.7—82.0)
(267—425)
(204—428)
Maximal Aerobic Power (mI/kg/mm)
66.9±5.4*
48.9±7.3
LVEDV
185±18*
144±19
(57.1—73.9)
(31.9—62.3)
(cm/rn2 BSA)
(152—215)
(114—194)
ST/LVIDd Ratio
0.15±0.02
0.15±0.03
(0.11—0.21)
(0.11—0.21)
0.17±0.02
0.17±0.02
(0.14—0.21)
(0.14—0.23)
Values are±standard deviation (range in parentheses). *Mean values of athletes significantly different from nonathietes (p
Relationships between Cardiac Dimensions, Anthropometric Characteristics and Maximal Aerobic Power (VO2max) in Young Men G. Osborne, L. A. Wolfe, G. W. Burggraf R. Norman School of Physical and Health Education, Queen's University and Division of Cardiology, Queen's University, Kingston, Ontario, Canada
Introduction G. Osborne, L. A. Wolfe, G. W. Burggraf and
R. Norman, Relationships between Cardiac Dimensions, Anthropometric Characteristics and Maximal Aerobic Power (VO2max) in Young Men. Tnt J Sports Med, Vol 13, No3,pp219—224, 1992.
Accepted: September 15, 1991
Echocardiographic dimensions, anthropometric data and maximal oxygen uptake (VO2max) were studied in 26 healthy sedentary male controls (mean age, 22.0 yrs) and 15 male endurance athletes (mean age, 20.3 yrs). Athletes displayed significantly greater mean values
for left ventricular internal dimension at end-diastole
(LVIDd), end-diastolic volume (LVEDV) and left ventricular mass (LVM). Statistically significant positive correlations were observed within the sedentary control group be-
tween left ventricular end-diastolic dimensions (LVIDd, mm and/or LVEDV, cm3) and body height (cm), body weight kg), chest circumference (cm) and body surface area (m ). Left ventricular mass (LVM, g) correlated significantly with lean body mass (kg). Ectomorphic somatotype rating (Ecto) correlated negatively with LVEDV and LVM.
Finally, VO2max (1/mm) correlated significantly with LVIDd, LVEDV and LVM. Multiple linear regression anal-
ysis indicated that the degree of endomorphy (Endo), LVIDd (mm/m2) and chest circumference accounted for 89% of the variance in VO2max (mi/kg/mm) within the athlete group. Endo, Ecto and LVIDd (mm/rn2) accounted for 86% of the variance in VO2max (ml/kg/min) in the control group. This study supports the hypothesis that maximal
aerobic power can be predicted from cardiac and anthropometric measurements. Key words
Echocardiography, anthropometry, maximal oxygen uptake
It is well established that elite male endurance athletes, when compared to sedentary non-athletes, are characterized by a high ectomorphic (lean body build) somatotype
rating (29), a greater maximal aerobic power (VO2max,
mi/kg/mm) and greater values for left ventricular internal dimension during diastole (LVIDd) and left ventricular mass (LVM) as determined by echocardiography (33).
Morganroth and Maron (20) hypothesized
that the enlarged cardiac dimensions exhibited by elite athletes depend on two factors: training intensity and type of physical conditioning. They proposed that strenuous dynamic or isotonic conditioning results in dilation of the left ventricular cavity with no significant alteration in the left ventricular wall thickness (i. e. eccentric cardiac enlargement).
Longitudinal conditioning studies are designed specifically to analyze chronic exercise effects on heart size. Published studies have reported rapid and highly significant enlargement (11), moderate increases (1, 6, 7, 34) and no significant change (23, 25, 30, 31) in echocardiographic cardiac dimensions following short-term conditioning.
Other published studies indicate that factors other than conditioning may play an important role in the cardiac enlargement process. For instance, twin studies (2, 5, 18) have examined the importance of genetic and/or non-training environmental influences on the heart, while others (3, 22, 32)
have observed significant positive correlations between indexes of skeletal and cardiac muscularity.
The present study analyzed the relationships between maximal aerobic power (VO2max), specific anthropometric variables (eg. somatotype, skinfolds, body girths, percent body fat, lean body mass, and body surface area), and echocardiographicallyd etermined cardiac dimensions both in healthy sedentary young men and in successful endurance athletes. It was hypothesized that body dimensions, cardiac dimensions and VO2max are significantly correlated in healthy young men. Methodology
Subject Selection Int.J.SportsMed. 13(1992)219—224 GeorgThieme VerlagStuttgartNewYork
Subjects were 26 healthy, nonsmoking male volunteers (mean age, 22.0 years) from the student population
Downloaded by: Queen's University. Copyrighted material.
