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Weizman O, Marijon E. [Physical activity to reduce cardiovascular risk -Why deprive yourself ?]. Ann Cardiol Angeiol (Paris) 2024; 73:101764. [PMID: 38723317 DOI: 10.1016/j.ancard.2024.101764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 06/05/2024]
Abstract
Sports-related sudden death is an uncommon event, affecting mainly middle-aged men who practice leisure sports, and is related to unknown coronary artery disease. In athletes, cardiac causes are also predominant, with a greater proportion of structural and electrical heart disease. If first-aid resuscitation measures are initiated, survival easily exceeds 50%, and this is an excellent educational illustration of how to improve the prognosis of non-sport-related cardiac arrest. Prevention of a sport-related cardiovascular event remains difficult, and relies on clinical examination, questioning (including family history) and resting ECG in participants >35 years old. The non-contraindication visit is also an opportunity to pass on to the patient the rules of good sports "hygiene" and life-saving gestures in the event of sudden death during sport in one of the partners (and the importance of regularly educating oneself in life-saving gestures...).
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Affiliation(s)
| | - Eloi Marijon
- European Georges Pompidou Hospital, Paris, France.
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2
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Ghani U, Farooq O, Alam S, Khan MJ, Rahim O, Rahim S. Sudden Cardiac Death in Athletes: Consensuses and Controversies. Cureus 2023; 15:e39873. [PMID: 37404395 PMCID: PMC10315103 DOI: 10.7759/cureus.39873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Exercise is widely considered beneficial for cardiovascular health. However, on rare occasions, athletes experience sudden cardiac death without any preceding symptoms. The devastating nature of these events necessitates us to understand the underlying causes. In younger athletes (age <35), the underlying causes are usually hereditary/genetic, whereas in older athletes (age >35), coronary artery disease is prevalent. Sudden cardiac death in athletes can occur regardless of the presence of any structural abnormality in the heart. Despite divergence between guidelines, the majority of cardiology societies recommend at least taking a comprehensive history and performing physical examinations for initial screening for all athletes. This article reviews the consensuses and controversies regarding the incidence, causes, and prevention of sudden cardiac death in athletes.
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Affiliation(s)
- Usman Ghani
- Cardiology, Northwest General Hospital and Research Center, Peshawar, PAK
| | - Omer Farooq
- Internal Medicine, Presence Saint Francis Hospital, Evanston, USA
| | - Sundus Alam
- Cardiology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, GBR
| | - Muhammad Junaid Khan
- Orthopaedic Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, GBR
| | - Omar Rahim
- Internal Medicine, Naseer Teaching Hospital, Peshawar, PAK
| | - Sarah Rahim
- Cardiology, Rehman Medical Institute, Peshawar, PAK
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Weizman O, Empana JP, Blom M, Tan HL, Jonsson M, Narayanan K, Ringh M, Marijon E, Jouven X. Incidence of Cardiac Arrest During Sports Among Women in the European Union. J Am Coll Cardiol 2023; 81:1021-1031. [PMID: 36922087 DOI: 10.1016/j.jacc.2023.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Women represent a growing proportion of sports participants. Still, few original data regarding sudden cardiac arrest during sports (Sr-SCA) in women are available. OBJECTIVES The authors sought to assess the incidence, characteristics, and outcomes of women presenting with Sr-SCA. METHODS Data were analyzed from 3 population-based European registries (ESCAPE-NET 2020 Horizon Program) that prospectively and exhaustively collect every case of SCA: SDEC (Paris-Sudden Death Expertise Center), ARREST (AmsteRdam REsuscitation Studies), and SRCR (Swedish Register for Cardiopulmonary Resuscitation). Sr-SCA was defined as SCA during or ≤1 hour after cessation of sports activity. RESULTS Of 34,826 SCA between 2006 and 2017, 760 Sr-SCA (2.2%) were identified, including 54 in women. The average annual incidence of Sr-SCA in women in the 3 registries ranged from 0.10 per million (95% CI: 0.01-0.71 per million) to 0.38 per million (95% CI: 0.14-1.04 per million). Overall, the average annual incidence rate of Sr-SCA in women was 0.19 per million (95% CI: 0.14-0.24 per million), >10-fold lower compared with men (2.63 per million [95% CI: 2.45-2.83 per million]; P < 0.0001). When extrapolating to the total European population and accounting for age and sex, this yields 98 cases per year (95% CI: 72-123 cases per year) in women and 1,350 cases per year (95% CI: 1,256-1,451 cases per year) in men. Subject characteristics and circumstances of occurrence were similar in women vs men. Bystander response, time to defibrillation, and survival rate at hospital admission (58.8% vs 58.5%; P = 0.99) and 30 days did not differ significantly between women and men. CONCLUSIONS These findings emphasize the dramatically lower risk of Sr-SCA in women compared with men, despite similar subject characteristics. This should be considered in designing preparticipation screening strategies in the future.
