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Cardiac remodeling induced by exercise in Caucasian male master athletes: a cross-sectional study. Int J Cardiovasc Imaging 2021; 38:69-78. [PMID: 34357523 DOI: 10.1007/s10554-021-02368-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022]
Abstract
To describe cardiac remodeling in a population of male master athletes evaluated by transthoracic echocardiography and to analyse its relationship with several exercise-related characteristics. A total of 105 male master athletes aged ≥ 40 years old, mostly involved in endurance sports (81.0%) with a median training-volume of 66 [44; 103] METs/h/week, were studied. Left ventricular end-diastolic and end-systolic volumes were above the references in 84.8% and 75.8% athletes, decreasing in frequency when adjusted for BSA (26.3% and 23.2%). LV geometry was changed in more than half of the athletes (eccentric hypertrophy 28.3%, concentric remodelling 15.2% and concentric hypertrophy 8.1%) and several right ventricular (RV) dimensions were increased. Left atrium was dilated in 53.5% and right atrium in 37.4% athletes; only one athlete had a dilated aorta. Mean LV ejection fraction was 61 ± 7% and global longitudinal strain - 18.3 ± 2.0%. Changes in LV geometry were more common in high intensity sports; LV dilation in athletes exercising > 10 h/week and in high intensity sports; RV dilation in athletes exercising > 66 MET-hour/week and in endurance sports. In multivariate analysis high intensity sports remained an independent predictor of changes in LV geometry. A significant proportion of male master athletes showed altered echocardiographic parameters compared to the reference values, more pronounced in those involved in endurance sports, with high intensity and high volume of exercise. This may correspond to exercise-induced physiological adaptations, reinforcing the concept that the characteristics of exercise are major determinants of cardiac remodeling and should be considered during athletes' evaluation.
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Herbert P, Hayes LD, Beaumont AJ, Grace FM, Sculthorpe NF. Six weeks of high intensity interval training (HIIT) facilitates a four year preservation of aerobic capacity in sedentary older males: A reunion study. Exp Gerontol 2021; 150:111373. [PMID: 33895265 DOI: 10.1016/j.exger.2021.111373] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
Long-term implications of acutely increased cardiorespiratory fitness following short-term exercise interventions in older adults are unknown. In this study, we examined peak oxygen uptake (VO2peak) after 4-years of 'free-living' after a high intensity interval training (HIIT) intervention. Seventeen lifelong exercisers (LEX) and 17 previously sedentary (SED) males (55-74 years of age in 2012) were tested four years (phase D) after our previous experiment which included 6-weeks of aerobic moderate intensity exercise (phase B), followed by 6-weeks of HIIT (phase C). At all stages, a standard incremental exercise protocol on a cycle ergometer was completed to determine VO2peak. SED (P = 1.000, Cohen's d = 0.01) and LEX (P = 1.000, Cohen's d = 0.11) VO2peak at phase D was not different from phase A (enrolment). SED experienced a large decrease in VO2peak from phase C to phase D (32 ± 6 ml·kg·min-1 to 27 ± 6 ml·kg·min-1 [P < 0.001, Cohen's d = 0.81]). LEX experienced a small decrease in VO2peak from phase C to phase D (42 ± 7 ml·kg·min-1 to 39 ± 9 ml·kg·min-1 [P < 0.001, Cohen's d = 0.46]). At phase D, LEX had greater VO2peak than SED (P < 0.001, Cohen's d = 1.73). The proportion of subjects who reported discontinuing training, maintaining moderate training, and maintaining HIIT differed between groups (P = 0.023), with LEX self-reporting more HIIT, and SED self-reporting more discontinuation from exercise. Those who continued exercising experienced a reduction in VO2peak over the four years from 39 ± 7 ml·kg·min-1 to 36 ± 9 ml·kg·min-1 (N = 25, P < 0.001, Cohen's d = 0.37), and those who discontinued exercising also experienced a reduction in VO2peak from 30 ± 7 ml·kg·min-1 to 25 ± 9 ml·kg·min-1 (N = 9, P = 0.003, Cohen's d = 0.62). Four years after completing a brief period of aerobic exercise and HIIT, older males demonstrated a preservation of VO2peak, irrespective of training status (LEX or SED). However, LEX exhibited greater VO2peak than SED after 4-years of unsupervised 'free-living'. Notably, participants who discontinued exercising experienced a greater reduction in VO2peak. These data suggest that a 6 weeks of supervised HIIT can facilitate the long term.
