Search Results (360)

Background: Hypertrophic cardiomyopathy (HCM) is a heterogeneous myocardial disease in which conventional prognostic models, primarily focused on sudden cardiac death, often fail to identify patients at risk of clinically relevant events such as heart failure progression or rehospitalization. Cardiopulmonary exercise testing (CPET) quantifies functional capacity, while stress echocardiography (SE) provides mechanistic insights into exercise-induced hemodynamic changes. Their combined application (CPET–SE) may enhance risk stratification in patients with HCM. Methods: In this retrospective study, 388 patients with obstructive and non-obstructive HCM (mean age 48 ± 15 years, 63.1% male) underwent baseline CPET–SE between 2010 and 2022 and were followed for a median of 7.4 years [IQR 4.3–10.2]. Echocardiographic parameters were assessed at rest and peak exercise, and CPET indices included peak oxygen consumption (pVO₂), ventilatory efficiency, and anaerobic threshold. The primary outcome was a composite of heart failure hospitalization or progression to end-stage HCM. Results: Over a median follow-up of 7.4 years, 63 patients (16.2%) experienced an event of the primary outcome. Patients who developed a primary outcome had greater left atrial diameter (45.0 vs. 41.0 mm, p < 0.001) and indexed volume at rest (36.4 vs. 29.0 mL/m², p < 0.001), with further dilation during stress (p = 0.046); increased LV wall thickness (p = 0.001); higher average E/e′ at rest and during stress (p ≤ 0.004); and higher pulmonary artery systolic pressure at rest (p = 0.027) and during stress (p = 0.044). CPET findings included lower pVO₂ (16.0 vs. 19.5 mL/kg/min, p = 0.001), reduced % predicted pVO₂ (p = 0.006), earlier anaerobic threshold (p = 0.032), impaired ventilatory efficiency (p = 0.048), and chronotropic incompetence (p < 0.001) in patients who experienced a primary outcome. Multivariable analysis identified dyslipidemia (OR 2.58), higher E/e′ (OR 1.06), and lower pVO₂ (OR 0.92) as independently associated with the primary outcome. Conclusions: CPET–SE provided a comprehensive evaluation of patients with HCM, associating aerobic capacity to its hemodynamic determinants. Reduced pVO₂ showed the strongest association with adverse outcomes, while exercise-induced diastolic dysfunction and elevated pulmonary pressures identified a high-risk phenotype. Incorporating CPET–SE into longitudinal management of patients with HCM may enable earlier detection of physiological decompensation and guide personalized therapeutic strategies. Full article

Background: Rowing is a highly demanding endurance sport, requiring simultaneous work of approximately 70% of the body’s muscle mass and the combined contribution of aerobic and anaerobic energy systems. Objective: This study aimed to analyze the cardiorespiratory responses and performance characteristics of elite junior male and female rowers during maximal effort over 2000 m on a rowing ergometer. Methods: Fifteen junior rowers (six males aged 15–17 and nine females aged 15–18) participated in the study. Anthropometric data (body height, weight, and body surface area) were recorded. All participants performed a maximal 2000 m test on a Concept2 D-model ergometer. Throughout the test, oxygen uptake (VO₂), carbon dioxide production (VCO₂), heart rate, and ventilation parameters were continuously measured. Performance and physiological data were analyzed in three intensity zones, defined by ventilatory thresholds (VT1–VT3), as well as at peak exercise. Results: Significant anthropometric differences were observed between genders. In terms of performance, males completed the 2000 m test significantly faster than females (208.83 ± 87.66 s vs. 333.78 ± 97.51 s, p = 0.0253). Relative VO₂ at peak exercise was higher in males (58.73 ± 5.25 mL·kg⁻¹·min⁻¹) than females (48.32 ± 6.09 mL·kg⁻¹·min⁻¹, p = 0.0046). In most cardiorespiratory parameters, males outperformed females significantly, except for heart rate and ventilatory equivalents. Ranking analysis revealed that higher VO₂max values were generally associated with a better placement in both genders, though this relationship was not perfectly linear. Performance time was negatively correlated with VO₂Peak (r = −0.8286; p < 0.001), rVO₂Peak (r = −0.6781; p < 0.01), and O₂P_Peak (r = −0.7729; p < 0.01). Conclusions: The findings confirm significant gender differences in anthropometric and cardiorespiratory characteristics of elite junior rowers and reinforce VO₂max as a key determinant of performance. Yet, deviations from a direct VO₂max–rank correlation highlight the influence of tactical, psychological, and biomechanical factors. Future research should provide practical recommendations for monitoring performance and tailoring training to optimize adaptation and long-term athlete development. Full article

