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Hansen CJ, Svane J, Palsøe MK, Isbister JC, Paratz E, Molina P, Morentin B, Winkel BG, La Gerche A, Linnet K, Banner J, Lucena J, Semsarian C, Tfelt-Hansen J. Toxicology Screening in Sports-Related Sudden Cardiac Death: A Multinational Observational Study. JACC Clin Electrophysiol 2023:S2405-500X(23)00833-2. [PMID: 38127009 DOI: 10.1016/j.jacep.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Knowledge of toxicological findings among sports-related sudden cardiac death (SrSCD) is scarce. OBJECTIVES This study aimed to describe postmortem toxicology findings in a multinational cohort of young SrSCD. METHODS Patients with sudden cardiac death (SCD) aged 12 to 49 years with a complete post mortem were included from Denmark, Spain, and Australia. Postmortem findings were compared between SrSCD and non-SrSCD, and toxicology findings in SrSCD were assessed. RESULTS We included 3,189 SCD, of which 219 (7%) were sports-related. SrSCD patients were younger (36 years vs 41 years; P < 0.001) and of male predominance (96% vs 75%; P < 0.001), and their death was more often caused by structural cardiac disease (68% vs 61%; P = 0.038). Positive toxicology screenings were significantly less likely among SrSCD than non-SrSCD (12% vs 43%; P < 0.001), corresponding to 82% lower odds of a positive toxicology screening in SrSCD. Patient characteristics were similar between SrSCDs with positive and negative toxicology screenings, but deaths were more often unexplained (59% vs 34%). Nonopioid analgesics were the most common finding (3%), and SCD-associated drugs were detected in 6% of SrSCD. SUD was more prevalent among the SrSCD with positive toxicology (59% vs 34%). CONCLUSIONS Sports-related SCD mainly occurred in younger men with structural heart disease. They had a significantly lower prevalence of a positive toxicology screening compared with non-SrSCD, and detection of SCD-associated drugs was rare.
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Affiliation(s)
- Carl J Hansen
- The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Jesper Svane
- The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marie K Palsøe
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Julia C Isbister
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, University of Sydney, Sydney, Australia
| | | | - Pilar Molina
- Institute of Legal Medicine and Forensic Sciences, Valencia, Spain
| | - Benito Morentin
- Basque Institute of Legal Medicine, Bilbao, Spain; Department of Medical and Surgical Specialties, University of the Basque Country, UPV/EHU, Leioa, Bizkaia, Spain
| | - Bo G Winkel
- The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | | | - Kristian Linnet
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jytte Banner
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Joaquin Lucena
- Institute of Legal Medicine and Forensic Sciences, Seville, Spain
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, University of Sydney, Sydney, Australia
| | - Jacob Tfelt-Hansen
- The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
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Pedersen JR, Møller M, Storm LK, Koes B, Ntoumanis N, Thorlund JB. To rest or to compete? A 4-week cohort study of analgesic use and willingness to compete hurt in Danish youth elite athletes. J Sci Med Sport 2023; 26:580-585. [PMID: 37739854 DOI: 10.1016/j.jsams.2023.08.181] [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: 02/08/2023] [Revised: 06/29/2023] [Accepted: 08/31/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVES To assess the association between analgesic use and willingness to compete hurt (WCH) in Danish youth elite athletes, and to explore factors associated with such willingness. DESIGN 4-week prospective cohort study. METHODS 592 Danish youth elite athletes (15-20 years) completed a baseline questionnaire assessing demographic information, sport history, and WCH, and provided weekly reports on analgesic use for 4 weeks via text messages. Analgesic use was categorized as no use (0 weeks) or use across 1, 2, 3, or 4 weeks, and as the total number of days with analgesic use. Multinomial logistic regression and zero-inflated negative binomial regression analyses estimated the association between analgesic use and WCH. Linear backward stepwise regression analysis was used to identify factors associated with WCH. RESULTS Overall, risk of analgesic use increased significantly with increasing WCH scores (relative risk ratios ranging from 1.06 (95% CI 1.0 to 1.12%) to 1.34% (95% CI 1.15 to 1.57)). The incidence rate of analgesic use increased significantly with increasing WCH scores (incidence rate ratio 1.09 (95% CI 1.04 to 1.14)). Associations between the investigated possible antecedent factors and WCH were weak and not considered practically important (R2 = 0.05 or lower). CONCLUSIONS Higher WCH scores were associated with increasing risk of analgesic use, irrespective of the underlying reason for the use, in Danish youth elite athletes, suggesting that analgesics may be an ingrained part of a sport-specific culture of risk acceptance. Future studies should include measures of culture, norms, and social interaction to better explain the variance in WCH.