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Affiliation(s)
- Peter Herbert
- School of Sport, Health and Outdoor Education, Trinity Saint David, University of Wales, UK
| | - Lawrence D Hayes
- School of Health and Life Sciences, University of the West of Scotland, UK.
| | | | - Fergal M Grace
- Faculty of Health, Federation University, Victoria, Australia
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Perrone MA, Passino C, Vassalle C, Masotti S, Romeo F, Guccione P, Bernardini S, Clerico A. Early evaluation of myocardial injury by means of high-sensitivity methods for cardiac troponins after strenuous and prolonged exercise. J Sports Med Phys Fitness 2020; 60:1297-1305. [PMID: 32720778 DOI: 10.23736/s0022-4707.20.11016-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
All the latest international guidelines recommend that cardiac troponin (cTn) I and T should be considered the preferred biomarkers for diagnosis of acute myocardial infarction. However, only in the last 5 years, a progressive improvement in analytical performance of immunometric assays has allowed the measurement of circulating levels of cTnI and cTnT in the large part of apparently healthy adult subjects. The routine use of these high-sensitivity methods for cardiac troponin (hs-cTn) assay has in a short time demonstrated that cardiac troponin concentrations frequently increase after strenuous prolonged exercise in healthy athletes. This acute response of hs-cTn assay following exercise was at first considered to be physiological and without long-term adverse consequences. More recent studies have suggested that exercise-induced increases in hs-cTn values may not be always a physiological response to exercise, but, conversely, it should sometimes be considered as an early cardiovascular risk marker. The aim of this review is to provide an overview of acute and chronic effects of strenuous physical exercise on hs-cTn circulating levels and also to discuss the potential pathophysiological and clinical implications of biomarker responses.
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Affiliation(s)
- Marco A Perrone
- Department of Cardiology, Tor Vergata University, Rome, Italy - .,Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy - .,University Sports Center, Tor Vergata University, Rome, Italy -
| | - Claudio Passino
- Fondazione Toscana G. Monasterio, Council of National Research, Pisa, Italy.,Scuola Superiore Sant'Anna, Pisa, Italy
| | - Cristina Vassalle
- Fondazione Toscana G. Monasterio, Council of National Research, Pisa, Italy.,Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvia Masotti
- Fondazione Toscana G. Monasterio, Council of National Research, Pisa, Italy.,Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesco Romeo
- Department of Cardiology, Tor Vergata University, Rome, Italy
| | - Paolo Guccione
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Sergio Bernardini
- University Sports Center, Tor Vergata University, Rome, Italy.,Department of Clinical Biochemistry and Clinical Molecular Biology, Tor Vergata University, Rome, Italy
| | - Aldo Clerico
- Fondazione Toscana G. Monasterio, Council of National Research, Pisa, Italy.,Scuola Superiore Sant'Anna, Pisa, Italy
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Beaumont AJ, Grace FM, Richards JC, Campbell AK, Sculthorpe NF. Aerobic Training Protects Cardiac Function During Advancing Age: A Meta-Analysis of Four Decades of Controlled Studies. Sports Med 2020; 49:199-219. [PMID: 30374946 PMCID: PMC6513799 DOI: 10.1007/s40279-018-1004-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. Electronic supplementary material The online version of this article (10.1007/s40279-018-1004-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander J Beaumont
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK
| | - Fergal M Grace
- Human Movement and Sports Science Group, Faculty of Health, Federation University Australia, Ballarat, VIC, Australia
| | - Joanna C Richards
- School of Sport Science and Physical Activity, Institute of Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK
| | - Amy K Campbell
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK
| | - Nicholas F Sculthorpe
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK.