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Affiliation(s)
- Orianne Weizman
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Marieke Blom
- Cardiology Department, Academic Medical Center, Amsterdam, the Netherlands
| | - Hanno L Tan
- Cardiology Department, Academic Medical Center, Amsterdam, the Netherlands
| | - Martin Jonsson
- Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Mattias Ringh
- Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France; Hôpital Européen Georges Pompidou, Paris, France.
| | - Xavier Jouven
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris Sudden Death Expertise Center (Paris-SDEC), Paris, France; Hôpital Européen Georges Pompidou, Paris, France
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Bassi MD, Farina JM, Bombau J, Fitz Maurice M, Bortman G, Nuñez E, Márquez M, Bornancini N, Baranchuk A. Sudden Cardiac Arrest in Basketball and Soccer Stadiums, the Role of Automated External Defibrillators: A Review. For the BELTRAN Study (BaskEtbaLl and soccer sTadiums: Registry on Automatic exterNal defibrillators). Arrhythm Electrophysiol Rev 2023; 12:e03. [PMID: 36845166 PMCID: PMC9945480 DOI: 10.15420/aer.2022.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023] Open
Abstract
Sudden cardiac arrest (SCA) during sports events has a dramatic impact on stadium-goers and the public and is often associated with poor outcomes unless treated with an automated external defibrillator (AED). Despite this, stadiums vary in AED use. This review aims to identify the risks and incidences of SCA, and the use of AEDs in soccer and basketball stadiums. A narrative review of all relevant papers was conducted. Athletes across all sports face an SCA risk of 1:50,000 athlete-years, with the greatest risk of SCA in young male athletes (1:35,000 person-years) and black male athletes (1:18,000 person-years). Africa and South America have the poorest soccer SCA outcomes at 3% and 4% survival. AED use on-site improves survival greater than defibrillation by emergency services. Many stadiums do not have AEDs implemented into medical plans and the AEDs are often unrecognisable or are obstructed. Therefore, AEDs should be used on-site, use clear signalling, have certified trained personnel, and be incorporated into stadiums' medical plans.
