{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:54:05Z","timestamp":1790398445684,"version":"4.1.0"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Athletes are characterized by distinct haemodynamic adaptations of the cardiovascular system, including descending aorta haemodynamics, that could influence the diagnosis of coarctation of the aorta. This study aims to evaluate the normal range for the maximum velocity of blood flow in the descending aorta (Vmax-AoDesc) and the predictors of Vmax-AoDesc in apparently healthy athletes without coarctation of the aorta. Methods: We examined 559 asymptomatic healthy athletes with an age of at least 12 years and a tricuspid aortic valve (420 males, age: 29 \u00b1 14 years). We performed evaluations of athletic history, measurements of brachial systolic and diastolic blood pressure, cardiac and aorta ultrasonography and cardiopulmonary exercise testing. Forty athletes were reassessed after a median follow-up of 3.0 (IQR: 2.1) years. Results: The median Vmax-AoDesc was 1.29 (IQR: 0.28) m\/s, with a maximum of 2.00 m\/s. The Vmax-AoDesc could be independently predicted by age (\u03b2 = \u22120.392, p &lt; 0.001), ratio of systole\/diastole (\u03b2 = 0.095, p = 0.023), brachial systolic blood pressure (\u03b2 = 0.251, p &lt; 0.001), left ventricular stroke volume (\u03b2 = 0.256, p &lt; 0.001), ascending aorta diameter (\u03b2 = \u22120.230, p &lt; 0.001), aortic arch diameter (\u03b2 = \u22120.111, p = 0.044) and descending aorta diameter (\u03b2 = \u22120.103, p = 0.017). Age accounted for the greatest variability of Vmax-AoDesc (5.8%). Vmax-AoDesc correlated positively with h\/week of endurance exercise training (rho = 0.182, p &lt; 0.001) and oxygen uptake at second ventilatory threshold (rho = 0.299, p = 0.001). Vmax-AoDesc did not change significantly during follow-up (p = 0.438). The median change in Vmax-AoDesc was \u22120.05 (IQR: 0.18) m\/s. However, when Vmax-AoDesc was adjusted for all the above-mentioned independent predictors of Vmax-AoDesc apart from age and systolic blood pressure, there was a reduction in adjusted Vmax-AoDesc during follow-up (p = 0.007), indicating a reduction in Vmax-AoDesc with aging. Conclusions: The upper limit of the normal range for Vmax-AoDesc was 2.00 m\/s in athletes without coarctation of the aorta. Young age was the most important predictor for the measurement of high Vmax-AoDesc. There was an upregulation of Vmax-AoDesc in athletes with a greater volume of endurance exercise training.<\/jats:p>","DOI":"10.3390\/jcm15114378","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:43:04Z","timestamp":1780648984000},"page":"4378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Maximum Velocity of Blood Flow in Descending Aorta in Athletes"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7004-8718","authenticated-orcid":false,"given":"Georgios A.","family":"Christou","sequence":"first","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, University of Ioannina, 45332 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios N.","family":"Kiortsis","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, University of Ioannina, 45332 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"429","article-title":"Asymptomatic severe aortic coarctation in an 80-year-old man","volume":"31","author":"Cevik","year":"2004","journal-title":"Tex. Heart Inst. J."},{"key":"ref_3","first-page":"535463","article-title":"A case of severe asymptomatic aortic coarctation in an adult female","volume":"2011","author":"Tsikrikas","year":"2011","journal-title":"Case Rep. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4070\/kcj.2012.42.1.62","article-title":"Severe aortic coarctation in a 75-year-old woman: Total simultaneous repair of aortic coarctation and severe aortic stenosis","volume":"42","author":"Park","year":"2012","journal-title":"Korean Circ. J."},{"key":"ref_5","first-page":"100606","article-title":"Late diagnosis of severe aortic coarctation in a 65-year-old endurance athlete: Insights into exercise physiology and collateral compensation","volume":"21","author":"Sharma","year":"2025","journal-title":"Int. J. Cardiol. Congenit. Heart Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.xjtc.2020.03.002","article-title":"A young marathon runner with severe aortic coarctation and bicuspid aortic valve disease complicated by contained aortic rupture","volume":"2","author":"Mihalj","year":"2020","journal-title":"JTCVS Tech."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1097\/MS9.0000000000001614","article-title":"Un-diagnosed coarctation of the aorta in a 27-year-old adult with a rare presentation: A rare case report","volume":"86","author":"Shhada","year":"2023","journal-title":"Ann. Med. