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Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
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Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
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Pulmonary Function Tests (PFTs)
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Cardiopulmonary Exercise Testing in Elite Athletes: Rethinking Sports Classification.

Maria Rosaria Squeo1, Armando Ferrera1, Sara Monosilio1,2

  • 1Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197 Rome, Italy.

Journal of Clinical Medicine
|July 12, 2025
PubMed
Summary
This summary is machine-generated.

Elite athletes

Keywords:
cardiopulmonary exercise testelite athletessports cardiologysports medicine

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Area of Science:

  • Sports Medicine
  • Cardiology
  • Exercise Physiology

Background:

  • The 2020 European Society of Cardiology (ESC) sports classification, based on cardiac morphology, may not fully capture functional variations in athletes.
  • Elite athletes undergo pre-participation screening to assess physiological parameters.

Purpose of the Study:

  • To characterize cardiopulmonary exercise testing (CPET)-derived physiological parameters in elite athletes across different sport categories.
  • To evaluate if the ESC morphological classification aligns with a functional categorization of athletes.

Main Methods:

  • 1033 elite athletes from skill, power, mixed, and endurance disciplines were classified.
  • Cardiopulmonary exercise testing (CPET) was conducted using a cycle ergometer ramp protocol.
  • Measurements included maximal oxygen uptake (VO2 max), heart rate, power output, and ventilatory efficiency.

Main Results:

  • Significant differences in oxygen pulse and VO2 max were observed across sport categories (p < 0.0001).
  • Endurance athletes exhibited the highest VO2 max (52.4 ± 9.7 mL/min/kg), while skill athletes had the lowest (36.3 ± 7.9 mL/min/kg).
  • VO2 max was significantly higher in power disciplines compared to mixed disciplines (p = 0.005), with some overlap noted.

Conclusions:

  • This study provides normative CPET values for elite athletes across various disciplines.
  • Significant functional differences exist among sport categories, with endurance athletes demonstrating superior cardiorespiratory fitness.
  • The ESC morphological classification shows some overlap with functional categorization, particularly between power and mixed disciplines.