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sudden death and exercise

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https://www.readbyqxmd.com/read/28318658/sudden-death-in-athletes
#1
Domenico Corrado, Alessandro Zorzi
Competitive sports activity is associated with an increased risk of sudden cardiovascular death (SCD) in adolescents and young adults with clinically silent cardiovascular disorders. While in middle-aged/senior athletes atherosclerotic coronary artery disease accounts for the vast majority of SCDs, in young athletes the spectrum of substrates is wider and includes inherited (cardiomyopathies) and congenital (anomalous origin of coronary arteries) structural heart diseases. Inherited ion channel diseases have been implicated in SCDs occurring with an apparently normal heart at autopsy...
March 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28316113/the-utility-of-exercise-testing-in-risk-stratification-of-asymptomatic-patients-with-type-1-brugada-pattern
#2
Muthiah Subramanian, Mukund A Prabhu, M S Harikrishnan, Saritha S Shekhar, Praveen G Pai, K U Natarajan
INTRODUCTION: Risk stratification of asymptomatic patients with a Brugada type 1 ECG pattern remains an unresolved clinical conundrum. In contrast to provocative pharmacological testing in Brugada syndrome, there is limited data on the role of exercise stress testing as a risk stratification modality. The objective of this study was to evaluate the utility of exercise testing in asymptomatic patients with type 1 Brugada pattern to prognosticate major arrhythmic events(MAE) during follow-up...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28306757/effect-of-moderate-intensity-exercise-training-on-peak-oxygen-consumption-in-patients-with-hypertrophic-cardiomyopathy-a-randomized-clinical-trial
#3
Sara Saberi, Matthew Wheeler, Jennifer Bragg-Gresham, Whitney Hornsby, Prachi P Agarwal, Anil Attili, Maryann Concannon, Annika M Dries, Yael Shmargad, Heidi Salisbury, Suwen Kumar, Jonathan Herrera, Jonathan Myers, Adam S Helms, Euan A Ashley, Sharlene M Day
Importance: Formulating exercise recommendations for patients with hypertrophic cardiomyopathy is challenging because of concern about triggering ventricular arrhythmias and because a clinical benefit has not been previously established in this population. Objective: To determine whether moderate-intensity exercise training improves exercise capacity in adults with hypertrophic cardiomyopathy. Design, Setting, and Participants: A randomized clinical trial involving 136 patients with hypertrophic cardiomyopathy was conducted between April 2010 and October 2015 at 2 academic medical centers in the United States (University of Michigan Health System and Stanford University Medical Center)...
March 17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28293624/excessive-exercise-habits-in-marathoners-as-novel-indicators-of-masked-hypertension
#4
Young-Joo Kim, Yongbum Park, Duk-Ho Kang, Chul-Hyun Kim
Background. Excessive exercise such as marathon running increases the risk of cardiovascular events that may be related to myocardial infarction and sudden death. We aimed to investigate that the exercise characteristics can be used as a novel indicator of masked hypertension. Methods. A total of 571 middle-aged recreational male marathoners were assigned to a high blood pressure group (HBPG; n = 214) or a normal blood pressure group (NBPG; n = 357). A graded exercise test was used to examine the hemodynamic response and cardiac events, and the personal exercise characteristics were recorded...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28291666/risk-and-protective-factors-for-sudden-cardiac-death-during-leisure-activities-in-the-mountains-an-update
#5
REVIEW
Martin Burtscher
INTRODUCTION: Annually, more than 100 million tourists with widely varying health and fitness status are attracted by the mountainous areas around the world. Whereas mountaineering activities may contribute to the well established beneficial effects of regular exercise, for certain individuals these activities are also associated with a relatively high risk of death. METHODS: This manuscript presents an updated overview of risk and protective factors for sudden cardiac death during leisure activities in the mountains...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28287681/the-preparticipation-physical-evaluation
#6
Patrick J Lehman, Rebecca L Carl
With rising rates of sports participation among children and adolescents, pediatricians are increasingly being called upon to perform preparticipation physical evaluations (PPEs) for young athletes. The purpose of this review article is to discuss the general structure of a comprehensive PPE and how the PPE differs from a typical health maintenance visit. The PPE focuses attention on screening for cardiac conditions that predispose athletes to sudden cardiac death with exercise. This review also addresses the debate over whether electrocardiogram screening should be a routine required part of the PPE...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28282353/the-use-of-echocardiograms-in-preparticipation-examinations
#7
Caroline Lucas, Deanna L Kerkhof, Jacilyn E Briggs, Gianmichel D Corrado
Sudden cardiac death (SCD) is the leading cause of death during exercise in young athletes. Preparticipation physical examinations were developed to maintain the health and safety of athletes, including the prompt identification of those at risk for SCD. The use of medical history and physical examinations, electrocardiography, and echocardiography, or some combination thereof, is the source of continued debate. This article provides an overview of the etiology of SCD and reviews literature relating to preparticipation echocardiography, with a focus on its evolution, utility, and effectiveness...
