Introduction Intense exercise over a long period leads to morphological and functional changes in the heart, cardiovascular systems, lungs, and muscles. Endurance sports produce eccentric hypertrophy of the left ventricle (LV), an increase in the dimensions of all hearts cavities, and high fitness expressed in maximum oxygen consumption (VO2max), while strength sports lead to concentric hypertrophy of the LV without a significant increase in heart dimensions with a small increase in aerobic capacity compared to sedentary people. Objectives This study aimed to compare anthropometric, echocardiographic, and functional parameters of cardiorespiratory fitness between professional water polo and volleyball players. Methods This study includes 97 professional male players divided in two groups: water polo (n1=58, aged 21.66±4.41years, body height 191.52±4.81cm, body weight 92.89±10.12kg) and volleyball (n2=39, aged 22.56±4.85years, body height 196.19±5.75cm, body weight 87.28±10.05kg). All players treining more then 10 years and more then 15 hours per week. Subjects underwent anthropometry ,body composition,electrocardiography,echocardiography and ergospirometry test on a treadmill using Quark CPET Cosmed. Student's T-test was used for comparison of measured parameters. Results Water polo players train more hours per week, are shorter, heavier, have higher BMI, have higher systolic and diastolic blood pressure at rest, and more pronounced hypertrophy of the LV was registered in them: septum, posterior wall, left ventricle mass, left ventricle mass index (p<0.001 for all).In water polo players was observed the left ventricular dilation in absolute values and values standardized according to body surface area BSA: LV diastolic volume LVEDV (p<0.05), EDV/BSA, systolic volume SV, systolic volume index Si (p<0.01).In VO2max/kg we didn't notice any significant differences. Conclusion Both sports disciplines require a high level of aerobic fitness, but water polo leads to greater remodeling of the heart manifested in left ventricular dilation and hypertrophy. Bearing in mind that water polo players achieve an equally high oxygen consumption even though they have a higher body weight on average compared to volleyball players, it can be indirectly concluded that water polo players have significantly higher absolute values of VO2 max and therefore higher absolute total work, which can explain the greater remodeling of the heart.
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