Purpose: Water polo is a sport involving extremely intense exercise training that might be expected to result in major cardiac adaptations. The purpose of our study was to evaluate cardiac size, determine [latin capital V with dot above]O2max of top-level water polo players, and compare the findings with those of other top-level athletes. Methods: Treadmill [latin capital V with dot above]O2max and 2D guided M-mode and Doppler echocardiographic data were obtained on players (N = 15) of the Olympic champion (Sydney 2000) Hungarian team and compared with data of Hungarian sedentary subjects (N = 19), and top-level endurance (N = 16) and power athletes (N = 15). Results: Aerobic power of the water polo players was significantly lower (57.8 +/- 12.3 mL[middle dot]min-1[middle dot]kg-1) than that of endurance athletes (70.9 +/- 8.9), higher than sedentary controls (49.7 +/- 4.3), and not different from that of power athletes (50.5 +/- 6.0). Body size related mean left ventricular wall thickness (LVWT/BSA0.5) was the highest in the water polo players (16.8 +/- 1.5 vs 15.9 +/- 1.1 in endurance, 14.5 +/- 1.0 in the power athletes, and 12.8 +/- 0.6 mm[middle dot]m-1 in nonathletes). Left ventricular muscle mass (LVMM/BSA1.5) was higher in the water polo players (115 +/- 22 g[middle dot]m-3) than in power athletes (86 +/- 12) or nonathletes (74 +/- 9) and similar to that of endurance athletes (112 +/- 15). Resting heart rate was lower in the water polo players (55.1 +/- 9.7 beats[middle dot]m-1) and endurance athletes (59.3 +/- 10.6) than in power athletes (66.0 +/- 16.1) or in sedentary subjects (72.9 +/- 10.9). Conclusions: Results indicate that high-level water polo results in marked cardiac hypertrophy that involves predominantly an increase of wall thickness, and in a [latin capital V with dot above]O2max lower than that of endurance athletes but similar to those of basketball and soccer players.
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