Abstract
220 mt. J. Sports Med. 13(1992)
G. Osborne, L. A. Wolfe, G. W. Burggraf R. Norman
two years.
Each subject participated in three laboratory sessions. The initial visit included a complete explanation of
the equipment and testing protocol. An informed consent form was read and signed by each individual at this time. Medical screening procedures involved completion of a PARQ Health Questionnaire, measurement of resting blood pres-
sure and a recording of a resting 12-lead electrocardiogram (physician interpreted). Finally, during this visit, all anthropometric data were collected as described below. The second session took place at Hotel Dieu Hospital (Kingston, Ontario), and involved the assessment of resting cardiac dimensions by echocardiography. The final session involved the de-
Echocardiographic Measurements Left ventricular echocardiograms were obtained by an experienced technician, with subjects in the resting state, head tilted up at 30 degrees and in the left lateral decubitus position. Measurements were obtained using a Hewlett-Packard model HP77020 two-dimensional imaging system, 2.25 MHz phased array transducer, and a Honeywell strip chart recorder. To avoid respiratory variability, tracings were recorded at the end of normal expiration. The left ventricle was observed in the standard parasternal two-dimension long axis plane. M-mode recordings (paper speed, 50 mm/sec.) were derived from a cursor line crossing the left ventricle at or just below the tips of the mitral valve leaflets. M-mode recordings were analyzed by an in-
dependent experienced reader without the knowledge of the subjects' identities or group allocations, and in accordance with the Penn convention (9). Basic measurements, expressed to the nearest mm, were the following: left ventricular internal dimension at end-diastole (LVIDd); left ventricular internal dimension at end-systole (LVIDs); posterior wall thickness at end-diastole (PWT); thickness of the interventricular septum at end-diastole (ST).
termination of their VO2max.
The R wave peak of a simultaneously recorded electrocardiogram was used as the reference point for end-diastolic measurements. LVIDs was taken as the minimum sepa-
Anthropometric Measurements Body height (cm) and body weight (kg) were determined. Body surface area (m2) was calculated from the height and weight measurements using the Dubois-Meeh formula. Skinfold sites were assessed using Harpenden calipers and included the triceps, biceps, subscapular, iliac and medial calf skinfolds. Girth measurements included the chest (after normal expiration), the abdomen, the hip, the right biceps (when fully contracted) and the right calf (when in a relaxed state with the leg bent at 90 degrees). Humerus and femur biepicondylar diameters were measured using Harpenden anthropometers. Somatotype was evaluated using the data described above and the Heath-Carter rating method (17).
Body density (Db) was determined via hydro-
static weighing, where: Db = (body weightwater density)/[body
weight — (underwater
weight + (water
den-
sityresidual volume))]. In this regard, vital capacity of the lung (VC) was determined using a Cavitron Model SC-20 spirometer and residual lung volume estimated as 0.24 VC. Percentage body fat was calculated from body density (Db) using the formula of Brozek: % Fat 4.570/Db —4.142. Lean body mass was calculated as total body weight minus fat weight.
Maximal Exercise Testing Maximal aerobic power (VO2max) was determined using the Bruce treadmill protocol and a Beckman Metabolic Measurement Cart. Heart rate was determined electrocardiographically. Criteria for attainment of maximal oxygen uptake were levelling off of VO2max despite an increase in work rate, or attainment of age-predicted maximal heart rate (220 beats/minute — age) and a respiratory exchange ratio greaterthan 1.1.
ration of the posterior wall and septum during systole. All measurements were the average of 5 heart cycles in held expiration. Left ventricular mass (LVM, g) was estimated using a previously validated (8) regression corrected "cube formula":
LV mass= 1.04 [(LVIDd+PWT+ST)3—LVIDd3]--- 14, when echocardiographic measurements are expressed in cm. A modification of Simpson's Rule (10) was implemented to calculate left ventricular end-diastolic volume (LVEDV). In this regard: LVEDV = (AmL/3) + [(Am + Ap)/2-L/3] + (1/3 Ap-L/3), where: Am = area of the mitral plane determined from 2-D short axis view; Ap area of the papillary muscle plane determined from 2-D short axis view; L = longitudinal diameter of the left ventricle determined from a 2-D long axis view. It was represented as the longest recorded value from either the 2 chamber or the 4 chamber view. It was assumed that the length of each section was one-third the longitudinal diameter of the left ventricle (10). All measurements included the myocardium of the left ventricle. The peak of a simultaneously recorded electrocardiogram was used as the reference point for all two-dimensional measurements. All recordings were analyzed by an independent experienced reader without the knowledge of the subjects' identities or group allocation.