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Affiliation(s)
- Mario D. Bassi
- Department of Medicine, Kingston Health Science Centre, Queen’s University, Kingston, Ontario, Canada
| | - Juan M. Farina
- Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, Arizona, US
| | - Jorge Bombau
- Internal Medicine, National University of La Plata, Argentina
| | - Mario Fitz Maurice
- Department of Cardiology, Hospital de Agudos Bernardino Rivadavia, Buenos Aires, Argentina
| | | | - Elaine Nuñez
- Servicio de Cardiología, Cedimat Centro Cardiovascular, Santo Domingo, República Dominicana
| | - Manlio Márquez
- Department of Electrophysiology, Centro Médico ABC (American British Cowdray), Ciudad de México, México
| | - Norberto Bornancini
- Department of Cardiology, Hospital General de Agudos “General Manuel Belgrano”, Buenos Aires, Argentina
| | - Adrian Baranchuk
- Department of Medicine, Kingston Health Science Centre, Queen’s University, Kingston, Ontario, Canada,Division of Cardiology, Queen’s University, Kingston, Ontario, Canada
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De Palma FDE, Nunziato M, D’Argenio V, Savarese M, Esposito G, Salvatore F. Comprehensive Molecular Analysis of DMD Gene Increases the Diagnostic Value of Dystrophinopathies: A Pilot Study in a Southern Italy Cohort of Patients. Diagnostics (Basel) 2021; 11:diagnostics11101910. [PMID: 34679607 PMCID: PMC8534830 DOI: 10.3390/diagnostics11101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Duchenne/Becker muscular dystrophy (DMD/BMD) is an X-linked neuromuscular disease due to pathogenic sequence variations in the dystrophin (DMD) gene, one of the largest human genes. More than 70% of DMD gene defects result from genomic rearrangements principally leading to large deletions, while the remaining are small nucleotide variants, including nonsense and missense variants, small insertions/deletions or splicing alterations. Considering the large size of the gene and the wide mutational spectrum, the comprehensive molecular diagnosis of DMD/BMD is complex and may require several laboratory methods, thus increasing the time and costs of the analysis. In an attempt to simplify DMD/BMD molecular diagnosis workflow, we tested an NGS method suitable for the detection of all the different types of genomic variations that may affect the DMD gene. Forty previously analyzed patients were enrolled in this study and re-analyzed using the next generation sequencing (NGS)-based single-step procedure. The NGS results were compared with those from multiplex ligation-dependent probe amplification (MLPA)/multiplex PCR and/or Sanger sequencing. Most of the previously identified deleted/duplicated exons and point mutations were confirmed by NGS and 1 more pathogenic point mutation (a nonsense variant) was identified. Our results show that this NGS-based strategy overcomes limitations of traditionally used methods and is easily transferable to routine diagnostic procedures, thereby increasing the diagnostic power of DMD molecular analysis.
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Affiliation(s)
- Fatima Domenica Elisa De Palma
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
| | - Marcella Nunziato
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
| | - Valeria D’Argenio
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Open University, Via di Val Cannuta 247, 00166 Roma, Italy
| | - Maria Savarese
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
| | - Gabriella Esposito
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (G.E.); (F.S.); Tel.: +81-746-3146 (G.E.); +81-373-7826 (F.S.)
| | - Francesco Salvatore
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Naples, Italy; (F.D.E.D.P.); (M.N.); (V.D.); (M.S.)
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (G.E.); (F.S.); Tel.: +81-746-3146 (G.E.); +81-373-7826 (F.S.)
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Sollazzo F, Palmieri V, Gervasi SF, Cuccaro F, Modica G, Narducci ML, Pelargonio G, Zeppilli P, Bianco M. Sudden Cardiac Death in Athletes in Italy during 2019: Internet-Based Epidemiological Research. ACTA ACUST UNITED AC 2021; 57:medicina57010061. [PMID: 33445447 PMCID: PMC7827560 DOI: 10.3390/medicina57010061] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 02/02/2023]
Abstract
Background and objectives: An Italian nationwide pre-participation screening approach for prevention of sudden cardiac death in athletes (SCD-A) in competitive sportspeople showed promising results but did not achieve international consensus, due to cost-effectiveness and the shortfall of a monitoring plan. From this perspective, we tried to provide an epidemiological update of SCD-A in Italy through a year-long internet-based search. Materials and Methods: One year-long Google search was performed using mandatory and non-mandatory keywords. Data were collected according to prevalent SCD-A definition and matched with sport-related figures from Italian National Institute of Statistics (ISTAT) and Italian National Olympic Committee (CONI). Results: Ninety-eight cases of SCD-A in 2019 were identified (48.0% competitive, 52.0% non-competitive athletes). Male/female ratio was 13:1. The most common sports were soccer (33.7%), athletics (15.3%) and fitness (13.3%). A conclusive diagnosis was achieved only in 37 cases (33 of cardiac origin), with the leading diagnosis being coronary artery disease in 27 and a notably higher occurrence among master athletes. Combining these findings with ISTAT and CONI data, the SCD-A incidence rate in the whole Italian sport population was found to be 0.47/100,000 persons per year (1.00/100,000 in the competitive and 0.32/100,000 in the non-competitive population). The relative risk of SCD-A is 3.1 (CI 2.1–4.7; p < 0.0001) for competitive compared to non-competitive athletes; 9.9 for male (CI 4.6–21.4; p < 0.0001) with respect to female. Conclusions: We provided an updated incidence rate of SCD-A in both competitive and non-competitive sport in Italy. A higher risk of SCD-A among competitive and male athletes was confirmed, thus corroborating the value of Italian pre-participation screening in this population.