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Beaumont A, Campbell A, Grace F, Sculthorpe N. Cardiac Response to Exercise in Normal Ageing: What Can We Learn from Masters Athletes? Curr Cardiol Rev 2018; 14:245-253. [PMID: 30095058 PMCID: PMC6300801 DOI: 10.2174/1573403x14666180810155513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. CONCLUSION This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy.
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Affiliation(s)
- A. Beaumont
- Address correspondence to this author at the Institute of Clinical Exercise and Health Science, University of the West of Scotland, G72 0LH, Scotland; E-mail:
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Tinker A, Haines E, Molloy L, Pennells L, Russell E, Monks I. What future for older women ex-athletes? Med Chir Trans 2017; 110:129-130. [DOI: 10.1177/0141076817692157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anthea Tinker
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
| | - Elodie Haines
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
| | - Laura Molloy
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
| | - Laura Pennells
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
| | - Evelina Russell
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
| | - Imogen Monks
- Institute of Gerontology, King’s College London, London WC2R 2LS, UK
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Liu HB, Yuan WX, Qin KR, Hou J. Acute effect of cycling intervention on carotid arterial hemodynamics: basketball athletes versus sedentary controls. Biomed Eng Online 2015; 14 Suppl 1:S17. [PMID: 25602805 PMCID: PMC4306107 DOI: 10.1186/1475-925x-14-s1-s17] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To compare the acute effects of a cycling intervention on carotid arterial hemodynamics between basketball athletes and sedentary controls. METHODS Ten young long-term trained male basketball athletes (BA) and nine age-matched male sedentary controls (SC) successively underwent four bouts of exercise on a bicycle ergometer at the same workload. Hemodynamic variables at right common carotid artery were determined at rest and immediately following each bout of exercise. An ANCOVA was used to compare differences between the BA and SC groups at rest and immediately following the cycling intervention. The repeated ANOVA was used to assess differences between baseline and each bout of exercise within the BA or SC group. RESULTS In both groups, carotid hemodynamic variables showed significant differences at rest and immediately after the cycling intervention. At rest, carotid arterial stiffness was significantly decreased and carotid arterial diameter was significantly increased in the BA group as compared to the SC group. Immediately following the cycling intervention, carotid arterial stiffness showed no obvious changes in the BA group but significantly increased in the SC group. It is worth noting that while arterial stiffness was lower in the BA group than in the SC group, the oscillatory shear index (OSI) was significantly higher in the BA group than in the SC group both at rest and immediately following the cycling intervention. CONCLUSION Long-term basketball exercise had a significant impact on common carotid arterial hemodynamic variables not only at rest but also after a cycling intervention. The role of OSI in the remodeling of arterial structure and function in the BA group at rest and after cycling requires clarification.