March 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28271806/cardiovascular-physiology-and-disease-in-youth-2016
#8
Thomas Rowland
The two articles in the area of cardiovascular physiology and disease in youth were chosen for commentary because of their exploration of new approaches to the diagnosis and management of cardiovascular derangements in young persons. The first, by Hinds et al., describes the potential clinical importance of detection of cardiovascular changes during exercise testing in adolescent athletes following concussions. This approach might prove useful in establishing safe return-to-play guidelines. The second, a review article by Van De Schoor et al, evaluates the frequency of myocardial scarring in athletes, some of adolescent age, which is a recognized risk factor for sudden cardiac death...
February 2017: Pediatric Exercise Science
https://www.readbyqxmd.com/read/28267896/treatment-of-supraventricular-tachycardia-in-a-horse
#9
Dorothy D Whelchel, Brett S Tennent-Brown, Amanda E Coleman, Gregg S Rapoport, Uriel Blas-Machado, Herbert W Maisenbacher, Brenton C Credille, Steeve Giguère
OBJECTIVE: To describe the treatment of persistent supraventricular tachycardia (SVT) in a young horse in endurance training. CASE SUMMARY: A 6-year-old Arab gelding in endurance training presented for a dysrhythmia and decreased performance. SVT was diagnosed and conversion to a normal sinus rhythm was achieved following administration of a constant rate infusion of amiodarone. However, reversion to SVT occurred shortly after initiation of ridden exercise. A second attempt to convert the dysrhythmia with amiodarone failed, but normal sinus rhythm was achieved with transvenous electrical cardioversion (TVEC)...
March 7, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28255936/sudden-arrhythmic-death-during-exercise-a-post-mortem-genetic-analysis
#10
Oscar Campuzano, Olallo Sanchez-Molero, Anna Fernandez, Irene Mademont-Soler, Monica Coll, Alexandra Perez-Serra, Jesus Mates, Bernat Del Olmo, Ferran Pico, Laia Nogue-Navarro, Georgia Sarquella-Brugada, Anna Iglesias, Sergi Cesar, Esther Carro, Juan Carlos Borondo, Josep Brugada, Josep Castellà, Jordi Medallo, Ramon Brugada
BACKGROUND: Sudden cardiac death is a natural and unexpected death that occurs within 1 h of the first symptom. Most sudden cardiac deaths occur during exercise, mostly as a result of myocardial infarction. After autopsy, some cases, especially in the young, are diagnosed as cardiomyopathies or remain without a conclusive cause of death. In both situations, genetic alterations may explain the arrhythmia. OBJECTIVE: Our aim was to identify a genetic predisposition to sudden cardiac death in a cohort of post-mortem cases of individuals who died during exercise, with a structurally normal heart, and were classified as arrhythmogenic death...
March 3, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28229200/-current-impact-of-cardiac-implantable-electronic-devices
#11
J Kuschyk, B Rudic, M Borggrefe, I Akin
Sudden cardiac death and chronic heart failure are among the main contributors to persisting high mortality rates in Germany. In addition to removal of causal factors and guideline-conform pharmacological therapy, therapy with cardiac implantable electronic devices (CIED) is of undisputed importance. Subcutaneous defibrillators have the advantage that they do not have intracardiac electrodes but still have the same efficacy and safety. For patients with a wide QRS complex and reduced ejection fraction, cardiac resynchronization has led to a reduction of morbidity and mortality...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28217234/inappropriate-shocks-from-a-subcutaneous-implantable-cardioverter-defibrillator-due-to-oversensing-during-periods-of-rate-related-bundle-branch-block
#12
Maria João Sousa, Tim Betts
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel technology with proven efficacy in sudden cardiac death prevention; however, there is a lack of long-term safety data. We describe the case of a 55-year-old female patient implanted with an S-ICD due to idiopathic ventricular fibrillation, who subsequently presented with inappropriate shocks leading to ventricular fibrillation that was successfully terminated by another shock. Inappropriate shocks were due to intermittent T wave oversensing during periods of rate-dependent right bundle branch block...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28216547/mid-term-follow-up-of-school-aged-children-with-borderline-long-qt-interval
#13
Aya Miyazaki, Heima Sakaguchi, Yu Matsumura, Yosuke Hayama, Kanae Noritake, Jun Negishi, Etsuko Tsuda, Yoshihiro Miyamoto, Takeshi Aiba, Wataru Shimizu, Kengo Kusano, Isao Shiraishi, Hideo Ohuchi
BACKGROUND: There are no definitive diagnostic criteria or follow-up strategies for long QT syndrome (LQTS) in children with a borderline long QT interval (b-LQT).Methods and Results:We retrospectively evaluated the clinical course, genetic testing results, corrected QT interval (QTc), and LQTS score of 59 school-aged children (5-18 years old) with a b-LQT (400≤QTc<500 ms). Syncope, but neither aborted cardiac arrest nor sudden cardiac death, occurred in 2 patients during the follow-up (6±3...
