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Unnithan VB, Beaumont A, Rowland T, George K, Stewart L, Sculthorpe N, Lord RN, Oxborough DL. The effect of long-term soccer training on left ventricular structure and function in elite male youth soccer players. Scand J Med Sci Sports 2024; 34:e14594. [PMID: 38454596 DOI: 10.1111/sms.14594] [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: 10/10/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
AIMS Cardiac adaptations in elite, male adolescent youth soccer players have been demonstrated in relation to training status. The time course of these adaptations and the delineation of the influence of volatile growth phases from the training effect on these adaptations remain unclear. Consequently, the aims of the study were to evaluate the impact of 3 years of elite-level soccer training on changes in left ventricular (LV) structure and function in a group of highly trained elite youth male soccer players (SP) as they transitioned through the pre-to-adolescent phase of their growth. METHODS Twenty-two male youth SP from the highest Level of English Premier League Academy U-12 teams were evaluated once a year for three soccer seasons as the players progressed from the U-12 to U-14 teams. Fifteen recreationally active control participants (CON) were also evaluated over the same 3-year period. Two-dimensional transthoracic echocardiography was used to quantify LV structure and function. RESULTS After adjusting for the influence of growth and maturation, training-induced increases in Years 2 and 3 were noted for: LV end diastolic volume (LVEDV; p = 0.02) and LV end systolic volume (LVESV; p = 0.02) in the SP compared to CON. Training-induced decrements were noted for LV ejection fraction (LVEF; p = 0.006) and TDI-S' (p < 0.001). CONCLUSIONS An increase in training volume (Years 2 and 3) were aligned with LV volumetric adaptations and decrements in systolic function in the SP that were independent from the influence of rapid somatic growth. Decrements in systolic function were suggestive of a functional reserve for exercise.
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Affiliation(s)
- Viswanath B Unnithan
- Division of Sport and Exercise, School of Health and Life Sciences, Sport and Physical Activity Research Institute, University of the West of Scotland, Hamilton, UK
| | - Alexander Beaumont
- School of Science, Technology and Health, York St. John University, York, UK
| | - Thomas Rowland
- Division of Sport and Exercise, School of Health and Life Sciences, Sport and Physical Activity Research Institute, University of the West of Scotland, Hamilton, UK
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Laura Stewart
- School of Computing, Engineering, and Physical Sciences, University of the West of Scotland, Paisley, UK
| | - Nicholas Sculthorpe
- Division of Sport and Exercise, School of Health and Life Sciences, Sport and Physical Activity Research Institute, University of the West of Scotland, Hamilton, UK
| | - Rachel N Lord
- Cardiff Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, UK
| | - David L Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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2
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Weberruß H, Baumgartner L, Mühlbauer F, Shehu N, Oberhoffer-Fritz R. Training intensity influences left ventricular dimensions in young competitive athletes. Front Cardiovasc Med 2022; 9:961979. [PMID: 36277759 PMCID: PMC9582149 DOI: 10.3389/fcvm.2022.961979] [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: 06/05/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background In young athletes, exercise causes changes in the heart that include growth in wall thickness and mass of the left ventricle and expansion of the heart’s chambers. The heart’s function is either preserved or enhanced, but this may change to the opposite over time. Objective This study aimed to assess structural and functional cardiac adaptations in relation to exercise training time, intensity, and performance in young competitive athletes. Methods A total of 404 children and adolescents (14.23 ± 2.0 years, 97 females) were enrolled in the Munich Cardiovascular Adaptations in Young Athletes Study (MuCAYA-Study). Eighty-five participants were examined two times a year. Two-dimensional echocardiography was performed to assess left ventricular structure and function. Training time and intensity was measured with the MoMo physical activity questionnaire, maximum aerobic capacity by cardiopulmonary exercise testing, and strength with the handgrip strength test. Results Maximum aerobic capacity significantly influenced interventricular septal thickness in diastole. Training intensity significantly influenced left ventricular internal diameter in diastole and systole, and left ventricular mass indexed to body surface area. Within one year, interventricular wall thickness, relative wall thickness and left ventricular mass, indexed to body surface area and height, increased significantly. Training intensity and aerobic capacity contributed to cardiac adaptations in young competitive athletes, as represented by altered structural parameters but preserved cardiac function. Within a year, however, structural changes and a decline in diastolic performance were observed within the longitudinal sub-sample. Conclusion Our results confirm the hypothesis that cardiac adaptations to exercise occur at a young age. Cardiac adaptation in our cohort was influenced by exercise intensity and maximum aerobic capacity.