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Vogel T, Lang PO, Schmitt E, Lepretre PM, Kaltenbach G, Goette-Di Marco P, Talha S, Lonsdorfer J, Geny B. Effects of a personalized nine weeks intermittent exercise working program on left ventricle filling function in middle-aged women with mild diastolic dysfunction. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bjerke W, Steinman S, Cotto V. Cardiac rehabilitation programmes for low-risk patients and leisure athletes: A potential paradox. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.2.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Wendy Bjerke
- associate clinical professor at Sacred Heart University in Fairfield CT, USA
| | - Stu Steinman
- Owner and Director of Westsports Medicine in Westport CT and is an Adjunct Professor at Sacred Heart University, USA
| | - Vincent Cotto
- environmental health and safety ergonomics intern at Sikorsky Aircraft Corporation in Stratford CT, USA
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Schmidt JF, Andersen TR, Andersen LJ, Randers MB, Hornstrup T, Hansen PR, Bangsbo J, Krustrup P. Cardiovascular function is better in veteran football players than age-matched untrained elderly healthy men. Scand J Med Sci Sports 2013; 25:61-9. [PMID: 24303918 DOI: 10.1111/sms.12153] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/29/2022]
Abstract
The aim of the study was to determine whether lifelong football training may improve cardiovascular function, physical fitness, and body composition. Our subjects were 17 male veteran football players (VPG; 68.1 ± 2.1 years) and 26 healthy age-matched untrained men who served as a control group (CG; 68.2 ± 3.2 years). Examinations included measurements of cardiac function, microvascular endothelial function [reactive hyperemic index (RHI)], maximum oxygen uptake (VO2max), and body composition. In VPG, left ventricular (LV) end-diastolic volume was 20% larger (P < 0.01) and LV ejection fraction was higher (P < 0.001). Tissue Doppler imaging revealed an augmented LV longitudinal displacement, i.e., LV shortening of 21% (P < 0.001) and longitudinal 2D strain was 12% higher (P < 0.05), in VPG. In VPG, resting heart rate was lower (6 bpm, P < 0.05), and VO2max was higher (18%, P < 0.05). In addition, RHI was 21% higher (P < 0.05) in VPG. VPG also had lower body mass index (P < 0.05), body fat percentage, total body fat mass, android fat percentage, and gynoid fat percentage (all P < 0.01). Lifelong participation in football training is associated with better LV systolic function, physical fitness, microvascular function, and a healthier body composition. Overall, VPG have better cardiovascular function compared with CG, which may reduce their cardiovascular morbidity and mortality.
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Affiliation(s)
- J F Schmidt
- Copenhagen Centre for Team Sport and Health, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Gentofte Hospital, Gentofte, Denmark
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Kusy K, Zieliński J. Aerobic capacity in speed-power athletes aged 20-90 years vs endurance runners and untrained participants. Scand J Med Sci Sports 2012; 24:68-79. [DOI: 10.1111/j.1600-0838.2012.01496.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2012] [Indexed: 11/28/2022]
Affiliation(s)
- K. Kusy
- Department of Athletics; Eugeniusz Piasecki University School of Physical Education; Poznań Poland
| | - J. Zieliński
- Department of Athletics; Eugeniusz Piasecki University School of Physical Education; Poznań Poland
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Comparison of pro-atrial natriuretic peptide and atrial remodeling in marathon versus non-marathon runners. Am J Cardiol 2012; 109:1060-5. [PMID: 22221947 DOI: 10.1016/j.amjcard.2011.11.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 01/18/2023]
Abstract
Long-term endurance sports are associated with atrial remodeling and an increased risk for atrial fibrillation (AF) and atrial flutter. Pro-atrial natriuretic peptide (pro-ANP) is a marker of atrial wall tension and elevated in patients with AF. The aim of this study was to test the hypothesis that atrial remodeling would be perpetuated by repetitive episodes of atrial stretching during strenuous competitions, reflected by elevated levels of pro-ANP. A cross-sectional study was performed on nonelite runners scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race. Four hundred ninety-two marathon and nonmarathon runners applied for participation, 70 were randomly selected, and 56 entered the final analysis. Subjects were stratified according to former marathon participations: a control group (nonmarathon runners, n = 22), group 1 (1 to 4 marathons, n = 16), and group 2 (≥5 marathons, n = 18). Results were adjusted for age, training years, and average weekly endurance training hours. The mean age was 42 ± 7 years. Compared to the control group, marathon runners in groups 1 and 2 had larger left atria (25 ± 6 vs 30 ± 6 vs 34 ± 7 ml/m(2), p = 0.002) and larger right atria (27 ± 7 vs 31 ± 8 vs 35 ± 5 ml/m(2), p = 0.024). Pro-ANP levels at baseline were higher in marathon runners (1.04 ± 0.38 vs 1.42 ± 0.74 vs 1.67 ± 0.69 nmol/L, p = 0.006). Pro-ANP increased significantly in all groups after the race. In multiple linear regression analysis, marathon participation was an independent predictor of left atrial (β = 0.427, p <0.001) and right atrial (β = 0.395, p = 0.006) remodeling. In conclusion, marathon running was associated with progressive left and right atrial remodeling, possibly induced by repetitive episodes of atrial stretching. The altered left and right atrial substrate may facilitate atrial arrhythmias.