Statistical Analysis VO2max, body dimensions and left ventricular dimensions of the two subject groups were compared using unpaired Student t-statistics. A correlation grid (Pearson product-moment correlation coefficient) was established within the overall nonathietic subject group (n = 26) for relevant experimental variables (VO2max, somatotype ratings, body dimensions and cardiac dimensions). This was utilized to detect any associations which may exist between VO2max, body dimensions and cardiac dimensions. Data from the athletic
Downloaded by: Queen's University. Copyrighted material.
at Queen's University. Most (n = 18) of the subjects had not engaged in any regular fitness conditioning for at least two years prior to the study. Eight additional subjects participated in recreational sports, but none engaged in any type of intensive sports training. A reference group which included 15 successful young male endurance athletes (long-distance runners) were recruited from the Queen's varsity track and cross country team (mean age, 20.3 years). The athletes were evaluated at the end of the cross country running season and had been averaging 50 miles/week of conditioning over the last
mt. I Sports Med. 13(1992) 221
Prediction of 170 2max
Nonathletic Group. Variable
Athletes
Nonathletes
(n=15)
(n=26)
TaWe 2 Cardiac Measurements of the Athletic Group and the Nonathletic Group. Athletes
Variable
Nonathletes
(n=15)
(n=26)
Body Surface
1.89±0.10
1.96±0.17
54±7*
Area (m2)
(1.66—2.02)
(1.75—2.46)
Resting Heart Rate (beats/mm)
66±10
(44—68)
(48—94)
Body Height (cm)
181.6±5.9
179.7±6.1
LVIDd (mm)
55.3±3.7*
52.0±4.4
(167.0—193.7)
(165.8—193.4)
(48.0—61.0)
(43.0—60.0)
Chest Circumference
91.2±4.4
95.3±9.5
26.6±2.1
(82.4—102.0)
(81.5—119.5)
LVIDd (mm/rn2 BSA)
29.3±1.8*
(cm)
25.3—31.4)
22.0—30.6)
Body Weight (kg)
68.6±5.4*
76.3±14.7
LVIDs (mm)
36.0 1.9
34.3 3.5
(58.6—78.2)
(60.5—123.8)
(33.0—41.0)
(29.0—42.0)
Endomorphy Rating
2.5±0.7*
4.8±2.1
9.2±0.8
8.7± 1.0
(1.5—4.0)
(1.5—9.0)
(8.0—10.0)
(7.0—11.0)
Mesomorphy Rating
2.3±0.4
2.8±1.3
8.4±1.1
7.8±1.3
(1.5—3.0)
(0.5—5.5)
(6.0—10.0)
(6.0—10.0)
Ectomorphy Rating
4.0±0.7
2.9±1.4
214±37
178±50
(3.0—5.5)
(0.5—5.0)
(180—303)
(96—296)
Percent Body Fat
10.7±2.2*
18.3±6.4
91±24
(7.8—33.8)
LVM (g/m2 BSA)
113±18*
(6.2—14.8)
(79—153)
(52—147)
Lean body Mass (kg)
61.2±4.2
61.7±8.5
LVEDV (cm3)
349±40*
283±52
(54.5—68.6)
(50.7—82.0)
(267—425)
(204—428)
Maximal Aerobic Power (mI/kg/mm)
66.9±5.4*
48.9±7.3
LVEDV
185±18*
144±19
(57.1—73.9)
(31.9—62.3)
(cm/rn2 BSA)
(152—215)
(114—194)
ST/LVIDd Ratio
0.15±0.02
0.15±0.03
(0.11—0.21)
(0.11—0.21)
0.17±0.02
0.17±0.02
(0.14—0.21)
(0.14—0.23)
Values are±standard deviation (range in parentheses). *Mean values of athletes significantly different from nonathietes (p