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Affiliation(s)
- Heidi Weberruß
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany,*Correspondence: Heidi Weberruß,
| | - Lisa Baumgartner
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Frauke Mühlbauer
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nerejda Shehu
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany,Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, Munich, Germany
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3
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Zhao K, Liu Y, Dong L, Gao B. Echocardiographic myocardial work in pre-adolescent male basketball players: a comparison with cardiopulmonary exercise test-derived aerobic capacity. Front Physiol 2022; 13:913623. [PMID: 35936902 PMCID: PMC9355256 DOI: 10.3389/fphys.2022.913623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Pressure-strain loop (PSL) analysis provides a novel, less load-dependent non-invasive method to quantify myocardial work and demonstrates a significant correlation with the contractile reserve in adult athletes. We aim to validate PSL-derived markers in characterizing LV function in pre-adolescent basketball players by comparing results before and after the cardiopulmonary exercise test (CPX) and explore its association with CPX-derived aerobic capacity.Methods: Cardiac morphology and function in 20 pre-adolescent basketball players were assessed at 9.7 years old (9.7 ± 1.1 year) before and after cardiopulmonary exercise testing. Echocardiography was performed in all subjects, including two-dimensional speckle-tracking echocardiography (STE). Simultaneous brachial-cuff-measured blood pressure was recorded to perform PSL analysis.Results: Nineteen subjects were included in the final analysis. Exercise training in pre-adolescent males was associated with lower global work index (GWI) and global work efficiency (GWE) at rest. GWE at stress was significantly correlated with VO2max and peak O2 pulse (p = 0.0122, r = 0.56; p = 0.00122, r = 0.69, respectively). When indexed by body mass, GWI and GWE both significantly correlated with relative VO2max (p = 0.0086 and 0.0011 respectively, r = 0.58 and 0.69 respectively); GWI and GWE at baseline and stress were all significantly correlated with peak O2 pulse (GWI at baseline, p< 0.0001, r = −0.90; GWE at baseline, p< 0.0001, r = −0.89; GWI at stress, p= 0.0289, r = −0.50; GWE at stress, p< 0.0001, r = −0.83).Conclusion: PSL-analysis-derived GWI and GWE at rest indexed by body mass are associated with cardiopulmonary exercise test-derived peak oxygen consumption and oxygen pulse in pre-adolescent athletes.
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Affiliation(s)
- Kewei Zhao
- High Performance Research Center, China Institute of Sport Science, Beijing, China
| | - Yu Liu
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Lili Dong
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Cardiovascular Diseases, Shanghai, China
- *Correspondence: Lili Dong, ; Binghong Gao,
| | - Binghong Gao
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
- *Correspondence: Lili Dong, ; Binghong Gao,
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4
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Colombo JN, Sawda CN, White SC. Cardiac Concerns in the Pediatric Athlete. Clin Sports Med 2022; 41:529-548. [PMID: 35710276 DOI: 10.1016/j.csm.2022.02.010] [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] [Indexed: 11/19/2022]
Abstract
Cardiovascular disease remains the number one cause of death in Americans. It is no secret that exercise mitigates this risk. Exercise and regular physical activity are beneficial for physical health including aerobic conditioning, endurance, strength, mental health, and overall improved quality of life. Unfortunately, today many children and adolescents are sedentary, lacking the recommended daily amount of physical activity, leading to higher rates of obesity, cardiovascular disease, stroke, diabetes, anxiety, and depression. Given this rising concern, the World Health Organization launched a 12-year plan to improve physical activity in children and adolescents by reducing the inactivity rate by 15% in the world. How does this apply to children and adolescents with acquired or congenital heart disease?.