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Affiliation(s)
- Fabrizio Sollazzo
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
| | - Vincenzo Palmieri
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
- Correspondence: ; Tel.: +39-06-3015-4078; Fax: +39-06-3015-6656
| | - Salvatore Francesco Gervasi
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
| | - Francesco Cuccaro
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
| | - Gloria Modica
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
| | - Maria Lucia Narducci
- Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Istituto di Cardiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.N.); (G.P.)
| | - Gemma Pelargonio
- Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Istituto di Cardiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.N.); (G.P.)
| | - Paolo Zeppilli
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
| | - Massimiliano Bianco
- Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.S.); (S.F.G.); (F.C.); (G.M.); (P.Z.); (M.B.)
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Gati S, Drezner J, Sharma S. Highlights from the 2020 ESC guidelines on sport cardiology: practical management for safe sports and exercise in patients with cardiovascular disease. Heart 2020; 107:heartjnl-2020-318179. [PMID: 33303477 DOI: 10.1136/heartjnl-2020-318179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Sabiha Gati
- Department of Cardiology, National Heart and Lung Institute, Imperial College London & Royal Brompton Hospital NHS Foundation Trust, London, UK
| | - Jonathan Drezner
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Sanjay Sharma
- Institute of Cardiovascular and Cell Sciences, St George's University of London, London, UK
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Arastoo S, Haptonstall KP, Choroomi Y, Moheimani R, Nguyen K, Tran E, Gornbein J, Middlekauff HR. Acute and chronic sympathomimetic effects of e-cigarette and tobacco cigarette smoking: role of nicotine and non-nicotine constituents. Am J Physiol Heart Circ Physiol 2020; 319:H262-H270. [PMID: 32559135 DOI: 10.1152/ajpheart.00192.2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Electronic cigarettes (ECs) and tobacco cigarettes (TCs) both release nicotine, a sympathomimetic drug. We hypothesized that baseline heart rate variability (HRV) and hemodynamics would be similar in chronic EC and TC smokers and that after acute EC use, changes in HRV and hemodynamics would be attributable to nicotine, not non-nicotine, constituents in EC aerosol. In 100 smokers, including 58 chronic EC users and 42 TC smokers, baseline HRV and hemodynamics [blood pressure (BP) and heart rate (HR)] were compared. To isolate the acute effects of nicotine vs. non-nicotine constituents in EC aerosol, we compared changes in HRV, BP, and HR in EC users after using an EC with nicotine (ECN), EC without nicotine (EC0), nicotine inhaler (NI), or sham vaping (control). Outcomes were also compared with TC smokers after smoking one TC. Baseline HRV and hemodynamics were not different in chronic EC users and TC smokers. In EC users, BP and HR, but not HRV outcomes, increased only after using the ECN, consistent with a nicotine effect on BP and HR. Similarly, in TC smokers, BP and HR but not HRV outcomes increased after smoking one TC. Despite a similar increase in nicotine, the hemodynamic increases were significantly greater after TC smokers smoked one TC compared with the increases after EC users used the ECN. In conclusion, chronic EC and TC smokers exhibit a similar pattern of baseline HRV. Acute increases in BP and HR in EC users are attributable to nicotine, not non-nicotine, constituents in EC aerosol. The greater acute pressor effects after TC compared with ECN may be attributable to non-nicotine, combusted constituents in TC smoke.NEW & NOTEWORTHY Chronic electronic cigarette (EC) users and tobacco cigarette (TC) smokers exhibit a similar level of sympathetic nerve activity as estimated by heart rate variability. Acute increases in blood pressure (BP) and heart rate in EC users are attribute to nicotine, not non-nicotine, constituents in EC aerosol. Acute TC smoking increased BP significantly more than acute EC use, despite similar increases in plasma nicotine, suggestive of additional adverse vascular effects attributable to combusted, non-nicotine constituents in TC smoke.