Cardiopulmonary Exercise Testing (CPET) is the gold standard for the functional assessment in patients with heart failure (HF), providing objective parameters that reflect the integrated response of the cardiovascular, respiratory, and muscular systems, in addition several CPET-derived variables have shown independent prognostic value in patients with both reduced (HFrEF) and preserved ejection fraction (HFpEF) HF. This review aims to critically analyze the main CPET prognostic variables in heart failure, highlighting their underlying pathophysiological mechanisms, their predictive capacity for mortality and hospitalizations, and their integration into clinical decision-making models. Parameters such as peak oxygen uptake (VO₂), minute ventilation/carbon dioxide production (VE/VCO₂) slope, periodic breathing (or exercise oscillatory ventilation—EOV), anaerobic threshold (AT), oxygen pulse, and VO₂/work slope provide complementary insights into clinical risk; moreover, the combination of multiple CPET variables allows for more accurate risk stratification compared to the isolated use of each parameter. Multiparametric prognostic models such as the Metabolic Exercise Cardiac Kidney Index (MECKI) score, the Seattle Heart Failure Model, and the Heart Failure Survival Score (HFSS) incorporate these variables alongside clinical and laboratory data to guide advanced management and therapeutic decisions, including heart transplantation or left ventricular assistant device (LVAD) implantation. For these reasons, CPET-derived variables are essential prognostic tools in heart failure. Beyond improving risk stratification, their integration into multiparametric models supports a more personalized therapeutic approach, including tailored pharmacological management. Full article

Cardiopulmonary exercise testing (CPET) is recommended as part of routine care in people with congenital heart disease. A significant difference has been observed in many CPET parameters, depending on the ergometer and exercise protocol used. The aim of this study is to investigate such differences in Fontan patients. All Fontan patients (<40 years old, NYHA class I/I–II) underwent two consecutive CPETs on different ergometers (treadmill with ramped Bruce protocol versus cycle ergometer with ramp protocol) within less than 12 months. The exclusion criterion was the presence of significant clinical/anthropometric changes between the two tests. Anthropometric, surgical, clinical, electrocardiogram (ECG) and CPET data were collected. 47 subjects were enrolled (25 males, mean age 16.4 at first test). Peak heart rate (HR) tended to be higher on the treadmill (p = 0.05 as % of predicted, p = 0.062 in absolute value). Peak oxygen consumption (VO₂) (mL/min, mL/kg/min, and % of predicted) was significantly higher on the treadmill (p < 0.01), as well the VO₂ at the ventilatory anaerobic threshold (VAT) and the peak oxygen pulse. A different kinetics of the oxygen pulse wave was observed in the same patient comparing the two testing modalities. Maximal respiratory-exchange-ratio values (>1.1) were reached more frequently on the cycle ergometer (p < 0.001). The minute ventilation–carbon dioxide output slope (VE/VCO₂ slope) was not different between the two tests (p = 0.400). Many parameters of CPET may differ depending on the ergometer used. These should be considered in clinical evaluation of Fontan patients and when exercise is to be prescribed. Full article

Background: Time-restricted eating (TRE), a dietary strategy that confines daily food intake to specific time windows, has been shown in animal models to enhance physical performance even without exercise training. However, evidence in humans under non-exercise conditions remains limited. Objective: This study aimed to investigate the effects of early TRE (eTRE; 08:00–14:00) and delayed TRE (dTRE; 12:00–18:00) on body weight, aerobic endurance, and anaerobic power in untrained adults. Methods: In a randomized crossover trial, 28 healthy university students (mean age 23.47 ± 2.87 years; 16 women) completed two 4-week interventions, eTRE and dTRE, separated by a 2-week washout. Participants did not engage in any structured exercise during the intervention period. Body weight, aerobic endurance (cycling time to exhaustion at a fixed workload), and anaerobic power (peak power output during sprint cycling) were assessed after each phase. Results: Body weight significantly decreased after eTRE (−1.56 kg; 95% CI [−2.07, −1.05]; p < 0.001; Cohen’s $d_z$ = 1.17) and dTRE (−0.61 kg; 95% CI [−1.12, −0.10]; p = 0.022; Cohen’s $d_z$ = 0.55), with a greater reduction observed in eTRE compared to dTRE (−0.95 kg; 95% CI [−1.74, −0.16]; p = 0.020). Aerobic endurance showed no significant change across phases (all p > 0.05). Anaerobic power significantly improved after both eTRE (+21.25 W; 95% CI [12.03, 30.47]; p < 0.001; Cohen’s $d_z$ = 1.10) and dTRE (+35.43 W; 95% CI [26.21, 44.65]; p < 0.001; Cohen’s $d_z$ = 1.20), and the improvement was significantly greater in dTRE compared to eTRE (+14.18 W; 95% CI [1.79, 26.57]; p = 0.025; Cohen’s $d_z$ = 0.54). Conclusions: Both early and delayed TRE independently led to weight loss and enhanced anaerobic power in the absence of an exercise intervention. eTRE was more effective for weight reduction, whereas dTRE produced greater improvements in anaerobic performance. Full article

