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Rio P, Cardim N. Exercise and sports revisited: Is too much exercise bad for your heart? Rev Port Cardiol 2024; 43:385-387. [PMID: 38789036 DOI: 10.1016/j.repc.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Affiliation(s)
- Pedro Rio
- Hospital CUF Descobertas, Lisboa, Portugal; Hospital de Santa Marta - CHULC, Lisboa, Portugal
| | - Nuno Cardim
- Hospital CUF Descobertas, Lisboa, Portugal; Nova Medical School, Lisboa, Portugal.
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Certo Pereira J, Santos R, Moscoso Costa F, Monge J, de Araújo Gonçalves P, Dores H. Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise. Rev Port Cardiol 2024; 43:377-384. [PMID: 38583858 DOI: 10.1016/j.repc.2024.03.001] [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: 02/28/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise. METHODS A total of 105 asymptomatic male veteran athletes (48±5.6 years old) were studied. A high coronary atherosclerotic burden was defined as one of the following characteristics in coronary computed tomography angiography: calcium score >100, >75th percentile, obstructive plaques, involving left main, three-vessels or two-vessels including proximal anterior descending artery, segment involvement score >5 or CT-adapted Leaman score ≥5. CV risk was stratified by SCORE2 and volume of exercise by metabolic equivalent task score. RESULTS Most athletes (n=88) were engaged in endurance sports for 17.1±9.8 years, with a median exercise volume of 66 [IQR 44-103] metabolic equivalent of tasks/hour/week. The mean Systematic Coronary Risk Evaluation 2 was 2.8±1.5%; 76.9% of athletes had a low-moderate risk and none a very high risk. High coronary atherosclerotic burden was present in 25.7% athletes. Athletes with high cardiovascular risk and high exercise volume (above the median) showed significantly high coronary atherosclerotic burden compared to those with low-moderate risk and high volume (50.0% vs. 15.6%; p=0.017). Among athletes with low to moderate risk, a high volume of exercise tended to be protective, while in those with low volume, there was similar rate of high coronary atherosclerotic burden, regardless of CV risk. CONCLUSIONS A combination of higher volume of exercise and high cardiovascular risk revealed the worst association with coronary atherosclerosis in veteran athletes. The relationship between these variables is controversial, but integrating exercise characteristics and risk assessment into preparticipation evaluation is essential.
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Affiliation(s)
| | | | | | | | - Pedro de Araújo Gonçalves
- Hospital de Santa Cruz, Lisboa, Portugal; Hospital da Luz, Lisbon, Portugal; CHRC, NOVA Medical School, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
| | - Hélder Dores
- Hospital da Luz, Lisbon, Portugal; CHRC, NOVA Medical School, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
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Sharykin AS, Badtieva VA. Sudden Death In Sports: Modern Concepts. KARDIOLOGIIA 2024; 64:80-87. [PMID: 38323448 DOI: 10.18087/cardio.2024.1.n2617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 02/08/2024]
Abstract
Regular physical activity provides significant health benefits and reduces the risk of premature death from any cause, including cardiovascular diseases (CVD). However, physical activity may provoke sudden cardiac death (SCD), especially in presence of unrecognized diseases. It is essential to identify risk factors that contribute to SCD in athletes and to implement effective prevention of such episodes. For this purpose, SCD registries are being created, medical terminology is being unified, and schedules of medical examination are being developed. The best strategy to combat SCD during sport activities is a combination of primary prevention by screening examination to identify athletes with CVD at risk and a proper planning of first aid measures during sports events, including the availability of an automatic external defibrillator on site.
