ABSTRACT: Aim: To investigate the role of anatomical variations in the physiological response to exercise-induced cardiac stress, focusing on their impact on cardiovascular performance, recovery, and abnormalities observed during exercise.

Material and Methods: This cross-sectional study included 90 participants (45 males and 45 females) aged 18–60 years. Participants underwent graded treadmill exercise testing (Bruce Protocol) with continuous monitoring of heart rate, blood pressure, oxygen consumption (VO₂), and electrocardiogram (ECG). Baseline anatomical variations, such as chamber dimensions, valvular morphology, and coronary artery anatomy, were assessed using echocardiography and cardiac magnetic resonance imaging (MRI). Data analysis involved one-way ANOVA and Pearson’s correlation to assess relationships between anatomical variations and physiological responses.

Results: Participants showed balanced demographics with no significant differences in baseline characteristics (e.g., resting heart rate: 72.15 ± 8.22 bpm; systolic BP: 118.23 ± 12.56 mmHg). VO₂max was slightly higher in males (43.45 ± 7.89 ml/kg/min) than females (41.23 ± 6.89 ml/kg/min). Coronary artery variations were the most common anatomical finding (25.56%), followed by valvular abnormalities (18.89%) and chamber enlargement (12.22%). ECG abnormalities, including arrhythmias (14.44%) and ischemic changes (10.00%), were relatively infrequent and similar between genders. Post-exercise recovery parameters showed no significant gender differences, with heart rate recovery averaging 23.45 ± 5.12 bpm.

Conclusion: Anatomical variations play a significant role in modulating responses to exercise-induced cardiac stress, affecting cardiovascular performance and recovery. Although no significant gender-based differences were observed, variations such as coronary artery configurations and chamber dimensions influenced individual responses. These findings underscore the importance of personalized exercise regimens and the need for further research, especially in populations with cardiovascular conditions, to enhance exercise safety and optimize performance.