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Affiliation(s)
- Sara Arastoo
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Kacey P Haptonstall
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Yasmine Choroomi
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Roya Moheimani
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Kevin Nguyen
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Elizabeth Tran
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Jeffrey Gornbein
- Departments of Medicine and Computational Medicine, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Holly R Middlekauff
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California
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9
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Casadesús JM, Aguirre F, Carrera A, Boadas-Vaello P, Serrando MT, Reina F. Diving-related fatalities: multidisciplinary, experience-based investigation. Forensic Sci Med Pathol 2019; 15:224-232. [DOI: 10.1007/s12024-019-00109-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 10/27/2022]
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10
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Feng R, Wang L, Li Z, Yang R, Liang Y, Sun Y, Yu Q, Ghartey-Kwansah G, Sun Y, Wu Y, Zhang W, Zhou X, Xu M, Bryant J, Yan G, Isaacs W, Ma J, Xu X. A systematic comparison of exercise training protocols on animal models of cardiovascular capacity. Life Sci 2018; 217:128-140. [PMID: 30517851 DOI: 10.1016/j.lfs.2018.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 11/30/2018] [Accepted: 12/01/2018] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) is a major global cause of mortality, which has prompted numerous studies seeking to reduce the risk of heart failure and sudden cardiac death. While regular physical activity is known to improve CVD associated morbidity and mortality, the optimal duration, frequency, and intensity of exercise remains unclear. To address this uncertainty, various animal models have been used to study the cardioprotective effects of exercise and related molecular mechanism such as the mice training models significantly decrease size of myocardial infarct by affecting Kir6.1, VSMC sarc-KATP channels, and pulmonary eNOS. Although these findings cement the importance of animal models in studying exercise induced cardioprotection, the vast assortment of exercise protocols makes comparison across studies difficult. To address this issue, we review and break down the existent exercise models into categories based on exercise modality, intensity, frequency, and duration. The timing of sample collection is also compared and sorted into four distinct phases: pre-exercise (Phase I), mid-exercise (Phase II), exercise recovery (Phase III), and post-exercise (Phase IV). Finally, because the life-span of animals so are limited, small changes in animal exercise duration can corresponded to untenable amounts of human exercise. To address this limitation, we introduce the Life-Span Relative Exercise Time (RETlife span) as a method of accurately defining short-term, medium-term and long-term exercise relative to the animal's life expectancy. Systematic organization of existent protocols and this new system of defining exercise duration will allow for a more solid framework from which researchers can extrapolate animal model data to clinical application.
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Affiliation(s)
- Rui Feng
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Liyang Wang
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Zhonguang Li
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China; Ohio State University School of Medicine, Columbus, OH 43210, USA
| | - Rong Yang
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Yu Liang
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Yuting Sun
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Qiuxia Yu
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - George Ghartey-Kwansah
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China; Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
| | - Yanping Sun
- College of Pharmacy, Xi'an Medical University, Xi'an 710062, China
| | - Yajun Wu
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Wei Zhang
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China
| | - Xin Zhou
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China; Ohio State University School of Medicine, Columbus, OH 43210, USA
| | - Mengmeng Xu
- Department of Pharmacology, Duke University Medical Center, Durham, NC 27708, USA
| | - Joseph Bryant
- University of Maryland School of Medicine, Baltimore, MD 21287, USA
| | - Guifang Yan
- Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - William Isaacs
- Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Jianjie Ma
- Ohio State University School of Medicine, Columbus, OH 43210, USA
| | - Xuehong Xu
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest of China/CGDB, Shaanxi Normal University College of Life Sciences, Xi'an 710119, China.
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