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Affiliation(s)
- A S Sharykin
- Moscow Center for Research and Practice in Medical Rehabilitation, Restorative and Sport Medicine; Pirogov Russian National Research Medical University
| | - V A Badtieva
- Moscow Center for Research and Practice in Medical Rehabilitation, Restorative and Sport Medicine; Sechenov First Moscow State Medical University
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Fontes-Carvalho R, Oliveira GMMD, Cardim N, Rochitte CE. 2020 Top 10 Original Articles in the Arquivos Brasileiros de Cardiologia and the Revista Portuguesa de Cardiologia. Rev Port Cardiol 2021; 40:903-910. [PMID: 34922695 DOI: 10.1016/j.repce.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Ricardo Fontes-Carvalho
- Departamento de Cardiologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
| | - Gláucia Maria Moraes de Oliveira
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil; Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Nuno Cardim
- Hospital da Luz-Lisboa, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa, Portugal
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil; Hospital do Coração (HCOR), São Paulo, SP, Brasil
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Handke J, Kummer L, Weigand MA, Larmann J. Modulation of Peripheral CD4 +CD25 +Foxp3 + Regulatory T Cells Ameliorates Surgical Stress-Induced Atherosclerotic Plaque Progression in ApoE-Deficient Mice. Front Cardiovasc Med 2021; 8:682458. [PMID: 34485396 PMCID: PMC8416168 DOI: 10.3389/fcvm.2021.682458] [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: 03/19/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
Systemic inflammation associated with major surgery rapidly accelerates atherosclerotic plaque progression in mice. Regulatory T cells (Tregs) have emerged as important modulators of atherogenesis. In coronary artery disease patients, low frequency of Tregs constitutes an independent risk factor for cardiovascular complications after non-cardiac surgery. In this exploratory analysis, we investigate whether preoperative Treg levels affect surgery-induced atherosclerotic lesion destabilization in a murine model of perioperative stress. After 9 weeks of high-cholesterol diet, atherosclerotic apolipoprotein E-deficient mice with modulated Treg levels were subjected to a 30-minute surgical procedure consisting of general isoflurane anesthesia, laparotomy and moderate blood loss. Controls underwent general anesthesia only. Brachiocephalic arteries were harvested 3 days after the intervention for histomorphological analyses of atherosclerotic plaques. Tregs were depleted by a single dose of anti-CD25 monoclonal antibody (mAb) administered 6 days prior to the intervention. Expansion of Tregs was induced by daily injections of IL-2/anti-IL-2 complex (IL-2C) on three consecutive days starting 3 days before surgery. Isotype-matched antibodies and PBS served as controls. Antibody-mediated modulation was Treg-specific. IL-2C treatment resulted in an eight-fold elevation of peripheral CD4+CD25+Foxp3+ Tregs compared to mice administered with anti-CD25 mAb. In mice treated with PBS and anti-CD25 mAb, surgical stress response caused a significant increase of atherosclerotic plaque necrosis (PBS: p < 0.001; anti-CD25 mAb: p = 0.037). Preoperative Treg expansion abrogated perioperative necrotic core formation (p = 0.556) and significantly enhanced postoperative atherosclerotic plaque stability compared to PBS-treated mice (p = 0.036). Postoperative plaque volume (p = 0.960), stenosis (p = 0.693), lesional collagen (p = 0.258), as well as the relative macrophage (p = 0.625) and smooth muscle cell content (p = 0.178) remained largely unaffected by preoperative Treg levels. In atherosclerotic mice, therapeutic expansion of Tregs prior to major surgery mitigates rapid effects on perioperative stress-driven atherosclerotic plaque destabilization. Future studies will show, whether short-term interventions modulating perioperative inflammation qualify for prevention of cardiovascular events associated with major non-cardiac surgery.