Accurate assessment of cardiorespiratory fitness (CRF) in adolescents is critical. However, normalizing oxygen consumption (VO₂) to body mass (BM) may underestimate CRF in overweight (OW) youth by including metabolically inactive fat mass. This study examined differences in VO₂ normalized by BM and fat-free mass (FFM) between normal weight (NW) and OW adolescents. Thirty-eight participants (19 NW, 19 OW; 12–17 years) underwent anthropometric, body composition, and cardiorespiratory fitness assessments. VO₂ at the aerobic threshold (VO₂AerT), anaerobic threshold (VO₂AnT), and peak exercise (VO₂peak) were measured and expressed in absolute terms and relative to BM and FFM. Group differences in the main outcomes were analyzed using a one-way ANOVA, and Pearson correlation was used to examine associations between VO₂, BM and FFM. When normalized by BM, NW adolescents showed significantly higher VO₂AerT (18.7 ± 3.6 vs. 14.5 ± 2.3), VO₂AnT (28.8 ± 6.3 vs. 23.6 ± 4.7), and VO₂peak (37.7 ± 6.7 vs. 29.1 ± 7.0) compared to OW peers (p < 0.05). No significant differences were found when VO₂ values were normalized by FFM. A group difference was observed in the VO₂peak vs. BM slope (p = 0.03) but not in the VO₂peak vs. FFM slope. FFM normalization provides a more accurate assessment of CRF by accounting for differences in body composition, underscoring the importance of evaluating the aerobic capacity of metabolically active tissue rather than total body weight in youth populations. Full article

Background: Generating oxidative stress in a predictable and controllable way without the risk of causing harm is important for enabling the safe validation of interventions such as dietary polyphenols and ensuring ethical standards in human studies, while also advancing mechanisms involved in the induced oxidative stress. Although, many experimental animal and in vitro models have been developed to conduct oxidative stress-based research, to date, very few reliable human models are available. Objective: This study’s main objective was to establish a standardised exercise model to induce oxidative stress in a repeatable and controllable manner and was tested with dietary polyphenols. Method: We applied a single blinded, randomised, cross-over, placebo-controlled trial with adult (25.95 ± 6.25 years) males (N = 40) where the induction of oxidative stress was achieved by an incremental aerobic exercise activity followed by a maximal anaerobic activity until exhaustion. To assess the model, rooibos polyphenolics was used as one of the interventions, while markers of safety and oxidative stress were measured on various occasions during the trial period. Results: The exercise regime reliably and repeatably induced oxidative stress, evidenced by increased levels of oxidative damage markers, i.e., oxidised glutathione (p = 0.003), malondialdehyde (p = 0.004), and a Comet assay tail moment (p < 0.05), while unconjugated bilirubin (p = 0.002) and the ferric reducing antioxidant potential (p < 0.001) increased over the study period, in the male study participants, irrespective of the oral intervention. Conclusions: This model showed an exercise regime that could be adapted to induce oxidative stress in a reliable and repeatable fashion without risk of causing harm. This study also demonstrated that a dietary polyphenolic intervention with rooibos did not complicate the onset of oxidative stress. Full article

