Document Type : Research Paper

Authors

1 School of Health and Sport Sciences, Liverpool Hope University, Liverpool, UK

2 Faculty of Motor Sciences, Universite Libre de Bruxelles, Belgium,

3 Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran.

Abstract

Purpose: The plasticity of the pre-adolescent cardiovascular system in response to structured endurance training remains incompletely characterized. Swimming, a unique volume-load stimulus, may promote beneficial cardiac remodeling in children, but data are scarce. This study aimed to investigate the effects of a 12-week swimming training program on cardiac structure and function in healthy, pre-adolescent boys. Method: In this study, twenty third-grade male students (age: 9.5 ± 0.5 years) were allocated to either a swimming group (Exer, n=10) or a control group (CON, n=10). The Exer group underwent a supervised swimming program (3 sessions/week, 45-60 min/session), while the CON group maintained usual activity. Echocardiographic assessments of cardiac structure (LV end-diastolic dimension [LVEDd], volume [LVEDV], mass [LV mass]) and function (stroke volume [LVSV], cardiac output [LVCO], ejection fraction [LVEF]) were performed pre- and post-intervention. Anthropometric and physiological data, including maximal oxygen consumption (VO₂max), were also collected. Results: Adherence to the training was excellent (>95%). Significant pre-to-post improvements were observed within the Exer group, including increased LVEDd (p=0.016), LVEDV (p=0.002), LV mass (p=0.001), and LVSV (p=0.006). Resting heart rate decreased and estimated VO₂max increased significantly in the Exer group (p<0.05). No significant within-group changes occurred in the CON group. Between-group analysis indicated a significant interaction effect for LVEF (p=0.044), though post-hoc analysis attributed this to a change within the SWIM group. Conclusion: A 12-week swimming training program induces significant, favorable adaptations in cardiac structure and function in pre-adolescent boys, characterized by eccentric remodeling and enhanced stroke volume. These findings demonstrate the trainability of the pre-adolescent heart and underscore the role of swimming as an effective exercise modality for promoting cardiovascular health in youth.

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 Pluim, B. M., Zwinderman, A. H., van der Laarse, A., & van der Wall, E. E; (2000). The athlete's heart: A meta-analysis of cardiac structure and function. Circulation, 101 (3): 336-344.
Weiner, R. B., & Baggish, A. L; (2012). Exercise-induced cardiac remodeling. Progress in Cardiovascular Diseases, 54 (5): 380-386.
Noushin Azadpour, Behzad Hajizadeh maleki, Sirwan Mohammad Amini Khayat, Ali Arman; (2024). Sport-Specific Cardiac Adaptations: A Comparative Echocardiographic Analysis of Basketball, Volleyball, and Handball Athletes. New Approaches in Exercise Physiology; 6(11): 246-269. doi: 10.22054/nass.2025.88049.1180
Sandberg, C. A., Åström, P., Ekblom, B., & von Koch, L; (2018). Cardiac structure and function in young elite swimmers: a comparison between trained swimmers and untrained controls. Scandinavian Journal of Medicine & Science in Sports; 28 (1): 136-144.
Baggish, A. L., & Levine, B. D; (2020). The Athlete's Heart: A Contemporary Appraisal of the 'Morganroth Hypothesis'. Sports Medicine; 50 (7): 1237–1242.
Rowland, T. W; (2011). The athlete's heart: A contemporary overview of its structure, function, and clinical implications. Cardiology in the Young, 21 (S2), 97-104.
Sascha Ketelhut, Sebastian R. Ketelhut, Kerstin Ketelhut; (2021). School-Based Exercise Intervention Improves Blood Pressure and Parameters of Arterial Stiffness in Children: A Randomized Controlled Trial. Pediatric Exercise Science (Human Kinetics); 33 (1): 1-7.
Mansi Gaitonde, Shannon Jones, Courtney McCracken, Matthew E; (2021). Evaluation of Left Ventricular Outflow Gradients during Staged Exercise Stress echocardiography helps differentiate pediatric patients with hypertrophic cardiomyopathy from athletes and normal subjects. Pediatric Exercise Science; (Human Kinetics), 33(4):196-202. doi: 10.1123/pes.2020-0217.
Naseh Abdollahzadeh, Fakhreddin Yaghoob Nezhad, Noushin Azadpour, Alain Massart; (2024). Comparative Effects of Physical Activity on Respiratory Function in Young Adult Males: A Study of Sleep Quality Relationships. New Approaches in Exercise Physiology; 6 (12). https://doi.org/10.22054/nass.2025.88456.1186
Bakhtyar Tartibian, Noushin Azadpour, Rasoul Eslami, Sirwan Mohammad Amini Khayat; (2024). Home-based exercise alters pulmonary function and cellular stress markers in overweight middle-aged men during covid-19 Home quarantine. BMC Sports Science, Medicine and Rehabilitation; 15 (61): 2-10. doi.org/10.1186/s13102-023-00673-9
Kyle, U. G., Bosaeus, I., De Lorenzo, A. D., Deurenberg, P., Elia, M., Gómez, J. M., ... & Composition of the ESPEN Working Group; (2004). Bioelectrical impedance analysis—part I: review of principles and methods. Clinical Nutrition; 23 (5): 1226-1243. https://doi.org/10.1016/j.clnu.2004.06.004
Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., ... & Lancellotti, P; (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography; 28 (1): 1-39. https://doi.org/10.1016/j.echo.2014.10.003
 Chen, M. J., Fan, X., & Moe, S. T; (2002). Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. Journal of Sports Sciences; 20(11): 873-899. doi: https://doi.org/10.1080/026404102320761787.
Fasihi, L., & Pirallahi, M. (2024). The relationship between some serum osteoporosis markers and body mass index with lumbar bone mineral density inactive postmenopausal women. New Approaches in Exercise Physiology, 6(12).
Fasihi, A., Siyahkohiyan, M., Jafarnezhadgero, A., Fasihi, L., & Sheikhalizade, H. (2021). The effect of exhaustive fatigue protocol on knee muscle co-contraction in healthy and pronated foot individuals during walking. Razi Journal of Medical Sciences, 28(8), 21–32
Lund, N., & Lund, H; (2007). Cardiac adaptation in young swimmers: a review. Pediatric Exercise Science; 19(4): 375-388.
Mazzilli, D. N., Ghorayeb, N., & Bar-Or, O; (2006). The effects of training on the cardiac function of children. The Journal of Pediatrics; 148(4): 529-534.
Vassilakopoulos, T., Tsimi, K., Fotiadis, I. A., Trakada, G., Tzallas, A., & Georgiou, M; (2016). Exercise training and cardiac structure and function in children. World Journal of Pediatrics; 12(1): 13-20.
Magalhaes, F. C., de Abreu, M. A., de Salles, B. F., & Lima, D. P; (2015). Effects of swimming training on cardiovascular risk factors in children and adolescents. Pediatric Exercise Science; 27(4): 485-495.
Omson, K., & Torg, J. S; (2010). Cardiovascular assessment of the young athlete. Sports Health; 2(4): 308-315.
Liao, Y., Liu, S., Li, C., Wang, W., Pan, Y., Zhao, H., ... & Zhao, H; (2020). Effects of swimming exercise on cardiac structure and function in young athletes: A systematic review and meta-analysis. Frontiers in Physiology; 11: 579554.