February 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#14
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28209387/associations-of-cardiovascular-and-all-cause-mortality-events-with-oxygen-uptake-at-ventilatory-threshold
#15
Setor K Kunutsor, Sudhir Kurl, Hassan Khan, Francesco Zaccardi, Jari A Laukkanen
BACKGROUND: Oxygen uptake (VO2) at ventilatory threshold (VT), is a cardiopulmonary exercise testing parameter which may be a proxy for peak VO2. We aimed to assess the associations of VO2 at VT with sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD), and all-cause mortality. METHODS AND RESULTS: VO2 at VT was assessed during a submaximal exercise test using respiratory gas analyzers in the Kuopio Ischemic Heart Disease cohort of 1639 middle-aged men...
February 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28202881/the-exercise-paradox-may-be-solved-by-measuring-the-overall-thrombotic-state-using-native-blood
#16
Hideo Ikarugi, Junichiro Yamamoto
While exercise is widely believed to prevent atherothrombotic diseases, it occasionally causes sudden death. This exercise paradox may be due to the inadequate testing of the thrombotic and thrombolytic status. A recently developed shear-induced thrombosis/endogenous fibrinolysis test performed with non-anticoagulated blood samples allows the assessment of the thrombotic state of an individual both at rest and after exercise. This sensitive and physiologically relevant test may help to solve the aforementioned exercise paradox...
February 14, 2017: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/28181352/benign-mitochondrial-myopathy-with-exercise-intolerance-in-a-large-multigeneration-family-due-to-a-homoplasmic-m-3250t-c-mutation-in-mttl1
#17
N Darin, C Hedberg-Oldfors, A-K Kroksmark, A-R Moslemi, G Kollberg, A Oldfors
BACKGROUND AND PURPOSE: Most mitochondrial disorders with onset in early childhood are progressive and involve multiple organs. The m.3250T>C mutation in MTTL1 has previously been described in a few individuals with a possibly riboflavin-responsive myopathy and an association with sudden infant death syndrome was suspected. We describe a large family with this mutation and evaluate the effect of riboflavin treatment. METHODS: Medical data were collected with the help of a standardized data collection form...
February 9, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28140625/ncaa-football-off-season-training-unanswered-prayers%C3%A2-a-prayer-answered
#18
Scott Anderson
Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 33 National Collegiate Athletic Association (NCAA) football players have died in sport: 27 nontraumatic deaths and 6 traumatic deaths, a ratio of 4.5 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season. Best practices, consensus guidelines, and precautions are ignored, elevating the risk...
February 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28137981/sudden-cardiac-death-the-pro-arrhythmic-interaction-of-an-acute-loading-with-an-underlying-substrate
#19
George R Sutherland
Sudden cardiac death (SCD) is a complex phenomenon, occurring either in apparently normal individuals or in those where there is a recognized underlying cardiac abnormality. In both groups, the lethal arrhythmia has frequently been related to the physiologic trigger of either exercise or stress. Prior research into SCD has focused mainly on a combination of identifying either vulnerable myocardial substrates; pharmacological approaches to altering electrical activation/repolarisation in substrates; or the suppression of induced lethal arrhythmias with implantable defibrillators...
January 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28122325/demographic-clinical-and-pathological-features-of-sudden-deaths-due-to-myocarditis-results-from-a-state-wide-population-based-autopsy-study
#20
Liliang Li, Yang Zhang, Allen Burke, Aimin Xue, Ziqin Zhao, David Fowler, Yiwen Shen, Ling Li
Causes of sudden cardiac deaths have been widely reported with limited data focused specifically on myocarditis. A retrospective review of cases from the Office of the Chief Medical Examiner (OCME), State of Maryland yielded a total of 103 sudden unexpected deaths (SUDs) due to myocarditis (0.17% of all SUDs and 0.70% of autopsied SUDs) from 2005 through 2014. Most deaths occurred in patients <30 years of age with a male:female ratio 1.3:1. Of the 103 cases, 45 (43.7%) patients were witnessed collapsed. Four deaths occurred during exertion, such as exercising at the gym or performing heavy physical work, and 2 deaths were associated with emotional stress...
January 3, 2017: Forensic Science International
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