Background: This study examined the effects of repeated ischemic preconditioning (IPC) combined with normobaric hypoxia on anaerobic performance and physiological stress markers. Methods: Fourteen physically active males (22.3 ± 3.1 years) completed three randomized, single-blind crossover sessions under the following conditions: (1) normoxia (NOR), (2) normobaric hypoxia (HYP; FiO₂ = 14.7%), and (3) hypoxia with IPC (IPC-HYP). Each session included three 30 s cycling Wingate tests separated by four minutes of passive recovery. Blood samples were collected pre-exercise, immediately post-exercise, and 15 min post-exercise to assess lactate, pH, bicarbonate (HCO₃⁻), and creatine kinase (CK) activity. Results: Peak power output was highest under NOR during Wingate II and III. IPC-HYP attenuated the decline in peak power compared to that under HYP (e.g., Wingate II: 15.56 vs. 12.52 W/kg). IPC-HYP induced greater lactate accumulation (peak: 15.45 mmol/L, p < 0.01), more pronounced acidosis (pH: 7.18 post-exercise), and lower bicarbonate (9.9 mmol/L, p < 0.01). CK activity, measured immediately and then 1 h and 24 h post-exercise, was highest under IPC-HYP at 24 h (568.5 U/L). Conclusions: IPC-HYP mitigates the decline in peak anaerobic power observed under hypoxia, despite eliciting greater metabolic and muscular stress. These findings suggest that IPC may enhance physiological adaptation to hypoxic training, potentially improving anaerobic performance. Full article

The circadian rhythm controls the sleep/wake cycle and a wide variety of metabolic and physiological functions. Clock genes regulate it in response to both external and endogenous stimuli, and their expression may change because of aging, leading to an increased risk of health problems. Despite the well-described benefits of physical exercise as a circadian synchronizer, there is a lack of literature regarding the role of chronic exercise intensity in clock gene expression during aging. This article aims to analyze the differential expression of genes that regulate the biological clock under the effects of variable-intensity aerobic swimming training in aging mice, determining whether these exercise regimens interfere with the genomic regulation of the circadian rhythm. For this purpose, the mice were exposed to low- and high-intensity exercise and had their heart and gastrocnemius tissues molecularly analyzed by cDNA synthesis and qPCR to determine the expression levels of the selected genes: Clock, Arntl, Per1, Per2, Cry1, Cry2, and Nr1d1. The results showed that low-intensity exercise, performed at workloads below the anaerobic threshold, significantly changed their expression in the gastrocnemius muscle (p < 0.05), while high-intensity exercise had no statistically significant effects (p > 0.05), with the heart being immune to exercise influence except when it comes to the Per1 gene, for which expression was increased (p = 0.031) by low-intensity exercise. Additionally, both body weight and lactate thresholds had no change during the experiment (p > 0.05), while the maximum supported workload was maintained for high-intensity exercise (p > 0.05) and increased for low-intensity exercise (p < 0.01), with the control group experiencing a decay instead (p < 0.05). Thus, the present study highlights the importance of chronic exercise in modulating clock genes and opens exciting possibilities for circadian medicine, such as improvements in exercise capacity, heart condition, and lipid metabolism for subjects of low-intensity regimens. Full article

Post-exertional malaise (PEM) is a defining symptom of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), yet its molecular underpinnings remain elusive. This study investigated the temporal–longitudinal DNA methylation changes associated with PEM using a structured two-day maximum repeated effort cardiopulmonary exercise testing (CPET) protocol involving pre- and two post-exercise blood samplings from five ME/CFS patients. Cardiopulmonary measurements revealed complex heterogeneous profiles among the patients compared to typical healthy controls, and VO₂ peak indicated all patients had poor normative fitness. The switch to anaerobic metabolism occurred at a lower workload in some patients on Day Two of the test. Reduced Representation Bisulphite Sequencing followed by analysis with Differential Methylation Analysis Package-version 2 (DMAP2) identified differentially methylated fragments (DMFs) present in the DNA genomes of all five ME/CFS patients through the exercise test compared with ‘before exercise’. With further filtering for >10% methylation differences, there were early DMFs (0–24 h after first exercise test) and late DMFs between (24–48 h after the second exercise test), as well as DMFs that changed gradually (between 0 and 48 h). Of these, 98% were ME/CFS-specific, compared with the two healthy controls accompanying the longitudinal study. Principal component analysis illustrated the three distinct clusters at the 0 h, 24 h, and 48 h timepoints, but with heterogeneity among the patients within the clusters, highlighting dynamic methylation responses to exertion in individual patients. There were 24 ME/CFS-specific DMFs at gene promoter fragments that revealed distinct patterns of temporal methylation across the timepoints. Functional enrichment of ME-specific DMFs revealed pathways involved in endothelial function, morphogenesis, inflammation, and immune regulation. These findings uncovered temporally dynamic epigenetic changes in stress/immune functions in ME/CFS during PEM and suggest molecular signatures with potential for diagnosis and of mechanistic significance. Full article

