{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T02:03:47Z","timestamp":1791079427312,"version":"4.1.0"},"reference-count":68,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"abstract":"\n Abstract<\/jats:title>\n \n Long\u2010term heat acclimation has been shown to elevate haemoglobin mass (Hb\n mass<\/jats:sub>\n ) and enhance maximal oxygen consumption (). To date, however, all evidence derives from exercise\u2010induced heat stress, making it unclear whether passive strategies, which allow athletes to maintain training intensities, can produce similar adaptations. Moreover, while heat\u2010induced increases in are often attributed to haematological changes, adaptation of other convective components of oxygen transport may underpin these improvements. To investigate whether 5\u00a0weeks of hot\u2010water immersion (HWI) would enhance , 10 well\u2010trained runners (nine male; \u00a0=\u00a064.5\u00a0\u00b1\u00a08.1\u00a0mL\u00a0min\n \u22121<\/jats:sup>\n \u00a0kg\n \u22121<\/jats:sup>\n ) completed a within\u2010subject, counterbalanced cross\u2010over intervention involving HWI (5\u00a0\u00d7\u00a045\u00a0min\u00a0week\n \u22121<\/jats:sup>\n ; \u226540\u00b0C) and a time\u2010matched control, alongside habitual training. Haematological and cardiac adaptations were assessed using carbon\u2010monoxide rebreathing (in duplicate) and four\u2010dimensional (4D) speckle\u2010tracking echocardiography, respectively. HWI increased Hb\n mass<\/jats:sub>\n (+33\u00a0g,\n P<\/jats:italic>\n \u00a0<\u00a00.001; [95% confidence interval (CI)\u00a018 to 49]), blood volume (+284\u00a0mL,\n P<\/jats:italic>\n \u00a0<\u00a00.001; [95% CI\u00a0113 to 455]) and left ventricular end\u2010diastolic volume (LVEDV; +10\u00a0mL,\n P<\/jats:italic>\n \u00a0<\u00a00.001; [95% CI\u00a06 to 13]), without altering 4D global peak longitudinal strain, diastolic\u2010strain rate or diastolic\u2010filling rate. These changes facilitated a 2.7\u00a0mL\u00a0kg\n \u22121<\/jats:sup>\n \u00a0min\n \u22121<\/jats:sup>\n improvement in (\n P<\/jats:italic>\n \u00a0<\u00a00.001; [95% CI\u00a01.4 to 4.1]) and a 0.8 km\u00a0h\n \u22121<\/jats:sup>\n increase in treadmill speed at (\n P<\/jats:italic>\n \u00a0<\u00a00.001; [95% CI\u00a00.5 to 1.1]). Best subset regression analysis identified Hb\n mass<\/jats:sub>\n as the strongest independent predictor of (\u03b2\u00a0=\u00a03.8,\u00a0\n P<\/jats:italic>\n \u00a0<\u00a00.001), with cardiac adaptations contributing additional explanatory value (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u00a0=\u00a00.825 fixed effects; 0.961 full model). Our findings demonstrate that passive heat exposure elicits coordinated adaptations to multiple convective components of the oxygen transport chain, and represents a physiologically effective and sustainable strategy for enhancing in well\u2010trained populations.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Long\u2010term heat acclimation can increase haemoglobin mass and maximal oxygen uptake; whether passive heat can produce similar effects was previously unknown.<\/jats:p>\n <\/jats:list-item>\n \n Whether cardiac adaptation contributes to the heat\u2010induced improvements in maximal oxygen consumption remains unclear.<\/jats:p>\n <\/jats:list-item>\n \n In a within\u2010subject, counterbalanced cross\u2010over design, 10 well\u2010trained runners completed 5\u00a0weeks of hot\u2010water immersion alongside their normal training and a time\u2010matched control period.<\/jats:p>\n <\/jats:list-item>\n \n Passive heating increased haemoglobin mass, total blood volume, and left\u2010ventricular end\u2010diastolic volume.<\/jats:p>\n <\/jats:list-item>\n \n These haematological and cardiac adaptations explained the observed improvement in maximal oxygen uptake, indicating that passive heat can enhance aerobic performance via coordinated effects across multiple components of the oxygen transport chain.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp289874","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:30:43Z","timestamp":1763706643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Long\u2010term passive heat acclimation enhances maximal oxygen consumption via haematological and cardiac adaptation in endurance runners"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4053-2410","authenticated-orcid":false,"given":"Elliott J.","family":"Jenkins","sequence":"first","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6207-1324","authenticated-orcid":false,"given":"Joseph A.","family":"Killick","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owain","family":"Zerilli","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-6081","authenticated-orcid":false,"given":"Andrew J. M.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7439-1372","authenticated-orcid":false,"given":"Liam","family":"Corr","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1667-294X","authenticated-orcid":false,"given":"Joshua C.","family":"Tremblay","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-6420","authenticated-orcid":false,"given":"Mike","family":"Stembridge","sequence":"additional","affiliation":[{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"issue":"5","key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.echo.2021.12.004","article-title":"Normal values of left ventricular size and function on three\u2010dimensional echocardiography: Results of the World Alliance Societies of echocardiography study","volume":"35","author":"Addetia K.","year":"2022","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"13","key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1161\/01.CIR.0000142863.71285.74","article-title":"Effect of aging and physical activity on left ventricular compliance","volume":"110","author":"Arbab\u2010Zadeh A.","year":"2004","journal-title":"Circulation"},{"issue":"24","key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1161\/CIRCULATIONAHA.114.010775","article-title":"Cardiac remodeling in response to 1 year of intensive endurance training","volume":"130","author":"Arbab\u2010Zadeh A.","year":"2014","journal-title":"Circulation"},{"key":"e_1_2_6_5_1","first-page":"424","volume-title":"Physiological testing of elite athletes","author":"Banister E.","year":"1991"},{"issue":"1","key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40798-015-0007-y","article-title":"Running economy: Measurement, norms, and determining factors","volume":"1","author":"Barnes K. 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