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By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
Charles Magee, Joshua Kazman, Mark Haigney, Ralph Oriscello, Kent J DeZee, Patricia Deuster, Patrick Depenbrock, Francis G O'Connor
BACKGROUND: Electrocardiogram (ECG) with preparticipation evaluation (PPE) for athletes remains controversial in the United States and diagnostic accuracy of clinician ECG interpretation is unclear. This study aimed to assess reliability and validity of clinician ECG interpretation using expert-validated ECGs according to the 2010 European Society of Cardiology (ESC) interpretation criteria. METHODS: This is a blinded, prospective study of diagnostic accuracy of clinician ECG interpretation...
July 2014: Annals of Noninvasive Electrocardiology
Calum J Redpath, Peter H Backx
PURPOSE OF REVIEW: Endurance exercise, despite a plethora of proven health benefits, is increasingly recognized as a potential cause of lone atrial fibrillation. Moderate exercise reduces all-cause mortality and protects against developing atrial fibrillation. However, more intense exercise regimes confer modest incremental health benefits, induce cardiac remodelling and negate some of the cardiovascular benefits of exercise. The implications of endurance exercise and athletic heart are becoming increasingly relevant as the popularity of endurance exercise has increased 20-fold within a generation...
January 2015: Current Opinion in Cardiology
Silvana Molossi, Michelle Grenier
Although rare, sudden cardiac death (SCD) is devastating to families and communities. Screening of athletes prior to sports participation by trained professionals is useful in identifying individuals who carry known risk factors for SCD. Inclusive in this population are those athletes with congenital heart disease. Sports medicine specialists should be able to identify those at risk for adverse events surrounding vigorous activity and direct appropriate evaluation by the specialist (ie, cardiologist) as deemed appropriate...
July 2015: Clinics in Sports Medicine
Todd A Astorino, Angela J Matera, Jency Basinger, Mindy Evans, Taylor Schurman, Rodney Marquez
Energy drinks are frequently consumed by athletes prior to competition to improve performance. This study examined the effect of Red Bull™ on repeated sprint performance in women athletes. Fifteen collegiate soccer players participated, with mean age, height, and body mass equal to 19.5±1.1 year, 168.4±5.8 cm, and 63.4±6.1 kg, respectively. After performing a familiarization trial, subjects performed three sets of eight bouts of the modified t test after ingestion of 255 mL of placebo or Red Bull 1 h pre-exercise in a randomized, placebo-controlled crossover design...
May 2012: Amino Acids
Jonathan H Kim, Peter A Noseworthy, David McCarty, Kibar Yared, Rory Weiner, Francis Wang, Malissa J Wood, Adolph M Hutter, Michael H Picard, Aaron L Baggish
We sought to determine the clinical and physiologic significance of electrocardiographic complete right bundle branch block (CRBBB) and incomplete right bundle branch block (IRBBB) in trained athletes. The 12-lead electrocardiographic and echocardiographic data from 510 competitive athletes were analyzed. Compared to the 51 age-, sport type-, and gender-matched athletes with normal 12-lead electrocardiographic QRS complex duration, the 44 athletes with IRBBB (9%) and 13 with CRBBB (3%) had larger right ventricular (RV) dimensions, as measured by the basal RV end-diastolic diameter (CRBBB 43 ± 3 mm, IRBBB 38 ± 6 mm, normal QRS complex 35 ± 4 mm, p <0...
April 1, 2011: American Journal of Cardiology
M G Wilson, S Sharma, F Carré, P Charron, P Richard, R O'Hanlon, S K Prasad, H Heidbuchel, J Brugada, O Salah, M Sheppard, K P George, G Whyte, B Hamilton, H Chalabi
Preparticipation screening programmes for underlying cardiac pathologies are now commonplace for many international sporting organisations. However, providing medical clearance for an asymptomatic athlete without a family history of sudden cardiac death (SCD) is especially challenging when the athlete demonstrates particularly abnormal repolarisation patterns, highly suggestive of an inherited cardiomyopathy or channelopathy. Deep T-wave inversions of ≥ 2 contiguous anterior or lateral leads (but not aVR, and III) are of major concern for sports cardiologists who advise referring team physicians, as these ECG alterations are a recognised manifestation of hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC)...