Whole-body electromyostimulation (WB-EMS) is a time-efficient, joint-friendly, and highly customizable training technology that particularly attracts sportspeople and athletes looking to enhance performance, accelerate regeneration, and prevent injuries with WB-EMS. Based on a systematic review of the literature, the present evidence map aimed to provide an overview of outcomes addressed by WB-EMS in exercising cohorts of different levels. In summary, the search identified 34 research projects with 39 studies and 43 publications that addressed 79 outcome categories (e.g., isometric strength) with more than 300 single outcomes (e.g., isometric strength of leg extensors). Thirty-one studies focused on performance-related outcomes, four studies addressed regeneration-related outcomes, and eight studies reported outcomes related to anthropometry. A further 14 studies reported health- and safety-related outcomes. Twenty-five of the 31 studies that reported performance parameters addressed strength, ten power, 18 jumping, ten sprinting, six agility, six endurance, five anaerobic power, and one each flexibility or balance, and five studies reported sport-specific performance outcomes (e.g., shot velocity). Apart from outcomes concerning injury prevention or sport-specific complaints, there are in particular evidence gaps relating to the acute effects of WB-EMS on regeneration, particularly with respect to muscle recovery. Semiprofessionals/professionals were rarely addressed, and if so, primarily cohorts from team sports were evaluated, while no study focused on elite strength, endurance, or precision sports athletes. Full article

High-intensity/sprint interval training (HIIT/SIT) improves aerobic and anaerobic performance, but it is unknown if HIIT/SIT increases strength, muscle mass/size, and muscle endurance (ME). We aimed to determine if HIIT/SIT increases strength, muscle mass/size, and ME. Databases (Ovid Medline, Sport Discus, EMBASE, and CINAHL) and the gray literature (Google Scholar) were searched for original research articles investigating the impact of HIIT/SIT on strength, muscle mass/size, and ME (23 March 2025). The risk of bias (ROB) was assessed via the Cochrane ROB 2 Tool. Meta-analyses were performed when three or more randomized controlled trials compared HIIT/SIT to a common comparator. Fifty-four studies were included (N = 1136). Twenty-five studies had a high ROB, while twenty-nine had some concerns. Standardized mean differences (SMD) (95% CI) of 0.16; (−0.09, 0.40), 0.33; (−0.21, 0.87) were observed for meta-analyses comparing the effect of HIIT/SIT to moderate intensity continuous training (MICT) and non-exercise controls (CON) on FFM, respectively. A meta-analysis comparing the effect of HIIT/SIT to resistance training (RT) on leg press strength yielded a SMD of −0.82; 95% CI: (−1.97, 0.33). HIIT/SIT may induce slightly greater gains than MICT and CON for FFM, while RT is likely superior to HIIT/SIT for improving leg press strength. However, the certainty of evidence is low, and 95% CIs intersect zero for all analyses. Full article

Background: Chronic chlorella intake combined with high-intensity intermittent training (HIIT) has been shown to accelerate aerobic and anaerobic capacities in rodents. This study aimed to clarify the effects of combining chlorella intake with short-term HIIT on exercise performance in humans, and to investigate the impact of chlorella intake on cardiac adaptation. Materials and Methods: In Study 1, twelve healthy young men completed a 3-week exhaustive HIIT, comprising 6–7 bouts of 20 s of cycling on a leg ergometer at an intensity of 170% maximal oxygen uptake ($\dot{\mathrm{V}}$O_2max), with a 10 s rest between each bout, 3 days/week. They were orally administered either placebo or chlorella during the 3 weeks in a double-blinded, randomized crossover trial (RCT). In Study 2, six healthy young men were orally administered either placebo or chlorella during 4 weeks in a double-blinded, placebo-controlled RCT. We measured $\dot{\mathrm{V}}$O_2max and cardiac function (stroke volume [SV], heart rate [HR], and cardiac output [CO]) during maximal exercise. In Study 3, chlorella-induced changes in molecular markers of maladaptation of the heart were measured in healthy rats. Results: [Study 1] After each HIIT, $\dot{\mathrm{V}}$O_2max significantly increased in the placebo and chlorella groups (p < 0.05). Changes in $\dot{\mathrm{V}}$O_2max were significantly higher in the chlorella group than in the placebo group (p < 0.05). [Study 2] Changes in SV and CO during maximal exercise were significantly higher in the chlorella group than in the placebo group (p < 0.05 each), but HR_max did not change. [Study 3] Chronic chlorella intake did not change the molecular markers of pathological cardiac hypertrophy. Conclusions: Chronic chlorella intake, which improves aerobic capacity by enhancing cardiac function without causing cardiac maladaptation, combined with short-term HIIT, further enhanced aerobic capacity. Thus, the chlorella-induced increase in cardiac function may further enhance aerobic capacity through HIIT. Full article