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Affiliation(s)
- Julie Rønne Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - Merete Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Oslo Sports Trauma Research Center, Department of Sport Medicine, Norwegian School of Sports Sciences, Norway. https://twitter.com/Merete_Moller
| | - Louise Kamuk Storm
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. https://twitter.com/StormKamuk
| | - Bart Koes
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Netherlands; Research Unit of General Practice, Department of Public health and Center for Muscle and Joint Health, University of Southern Denmark, Denmark. https://twitter.com/bartkoes
| | - Nikos Ntoumanis
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; School for Health and Welfare, Halmstad University, Sweden. https://twitter.com/NikosNtoumanis
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Department of Public Health, University of Southern Denmark, Denmark. https://twitter.com/jbthorlund
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Volpe-Fix AR, de França E, Silvestre JC, Thomatieli-Santos RV. The Use of Some Polyphenols in the Modulation of Muscle Damage and Inflammation Induced by Physical Exercise: A Review. Foods 2023; 12:foods12050916. [PMID: 36900433 PMCID: PMC10001084 DOI: 10.3390/foods12050916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Food bioactive compounds (FBC) comprise a vast class of substances, including polyphenols, with different chemical structures, and they exert physiological effects on individuals who consume them, such as antioxidant and anti-inflammatory action. The primary food sources of the compounds are fruits, vegetables, wines, teas, seasonings, and spices, and there are still no daily recommendations for their intake. Depending on the intensity and volume, physical exercise can stimulate oxidative stress and muscle inflammation to generate muscle recovery. However, little is known about the role that polyphenols may have in the process of injury, inflammation, and muscle regeneration. This review aimed to relate the effects of supplementation with mentation with some polyphenols in oxidative stress and post-exercise inflammatory markers. The consulted papers suggest that supplementation with 74 to 900 mg of cocoa, 250 to 1000 mg of green tea extract for around 4 weeks, and 90 mg for up to 5 days of curcumin can attenuate cell damage and inflammation of stress markers of oxidative stress during and after exercise. However, regarding anthocyanins, quercetins, and resveratrol, the results are conflicting. Based on these findings, the new reflection that was made is the possible impact of supplementation associating several FBCs simultaneously. Finally, the benefits discussed here do not consider the existing divergences in the literature. Some contradictions are inherent in the few studies carried out so far. Methodological limitations, such as supplementation time, doses used, forms of supplementation, different exercise protocols, and collection times, create barriers to knowledge consolidation and must be overcome.
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Affiliation(s)
| | - Elias de França
- Interdisciplinary Postgraduate Program in Health Sciences, Universidade Federal de São Paulo, Sao Paulo 05508-070, Brazil
| | - Jean Carlos Silvestre
- Interdisciplinary Postgraduate Program in Health Sciences, Universidade Federal de São Paulo, Sao Paulo 05508-070, Brazil
- Campus Rosinha Viegas, Universidade Metropolitana de Santos, Santos 11045-002, Brazil
- Center for Applied Social Sciences, Universidade Católica de Santos, Santos 11015-002, Brazil
| | - Ronaldo Vagner Thomatieli-Santos
- Postgraduate Program in Psychobiology, Universidade Federal de São Paulo, Sao Paulo 05508-070, Brazil
- Interdisciplinary Postgraduate Program in Health Sciences, Universidade Federal de São Paulo, Sao Paulo 05508-070, Brazil
- Correspondence:
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Meyer T. Two "hot topics" addressed and one article about "unknown territory". J Sci Med Sport 2022; 25:787. [DOI: 10.1016/j.jsams.2022.09.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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