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/j.jacc.2017.01.015","article-title":"International Recommendations for Electrocardiographic Interpretation in Athletes","volume":"69","author":"Sharma","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1249\/mss.0b013e3180304570","article-title":"Aerobic high-intensity intervals improve VO2max more than moderate training","volume":"39","author":"Helgerud","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/clc.23368","article-title":"The impact of demographic, anthropometric and athletic characteristics on left atrial size in athletes","volume":"43","author":"Christou","year":"2020","journal-title":"Clin. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1161\/CIRCULATIONAHA.112.000974","article-title":"A meta-analysis of aortic root size in elite athletes","volume":"127","author":"Iskandar","year":"2013","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1080\/17461391.2019.1587522","article-title":"Indirect clinical markers for the detection of anabolic steroid abuse beyond the conventional doping control in athletes","volume":"19","author":"Christou","year":"2019","journal-title":"Eur. J. Sport Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1080\/17461391.2021.1883125","article-title":"The role of cardiac computed tomography in pre-participation screening of mature athletes","volume":"22","author":"Christou","year":"2022","journal-title":"Eur. J. Sport Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1093\/eurheartj\/ehae179","article-title":"2024 ESC Guidelines for the management of peripheral arterial and aortic diseases","volume":"45","author":"Mazzolai","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Christou, G.A., Pagourelias, E.D., Deligiannis, A.P., and Kouidi, E.J. (2021). Exploring the Anthropometric, Cardiorespiratory, and Haematological Determinants of Marathon Performance. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.693733"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1002\/jmri.25081","article-title":"Age-related changes in aortic 3D blood flow velocities and wall shear stress: Implications for the identification of altered hemodynamics in patients with aortic valve disease","volume":"43","author":"Garcia","year":"2016","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/jmri.25773","article-title":"Distribution of blood flow velocity in the normal aorta: Effect of age and gender","volume":"47","author":"Garcia","year":"2018","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_19","first-page":"30","article-title":"Determination of normal values of the aortic blood flow profile using continuous Doppler echocardiography from apical and suprasternal echo position","volume":"81","author":"Gabrielsen","year":"1992","journal-title":"Z. Kardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/BF00877747","article-title":"Elastic properties and Windkessel function of the human aorta","volume":"9","author":"Belz","year":"1995","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e005617","DOI":"10.1161\/CIRCIMAGING.117.005617","article-title":"Imaging Insights on the Aorta in Aging","volume":"11","author":"Ohyama","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1161\/01.HYP.0000164579.73656.c4","article-title":"Aortic input impedance increases with age in healthy men and women","volume":"45","author":"Mazzaro","year":"2005","journal-title":"Hypertension"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1002\/mrm.24962","article-title":"Viscous energy loss in the presence of abnormal aortic flow","volume":"72","author":"Barker","year":"2014","journal-title":"Magn. Reson. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1002\/j.2040-4603.2016.tb00700.x","article-title":"Hemodynamics","volume":"6","author":"Secomb","year":"2016","journal-title":"Compr. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1136\/heartjnl-2021-320574","article-title":"Longitudinal changes of thoracic aortic diameters in the general population aged 55 years or older","volume":"108","author":"Thijssen","year":"2022","journal-title":"Heart"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0735-1097(02)01722-9","article-title":"Intrinsic sinus and atrioventricular node electrophysiologic adaptations in endurance athletes","volume":"39","author":"Stein","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1249\/MSS.0000000000003236","article-title":"Aortic Diameters and Calcifications in Former World-Class Cyclists","volume":"55","author":"Valenzuela","year":"2023","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.ejvs.2017.12.012","article-title":"Transthoracic Ultrasound Evaluation of Arch and Descending Thoracic Aortic Pathology","volume":"55","author":"Oladokun","year":"2018","journal-title":"Eur. J. Vasc. Endovasc. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4378\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:37:35Z","timestamp":1780652255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15114378"],"URL":"https:\/\/doi.org\/10.3390\/jcm15114378","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}