Compression pants, as functional sportswear providing external pressure, are widely used to enhance athletic performance and accelerate recovery. However, systematic investigations into their effectiveness during anaerobic exercise and the impact of different pressure levels on performance and post-exercise recovery remain limited. This randomized crossover controlled trial recruited 20 healthy male university students to compare the effects of four garment conditions: non-compressive pants (NCP), moderate-pressure compression pants (MCP), high-pressure compression pants (HCP), and ultra-high-pressure compression pants (UHCP). Anaerobic performance was assessed through vertical jump, agility tests, and the Wingate anaerobic test, with indicators including time at peak power (TPP), peak power (PP), average power (AP), minimum power (MP), power drop (PD), and total energy produced (TEP). Post-exercise blood lactate concentrations and heart rate responses were also monitored. The results showed that both HCP and UHCP significantly improved vertical jump height (p < 0.01), while MCP outperformed all other conditions in agility performance (p < 0.05). In the Wingate test, MCP achieved a shorter TPP compared to NCP (p < 0.05), with significantly higher AP, lower PD, and greater TEP than all other groups (p < 0.05), whereas HCP showed an advantage only in PP over NCP (p < 0.05). Post-exercise, all compression pant groups recorded significantly higher peak blood lactate (Lamax) levels than NCP (p < 0.05), with MCP showing the fastest lactate clearance rate. Heart rate analysis revealed that HCP and UHCP induced higher maximum heart rates (HR_max) (p < 0.05), while MCP exhibited superior heart rate recovery at 3, 5, and 10 min post-exercise (p< 0.05). These findings suggest that compression pants with different pressure levels yield distinct effects on anaerobic performance and physiological recovery. Moderate-pressure compression pants demonstrated the most balanced and beneficial outcomes across multiple performance and recovery metrics, providing practical implications for the individualized design and application of compression garments in athletic training and rehabilitation. Full article

We examined the physiological demands of trained rowers across four exercise intensity domains (considering the effects of weight category and sex). Twenty-four trained rowers (12 lightweight and 12 heavyweight) performed 7 × 3 min incremental bouts on a Concept2 rowing ergometer (30 W power increases and 60 s rest intervals). Performance, cardiorespiratory and metabolic responses were continuously assessed throughout the experimental protocol to characterize internal load across progressive exercise intensities. Statistical analyses included a repeated measures ANOVA test and independent t-tests (p ≤ 0.05). Heavyweight rowers exhibited greater absolute anaerobic energy production in the severe domain (41.25 ± 10.39 vs. 32.54 ± 5.92 kJ) (p = 0.02), higher peak metabolic power (up to 1.57 ± 0.30 vs. 1.48 ± 0.30 kW) (p = 0.001) and greater total energy expenditure (up to 277.52 ± 51.23 vs. 266.69 ± 51.59 kJ) (p = 0.001) than lightweight rowers, whereas the latter showed comparable relative cardiorespiratory responses to heavyweights. With respect to sex differences, males demonstrated higher oxygen uptake (from ~43–59 vs. ~34–48 mL·kg⁻¹·min⁻¹) (p = 0.001), ventilation (from ~78–146 vs. ~49–99 L·min⁻¹) (p = 0.001), metabolic power (from ~1.1–1.7 vs. ~0.7–1.0 kW) (p = 0.001) and energy expenditure (from ~193–305 vs. ~119–209 kJ) (p = 0.001) across all intensity domains. However, blood lactate levels and anaerobic energy contributions were similar between sexes. These findings demonstrated that domain-based physiological profiling effectively differentiates internal responses among rowers by weight category and sex. Heavyweights showed greater absolute energy output, while lightweights demonstrated higher metabolic efficiency. Males had elevated cardiorespiratory and metabolic values, but relative bioenergetic responses were similar across groups. These findings support individualized training based on physiological profiles. Full article