November 2012: British Journal of Sports Medicine
C C C Abad, A M do Nascimento, S Gil, R Kobal, I Loturco, F Y Nakamura, C T Mostarda, M C Irigoyen
The autonomic nervous system (ANS) has an important role in physical performance. However, the cardiac ANS activity in high-level track and field athletes has been poorly explored. Thus, we tested the hypothesis that endurance and power athletes would present a markedly different cardiac autonomic control at rest. We analyzed the cardiac ANS by means of time and frequency domains heart rate variability (HRV) analyses and by symbolic analysis. Endurance athletes showed higher pulse interval than power athletes (1,265±126 vs...
August 2014: International Journal of Sports Medicine
Niek H J Prakken, Arco J Teske, Maarten J Cramer, Arend Mosterd, Annieke C Bosker, Willem P Mali, Pieter A Doevendans, Birgitta K Velthuis
OBJECTIVE: Echocardiographic cut-off values are often used for cardiac MRI in athletic persons. This study investigates the difference between echocardiographic and cardiac MRI measurements of ventricular and atrial dimensions and ventricular wall thickness, and its effect on volume and wall mass prediction in athletic subjects compared with non-athletic controls. METHODS: Healthy non-athletic (59), regular athletic (59) and elite athletic (63) persons, aged 18-39 years and training 2...
April 2012: British Journal of Sports Medicine
Flavio D'Ascenzi, Antonio Pelliccia, Federico Alvino, Marco Solari, Antonella Loffreno, Matteo Cameli, Marta Focardi, Marco Bonifazi, Sergio Mondillo
OBJECTIVE: LV longitudinal strain, a recognised marker of LV function, has been recently applied to the evaluation of the athlete's heart. At present, little is known about the influence of training on LV global longitudinal strain (GLS) in athletes. The aim of this study was to prospectively investigate the impact of training on LV longitudinal strain and twist mechanics in a cohort of competitive athletes. METHODS: Ninety-one competitive athletes, practising team sports and competing at national or international level, were analysed...
November 2015: Heart: Official Journal of the British Cardiac Society
Shona L Halson
Many athletes, coaches, and support staff are taking an increasingly scientific approach to both designing and monitoring training programs. Appropriate load monitoring can aid in determining whether an athlete is adapting to a training program and in minimizing the risk of developing non-functional overreaching, illness, and/or injury. In order to gain an understanding of the training load and its effect on the athlete, a number of potential markers are available for use. However, very few of these markers have strong scientific evidence supporting their use, and there is yet to be a single, definitive marker described in the literature...
November 2014: Sports Medicine
Tim Luijkx, Maarten J Cramer, Constantinus F Buckens, Abbas Zaidi, Rienk Rienks, Arend Mosterd, Niek Hj Prakken, Barbara Dijkman, Willem P Th M Mali, Birgitta K Velthuis
BACKGROUND: Differentiating physiological left ventricular hypertrophy (LVH) in athletes from pathological hypertrophic cardiomyopathy (HCM) can be challenging. This study assesses the ability of cardiac MRI (CMR) to distinguish between physiological LVH (so-called athlete's heart) and HCM. METHODS: 45 patients with HCM (71% men and 20% athletic) and 734 healthy control participants (60% men and 75% athletic) underwent CMR. Quantitative ventricular parameters were used for multivariate logistic regression with age, gender, sport status and left ventricular (LV) end-diastolic volume (EDV) to ED ventricular wall mass (EDM) ratio as covariates...
November 2015: British Journal of Sports Medicine
Stefano Caselli, Dalma Montesanti, Camillo Autore, Fernando M Di Paolo, Cataldo Pisicchio, Maria Rosaria Squeo, Beatrice Musumeci, Antonio Spataro, Natesa G Pandian, Antonio Pelliccia
BACKGROUND: Two-dimensional speckle-tracking echocardiography is an emerging modality for the assessment of systolic and diastolic myocardial deformation in a broad variety of clinical scenarios. However, normal values and physiologic limits of left ventricular strain and strain rate in trained athletes are largely undefined. METHODS: Two hundred consecutive Olympic athletes (grouped into skill, power, mixed, and endurance disciplines) and 50 untrained controls were evaluated by two-dimensional speckle-tracking echocardiography...
