Evaluation and application of treadmill Cardiopulmonary Exercise Testing and field measurement results of female national team water polo players
Authors: Zamodics M , Babity M , Bucsko-Varga A , Kovacs E , Kulcsar P , Benko R , Boroncsok D , Grebur K , Fabian A , Horvath M , Lakatos B , Vago H , Kovacs A , Merkely B , Kiss O 
Published: November 2023

Abstract

Introduction
Due to intensive sport adaptation, examinations of elite athletes are a special entity of cardiology. Cardiovascular follow-up of elite athletes is a significant method of supporting safe and successful sport. In many sports like water polo, training work takes place in different environments and with different forms of movement, then the tests applied in laboratory circumstances. Although treadmill cardiopulmonary exercise testing (CPET) is widely used in cardiology screening, we have little information of its usefulness in physical fitness follow-up in non-running sports.

Purpose
We aimed to analyze and to compare the data of elite youth team (YT) and adult water polo players collected from maximal intensity cardio-pulmonary exercise testing (CPET) and field examinations in definition of current fitness status of the different age groups.

Methods
During the age- and sport specific field measurements (swimming tests) and CPET examinations, we collected resting and exercise heart rate data and lactate levels at defined time points. During CPET, continuous 12-lead ECG, gas analysis and repeated blood pressure measurements were also carried out.

Results
46 female water polo players were examined (age: 18.5±5.9y, adults: 19, training: 18.0±7.9h/w). Comparing CPET and field measurements, no differences were found between resting heart rate (75.7±13.4vs73.1±13.0 BPM, p=0.22) and resting lactate levels (1.5±0.4vs1.6±0.6 mM, p=0.29). Achieved maximal heart rates were higher during CPET examinations, than during field tests (196.3±9.7 vs 191.0±12.5 BPM, p=0.001) On the contrary, maximal lactate levels were lower during CPET in comparison to field measurements (8.4±2.4 vs 9.6±2.7 mM, p=0.01). Lactate levels stayed high after routine cool-down swimming ordered by the trainers, but decreased after suggested further training (6.6±2.7 vs 3.7±1.6 mM, p=10-16). When comparing the age groups, CPET examinations showed similar relative maximal aerobic capacity (44.4±4.8vs44.9±5.5 ml/kg/min, p=0.72) and peak lactate values (8.2±2.7vs8.7±1.9 mM, p=0.48), while maximal heart rates were higher in YT groups (200.7±7.2 vs 190.1±9.6 BPM, p&lt;0.001) as compared to adults. Similarly, maximal lactate levels showed no differences (9.1±2.6 vs 10.4±2,7 mM, p=0.13), while maximal heart rates were higher in YT groups (197.7±10.0 vs 181.4±8.9 BPM, p&lt;0.001) as compared to adults during field examinations.

Conclusions
Although field measurements and laboratory CPET results differ from several points of view, differences between age groups and the kinetics of the data are similar. Maximal heart rates are easier to achieve during CPET, while more intensive lactate increase could be observed during field measurements. Combining the above examinations helps defining maximal physiological values, fitness status, differences between different age groups, and optimizing training plans, as well as differentiating between physiological and pathological sport adaptation.