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Felipe Salech M, Rafael Jara L, Luis Michea A. Cambios fisiológicos asociados al envejecimiento. REVISTA MÉDICA CLÍNICA LAS CONDES 2012. [DOI: 10.1016/s0716-8640(12)70269-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Wilhelm M, Roten L, Tanner H, Wilhelm I, Schmid JP, Saner H. Gender differences of atrial and ventricular remodeling and autonomic tone in nonelite athletes. Am J Cardiol 2011; 108:1489-95. [PMID: 21864814 DOI: 10.1016/j.amjcard.2011.06.073] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 06/17/2011] [Accepted: 06/28/2011] [Indexed: 12/17/2022]
Abstract
Veteran endurance athletes have an increased risk of developing atrial fibrillation (AF), with a striking male predominance. We hypothesized that male athletes were more prone to atrial and ventricular remodeling and investigated the signal-averaged P wave and factors that promote the occurrence of AF. Nonelite athletes scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race, were invited. Of the 873 marathon and nonmarathon runners who were willing to participate, 68 female and 70 male athletes were randomly selected. The runners with cardiovascular disease or elevated blood pressure (>140/90 mm Hg) were excluded. Thus, 121 athletes were entered into the final analysis. Their mean age was 42 ± 7 years. No gender differences were found for age, lifetime training hours, or race time. The male athletes had a significantly longer signal-averaged P-wave duration (136 ± 12 vs 122 ± 10 ms; p <0.001). The left atrial volume was larger in the male athletes (56 ± 13 vs 49 ± 10 ml; p = 0.001), while left atrial volume index showed no differences (29 ± 7 vs 30 ± 6 ml/m²; p = 0.332). In male athletes, the left ventricular mass index (107 ± 17 vs 86 ± 16 g/m²; p <0.001) and relative wall thickness (0.44 ± 0.06 vs 0.41 ± 0.07; p = 0.004) were greater. No differences were found in the left ventricular ejection fraction (63 ± 4% vs 66 ± 6%; p = 0.112) and mitral annular tissue Doppler e' velocity (10.9 ± 1.5 vs 10.6 ± 1.5 cm/s; p = 0.187). However, the tissue Doppler a' velocity was higher (8.7 ± 1.2 vs 7.6 ± 1.3 cm/s; p < 0.001) in the male athletes. Male athletes had a higher systolic blood pressure at rest (123 ± 9 vs 110 ± 11 mm Hg; p < 0.001) and at peak exercise (180 ± 15 vs 169 ± 19 mm Hg; p = 0.001). In the frequency domain analysis of heart rate variability, the sympatho-vagal balance, represented by the low/high-frequency power ratio, was significantly greater in male athletes (5.8 ± 2.8 vs 3.9 ± 1.9; p < 0.001). Four athletes (3.3%) had at least one documented episode of paroxysmal AF, all were men (p = 0.042). In conclusion, for a comparable amount of training and performance, male athletes showed a more pronounced atrial remodeling, a concentric type of ventricular remodeling, and an altered diastolic function. A higher blood pressure at rest and during exercise and a higher sympathetic tone might be causal. The altered left atrial substrate might facilitate the occurrence of AF.
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Affiliation(s)
- Matthias Wilhelm
- Division of Cardiovascular Prevention, Rehabilitation, and Sports Cardiology, Department of Cardiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
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Reply to: do marathon runners face an “ominous” risk of myocardial fibrosis? Eur J Appl Physiol 2011. [DOI: 10.1007/s00421-011-1895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Do marathon runners face an "ominous" risk of myocardial fibrosis? Eur J Appl Physiol 2010; 111:1225-6; author reply 1227-9. [PMID: 21082194 DOI: 10.1007/s00421-010-1727-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2010] [Indexed: 10/18/2022]
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