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Affiliation(s)
- Jessica Handke
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Laura Kummer
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus A Weigand
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Larmann
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
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Fontes-Carvalho R, Oliveira GMMD, Cardim N, Rochitte CE. 2020 Top 10 Original Articles in the Arquivos Brasileiros de Cardiologia and the Revista Portuguesa de Cardiologia. Rev Port Cardiol 2021; 40:S0870-2551(21)00245-6. [PMID: 34404564 PMCID: PMC8364344 DOI: 10.1016/j.repc.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ricardo Fontes-Carvalho
- Departamento de Cardiologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
| | - Gláucia Maria Moraes de Oliveira
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil; Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Nuno Cardim
- Hospital da Luz-Lisboa, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa, Portugal
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil; Hospital do Coração (HCOR), São Paulo, SP, Brasil
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Fontes-Carvalho R, Oliveira GMMD, Cardim N, Rochitte CE. 2020 Top 10 Original Articles in the Arquivos Brasileiros de Cardiologia and the Revista Portuguesa de Cardiologia. Arq Bras Cardiol 2021; 116:1153-1160. [PMID: 34133603 PMCID: PMC8288525 DOI: 10.36660/abc.20210372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ricardo Fontes-Carvalho
- Departamento de Cardiologia - Centro Hospitalar de Vila Nova de Gaia/Espinho , Vila Nova de Gaia - Portugal.,Departamento de Cirurgia e Fisiologia - Faculdade de Medicina - Universidade do Porto , Porto - Portugal
| | - Gláucia Maria Moraes de Oliveira
- Faculdade de Medicina - Universidade Federal do Rio de Janeiro , Rio de Janeiro , RJ - Brasil.,Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , Rio de Janeiro , RJ - Brasil
| | - Nuno Cardim
- Hospital da Luz-Lisboa - Faculdade de Ciências Médicas da Universidade Nova de Lisboa , Lisboa - Portugal
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil.,Hospital do Coração (HCOR), São Paulo , SP - Brasil
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Dores H, Cardim N. Return to play after COVID-19: a sport cardiologist's view. Br J Sports Med 2020; 54:1132-1133. [PMID: 32381502 DOI: 10.1136/bjsports-2020-102482] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Helder Dores
- Department of Cardiology, Luz Hospital Lisbon, Lisbon, Portugal .,Human Performance Department, Sport Lisbon and Benfica, Lisbon, Portugal.,NOVA Medical School, Lisbon, Portugal
| | - Nuno Cardim
- Department of Cardiology, Luz Hospital Lisbon, Lisbon, Portugal.,NOVA Medical School, Lisbon, Portugal
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Wang R, Tian H, Guo D, Tian Q, Yao T, Kong X. Impacts of exercise intervention on various diseases in rats. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:211-227. [PMID: 32444146 PMCID: PMC7242221 DOI: 10.1016/j.jshs.2019.09.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/06/2019] [Accepted: 09/06/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exercise is considered as an important intervention for treatment and prevention of several diseases, such as osteoarthritis, obesity, hypertension, and Alzheimer's disease. This review summarizes decadal exercise intervention studies with various rat models across 6 major systems to provide a better understanding of the mechanisms behind the effects that exercise brought. METHODS PubMed was utilized as the data source. To collect research articles, we used the following terms to create the search: (exercise [Title] OR physical activity [Title] OR training [Title]) AND (rats [Title/Abstract] OR rat [Title/Abstract] OR rattus [Title/Abstract]). To best cover targeted studies, publication dates were limited to "within 11 years." The exercise intervention methods used for different diseases were sorted according to the mode, frequency, and intensity of exercise. RESULTS The collected articles were categorized into studies related to 6 systems or disease types: motor system (17 articles), metabolic system (110 articles), cardiocerebral vascular system (171 articles), nervous system (71 articles), urinary system (2 articles), and cancer (21 articles). Our review found that, for different diseases, exercise intervention mostly had a positive effect. However, the most powerful effect was achieved by using a specific mode of exercise that addressed the characteristics of the disease. CONCLUSION As a model animal, rats not only provide a convenient resource for studying human diseases but also provide the possibility for exploring the molecular mechanisms of exercise intervention on diseases. This review also aims to provide exercise intervention frameworks and optimal exercise dose recommendations for further human exercise intervention research.
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Affiliation(s)
- Ruwen Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Haili Tian
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Dandan Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Qianqian Tian
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Ting Yao
- Division of Pediatric Endocrinology, Department of Pediatrics, UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
| | - Xingxing Kong
- Division of Pediatric Endocrinology, Department of Pediatrics, UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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