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Affiliation(s)
- Jamie N Colombo
- Department of Pediatrics, Division of Cardiology, Washington University School of Medicine/St. Louis Children's Hospital, 1 Childrens Place, St. Louis, MO 63110, USA
| | - Christine N Sawda
- Department of Pediatrics, Division of Cardiology, Children's National Medical Center, 111 Michigan Avenue Northwest, Washington, DC 20010, USA
| | - Shelby C White
- Department of Pediatrics, Division of Cardiology, University of Virginia, PO Box 800386, Charlottesville, VA 22908, USA.
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5
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Yılmaz M, Korkmaz H. Recurrent births (multiparity) lead to permanent changes in cardiac structure. J Obstet Gynaecol Res 2022; 48:946-955. [PMID: 35238105 DOI: 10.1111/jog.15172] [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: 11/08/2021] [Revised: 01/13/2022] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Abstract
AIM Although the effects of pregnancy on the cardiovascular system have been covered by many studies, permanent changes in the hearts of multiparous women have not been investigated. This study therefore aimed to examine the permanent structural changes in the cardiac structure of multiparous women via transthoracic echocardiography (TTE). METHOD This case-control study included 366 females who had given birth to 1-21 children, and 218 females with no previous deliveries. Anamnesis, physical examination, electrocardiography (ECG), TTE, and exercise stress tests were used to determine whether the cases had additional systemic pathologies. The structural cardiac parameters of all cases were recorded with TTE. RESULTS The study revealed that LV mass, LV mass index, left ventricular end diastolic volume (LVEDV), left ventricular end diastolic volume index (LVEDVI) were observed higher in women with five or more deliveries when compared to nulliparous women. On the other hand, ejection fraction (EF) was significantly lower in the same group. Receiver operating curve (ROC) analysis demonstrated that the prediction sensitivity for the presence of eccentric hypertrophy was 74% among women who had given >10.5 births, and its specificity was 97.8% (AUC: 0.949, 95% CI 0.905-0.993; p < 0.0001). CONCLUSION The results showed that women with recurrent births had increased left ventricular end diastolic volume, left ventricular total mass in myocardium and decreased EF due to increased end diastolic volume. The results also showed delivering at frequent intervals (especially the birth of 11 or more) may be one of the causes of eccentric hypertrophy, in women of the low-to-middle income countries.
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Affiliation(s)
- Mücahid Yılmaz
- Department of Cardiology, Elazığ Fethi Sekin City Hospital, University of Health Sciences, Elazığ, Turkey
| | - Hasan Korkmaz
- Department of Cardiology, Fırat University School of Medicine, Elazığ, Turkey
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Perkins DR, Talbot JS, Lord RN, Dawkins TG, Baggish AL, Zaidi A, Uzun O, Mackintosh KA, McNarry MA, Cooper SM, Lloyd RS, Oliver JL, Shave RE, Stembridge M. The influence of maturation on exercise-induced cardiac remodelling and haematological adaptation. J Physiol 2021; 600:583-601. [PMID: 34935156 DOI: 10.1113/jp282282] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/15/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS It has long been hypothesised that cardiovascular adaptation to endurance training is augmented following puberty. We investigated whether differences in cardiac and haematological variables exist, and to what extent, between endurance-trained vs. untrained, pre- and post-peak height velocity (PHV) children, and how these central factors relate to maximal oxygen consumption. Using echocardiography to quantify left ventricular (LV) morphology and carbon monoxide rebreathing to determine blood volume and haemoglobin mass, we identified that training-related differences in LV morphology are evident in pre-PHV children, with haematological differences also observed between pre-PHV girls. However, the breadth and magnitude of cardiovascular remodelling was more pronounced post-PHV. Cardiac and haematological measures provide significant predictive models for maximal oxygen consumption in children that are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in before puberty. ABSTRACT