February 2015: Journal of the American Society of Echocardiography
Timothy E Paterick, Tia Gordon, Denise Spiegel
Cardiovascular physiologic remodeling associated with athleticism may mimic many of the features of genetic and acquired heart disease. The most pervasive dilemma is distinguishing between normal and abnormal physiologic remodeling in an athlete's heart. Imaging examinations, such as magnetic resonance imaging and computed tomography, which focus predominantly on anatomy, and electrocardiography, which monitors electrical components, do not simultaneously evaluate cardiac anatomy and physiology. Despite nonlinear anatomic and electrical remodeling, the athlete's heart retains normal or supernormal myocyte function, whereas a diseased heart has various degrees of pathophysiology...
September 2014: Journal of the American Society of Echocardiography
Terrie M Williams, Penni Bengtson, Diana L Steller, Donald A Croll, Randall W Davis
The incidence of cardiovascular disease in humans is more than three times that of many wild and domestic mammals despite nearly identical heart morphologies and responses to exercise. A survey of mammalian species from 0.002-kg shrews to 43,000-kg whales shows that the human heart is more dog-like than cat-like and that neither body size nor longevity accounts for the relative vulnerability to cardiovascular disease. Rather, a major difference is daily activity patterns, which may underlie the comparatively healthy hearts of wild mammals...
September 2015: Physiology
A Martinez-Nicolas, A Muntaner-Mas, F B Ortega
No abstract text is available yet for this article.
August 18, 2016: British Journal of Sports Medicine
Florent Besnier, Marc Labrunée, Atul Pathak, Anne Pavy-Le Traon, Céline Galès, Jean-Michel Sénard, Thibaut Guiraud
Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels...
August 16, 2016: Annals of Physical and Rehabilitation Medicine
Flavio D'Ascenzi, Marco Solari, Francesca Anselmi, Silvia Maffei, Marta Focardi, Marco Bonifazi, Sergio Mondillo, Michael Henein
AIMS: Previous studies investigated the exercise-induced adaptation of left (LA) and right atrium (RA) in adults, but little is known about respective changes in the growing heart of children. We aimed to longitudinally investigate the effects of endurance training on biatrial remodelling in preadolescent athletes. METHODS AND RESULTS: Ninety-four children (57 endurance athletes, 37 sedentary controls; mean age 10.8±0.2 and 10.2±0.2years, respectively) were evaluated at baseline and after 5months by ECG and by two-dimensional, three-dimensional (3D) and speckle-tracking echocardiography...
November 15, 2016: International Journal of Cardiology
Alejandro Santos-Lozano, Helios Pareja-Galeano, Fabian Sanchis-Gomar, Miguel Quindós-Rubial, Carmen Fiuza-Luces, Carlos Cristi-Montero, Enzo Emanuele, Nuria Garatachea, Alejandro Lucia
OBJECTIVE: To explore whether being physically active can decrease Alzheimer disease (AD) risk. PARTICIPANTS AND METHODS: We conducted a meta-analysis of prospective observational cohort studies reporting the association between physical activity (PA) and incident AD. Relevant articles were identified by title and abstract in the electronic databases PubMed, ScienceDirect, and Scopus using the keywords Alzheimer, Alzheimer disease, Alzheimer's, Alzheimer's disease, physical activity, sport, exercise, sedentary, fitness, and combinations thereof for articles published in any language up to February 15, 2016...
August 2016: Mayo Clinic Proceedings
Jonathan A Drezner, David S Owens, Jordan M Prutkin, Jack C Salerno, Kimberly G Harmon, Shelley Prosise, Alana Clark, Irfan M Asif
The most effective protocol for cardiovascular screening of competitive athletes remains highly controversial. This study was a prospective, multicenter trial of cardiovascular screening at 35 National Collegiate Athletic Association institutions. Screening included a standardized history and physical examination (PE) as recommended by the American Heart Association and a 12-lead electrocardiogram (ECG) at rest. Centralized electrocardiographic interpretation was provided using the Seattle criteria. Athletes with screening abnormalities underwent additional evaluation directed by the host institution medical team...
September 1, 2016: American Journal of Cardiology
Colin N Moran, Yannis P Pitsiladis
Cyclists in the Tour de France are endurance specialists. Twin and family studies have shown that approximately 50% of the variance in a number of performance-related phenotypes (whether measured at baseline, i.e., natural talent, or in response to training) including those important to cycling can be explained by genetic variation. Research into the specific genetic variants that are responsible has identified over 200 genes containing common genetic variants involved in the genetic predisposition to physical performance...
August 6, 2016: Journal of Sports Sciences
2016-08-10 22:07:33
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