Exploring morpho-functional and cardiometabolic parameters in elite female athletes with extreme anthropometry

Exercise-induced cardiac adaptation in female athletes with extreme anthropometry remains poorly defined. The aim of this study is to analyze cardiovascular and hematological features of female athletes with extreme anthropometric indices.

Olympic female athletes underwent medical evaluation including CPET and echocardiography. According to BMI and height athletes were divided into Group A (height > 186.1 cm and BMI < 27.7 kg/m²), Group B (height ≤ 186.1 cm and BMI > 27.7 kg/m²), and Group C (height 164-175 cm and BMI between 20.4 kg/m² and 23.5 kg/m²).

1137 athletes were enrolled (mean age 25.2 ± 5 years old, mean height 169.9 ± 8.1 cm, and mean BMI 22.1 ± 2.8 kg/m²). Athletes with extreme anthropometry showed same functional parameters (p = 0.071) although different relative VO₂max (VO₂ max = 39.8 ± 6.1 mL/min/kg in group C, 33.5 ± 5.5 mL/min/kg in group B, and 29.2 ± 7.4 mL/min/kg in group A, p < 0.0001), larger LV (LVEDD = 52.7 ± 3.2 mm in A, 50.9 ± 3.2 mm in B, and 49.4 ± 3 mm in control group, p < 0.0001), and, particularly in Group B, thicker IVS and PWT (p < 0.0001). Athletes with higher BMI showed a globally higher CV risk profile.

Athletes with extreme anthropometry exhibit, especially those with a high BMI, worse cardiovascular risk despite the same cardiorespiratory function. Athletes with high BMI exhibit increased LV thickness, while athletes with high height showed increased LV dimensions. Indexing for weight should not be used in extreme anthropometry.