Cardiovascular and haematological adaptations to endurance training facilitate greater maximal oxygen consumption, and such adaptations maybe augmented following puberty. Therefore, we compared left ventricular (LV) morphology (echocardiography), blood volume, haemoglobin (Hb) mass (CO-rebreathe) and in endurance-trained and untrained boys (n = 42, age = 9.0-17.1 years, = 61.6±7.2 mL∙kg∙min, and n = 31, age = 8.0-17.7 years, O2max = 46.5±6.1 mL∙kg∙min, respectively) and girls (n = 45, age = 8.2-17.0 years, O2max = 51.4±5.7 mL∙kg∙min and n = 36, age = 8.0-17.6 years, O2max = 39.8±5.7 mL∙kg∙min, respectively). Pubertal stage was estimated via maturity offset, with participants classified as pre- or post-peak height velocity (PHV). Pre-PHV, only a larger LV end-diastolic volume/lean body mass (EDV/LBM) for trained boys (+0.28 mL∙kgLBM , P = 0.007) and a higher Hb mass/LBM for trained girls (+1.65 g∙kgLBM , P = 0.007) were evident compared to untrained controls. Post-PHV, LV mass/LBM (boys:+0.50 g∙kgLBM , P = 0.0003; girls:+0.35 g∙kgLBM , P = 0.003), EDV/LBM (boys:+0.35 mL∙kgLBM , P<0.0001; girls:+0.31 mL∙kgLBM, P = 0.0004), blood volume/LBM (boys:+12.47 mL∙kgLBM , P = 0.004; girls:+13.48 mL∙kgLBM , P = 0.0002.) and Hb mass/LBM (boys:+1.29 g∙kgLBM , P = 0.015; girls:+1.47 g∙kgLBM , P = 0.002) were all greater in trained vs. untrained groups. Pre-PHV, EDV (R2 adj = 0.224, P = 0.001) in boys, and Hb mass and interventricular septal thickness (R2 adj = 0.317, P = 0.002) in girls partially accounted for the variance in O2max . Post-PHV, stronger predictive models were evident via the inclusion of LV wall thickness and EDV in boys (R2 adj = 0.608, P<0.0001), and posterior wall thickness and Hb mass in girls (R2 adj = 0.490, P<0.0001). In conclusion, cardiovascular adaptation to exercise training is more pronounced post-PHV, with evidence for a greater role of central components for oxygen delivery. Abstract figure legend: Schematic diagram depicting cardiac structural and haematological differences between trained and untrained boys and girls, pre-peak height velocity (PHV) and post-PHV alongside cardiac and haematological variables contributions to the variance in O2max . Cardiac and haematological variables are greater in trained vs. untrained pre-pubertal children, and a greater number and magnitude of differences are observed at post-PHV. These variables provide significant predictive models for maximal oxygen consumption in children and are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in O2max before puberty. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dean R Perkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jack S Talbot
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom.,Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Abbas Zaidi
- University Hospital of Wales, Cardiff, United Kingdom
| | - Orhan Uzun
- University Hospital of Wales, Cardiff, United Kingdom
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Stephen-Mark Cooper
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom.,Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand.,Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom.,Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Rob E Shave
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Mike Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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7
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Zacca R, Azevedo R, Ramos VR, Abraldes JA, Vilas-Boas JP, Castro FADS, Pyne DB, Fernandes RJ. Biophysical Follow-up of Age-Group Swimmers During a Traditional Three-Peak Preparation Program. J Strength Cond Res 2021; 34:2585-2595. [PMID: 30640304 DOI: 10.1519/jsc.0000000000002964] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zacca, R, Azevedo, R, Ramos, VR, Abraldes, JA, Vilas-Boas, JP, Castro, FAdS, Pyne, DB, and Fernandes, RJ. Biophysical follow-up of age-group swimmers during a traditional three-peak preparation program. J Strength Cond Res 34(9): 2585-2595, 2020-The aim of this study was to quantify changes and contributions of bioenergetic, technique, and anthropometric profiles across a traditional 3-peak swimming season. Twenty-four age-group swimmers (11 boys: 15 years 6 months ± 1 year 1 month; 13 girls: 14 years 5 months ± 10 months) of equal maturational stage were monitored through a 400-m test in front crawl (T400). Bioenergetic, technique, and anthropometric characteristics were compared before and