Use Of Cpet In Routine Pre-participation Screening: Results From The Italian Experience On A Large Cohort Of Olympic Athletes

INTRODUCTION: In the context of Olympic candidate athletes, a pre-participation evaluation (PPE) lacking a cardio-pulmonary exercise test (CPET) is deemed incomplete for the sports medicine evaluation. CPET data on large cohorts of elite athletes of different ESC sports categories are lacking. PURPOSE: to analyze CPET parameters in a cohort of Olympic athletes and evaluate eventual differences among different sports categories. METHODS: We enrolled all the athletes referred to the Institute for PPE prior to the 2023 European Games in Krakow. Medical evaluation comprised history, physical examination, rest ECG, and CPET. Key markers of cardiovascular fitness, including peak VO2 in absolute values (L/min) and relative values (mL/min/kg), power output (Watt), heart rate (HR), oxygen pulse (VO2/HR), work efficiency (VO2/Watt), and respiratory quotient (RQ) were collected. At the lactate threshold and the respiratory compensation threshold, measurements included: Power, VO2, and VE/VCO2. Athletes were stratified based on gender and compared dividing the entire cohort in different sports categories according to the European Society of Cardiology (ESC) sports classification. RESULTS: Four hundred and sixty-three Olympic athletes (52% males; mean age 25 ± 5 years), were enrolled. We found significant differences in all CPET parameters, specifically both male and female endurance athletes performed better in all major cardiopulmonary fitness parameters (Figure). CONCLUSION: CPET data are provided for the first time for different sport disciplines and for male and female Olympic athletes. We found significant differences in all CPET parameters among athletes of different sports categories, with endurance showing the greatest performance. CPET data provides interesting observations on the distinctive physiological adaptations exhibited by elite athletes in different sports disciplines