National Italian Olympic Committee (CONI), Institute of Sport and Science Medicine, Rome, Italy.
Squeo, Maria Rosaria; Menichini, Ilaria; Morviducci, Matteo; Spinelli, Alessandro; et al;
Physiological reports,2025 Apr
Ventilatory efficiency during cardiopulmonary exercise testing (CPET) is obtained by relating minute ventilation (V’ E ) to CO 2 output (V’CO 2 ). Limited information is available regarding exercise ventilatory efficiency in young elite athletes. We assessed ventilatory efficiency in elite athletes; evaluating the influence of sex and/or ESC sport categories; evaluating the agreement between the V’ E /V’CO 2 slope and nadir in measuring ventilatory efficiency; evaluating differences between subgroups of athletes stratified by ventilatory efficiency. A cohort of 443 elite athletes prospectively underwent CPET. The slope (s 1 ) and the intercept of the linear region of the V’ E /V’CO 2 relationship, the V’ E /V’CO 2 value at the lactate threshold and the V’ E /V’CO 2 nadir were used to assess ventilatory efficiency. Male athletes and endurance athletes, both males and females, had higher exercise ventilatory efficiency (p < 0.001). A strong positive correlation was observed between V’ E /V’CO 2 s 1 and nadir (p < 0.001). Of note, both high (V’ E /V’CO 2 s 1 < 24) and very high (V’ E /V’CO 2 s 1 < 22) levels of ventilatory efficiency were associated with greater exercise tolerance (i.e., peak oxygen uptake, maximal power; p < 0.001). The results of our study emphasize the need to include the measurement of ventilatory efficiency in the evaluation of elite athletes, potentially refining their training strategies.