after macrocycles I, II and III. Sex interaction was verified only for amplitude of the fast oxygen uptake component and height (moderate). Multiple linear regressions and principal component analysis were used to identify the most influential variables and the relative contribution of each domain (bioenergetics, technique, and anthropometrics) to changes in swimming performance of T400. The relative contributions for the performance of T400 after macrocycles I, II, and III were, respectively, 6, 18, and 27% for bioenergetics, 88, 69, and 54% for technique, and 6, 13, and 20% for anthropometrics. Technique was the biggest contributor (71%) for changes in the performance of T400 over the training season, followed by bioenergetics (17%) and anthropometrics (12%). Technique played the main role during the competitive season, regardless of gradual increase in the contribution of bioenergetics and anthropometrics. Despite that, bioenergetics and technique are closely connected, thus a powerful and endurable metabolic base and cannot be overlooked. Changes and contribution of bioenergetics, technique, and anthropometrics on age-group swimmers' performance over a traditional 3-peak swimming season could be described by the T400 swimming test, providing a comprehensive biophysical overview of the main contributors to swimming performance.
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Affiliation(s)
- Rodrigo Zacca
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal.,CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Rui Azevedo
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra PRD, Portugal
| | - Valdir R Ramos
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal.,CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil.,Institute of Physical Education and Sports, Federal University of Ceará, Fortaleza, Brazil
| | | | - João P Vilas-Boas
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | | | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Ricardo J Fernandes
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
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8
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Akkuş A, Belviranli M, Şap F, Okudan N. Assessment of Structure, Function, and Rhythm of the Heart with Echocardiography and Electrocardiography in Adolescent Swimmers. Pediatr Cardiol 2021; 42:182-188. [PMID: 32965565 DOI: 10.1007/s00246-020-02469-x] [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: 04/01/2020] [Accepted: 09/18/2020] [Indexed: 01/20/2023]
Abstract
The aim of this study was to evaluate the cardiac parameters by using electrocardiography and echocardiography in adolescent swimmers. Twenty-two adolescent swimmers and 22 gender- and age-matched sedentary controls admitted to our center between November 2018 and May 2019 were included in this study. In addition to demographical characteristics, participants were assessed via a 12-lead electrocardiography and two-dimensional echocardiography for cardiac function. On the echocardiography, end-systolic and end-diastolic interventricular septum, end-systolic and end-diastolic left ventricular posterior wall thicknesses, left atrial width, Tricuspid E, left ventricular mass and left ventricular mass index were higher in the swimmers when compared to the sedentary controls (P < 0.05). On the electrocardiography, Tp-e duration which reflects ventricular transmural repolarization, and Tp-e/QT and Tp-e/corrected QT ratios were higher in the swimmers than the sedentary controls (P < 0.05). In conclusion, swimming exercise in children leads to concentric thickening of left ventricle and induces an increase in Tp-e duration, and Tp-e/QT and Tp-e/corrected QT ratios, which are the novel markers for risk of ventricular arrhythmias.
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Affiliation(s)
- Abdullah Akkuş
- Department of Paediatrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Muaz Belviranli
- Division of Sports Physiology, Department of Physiology, Faculty of Medicine, Selçuk University, 42131, Konya, Turkey.
| | - Fatih Şap
- Division of Paediatric Cardiology, Department of Paediatrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Nilsel Okudan
- Division of Sports Physiology, Department of Physiology, Faculty of Medicine, Selçuk University, 42131, Konya, Turkey
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9
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Zacca R, Azevedo R, Chainok P, Vilas-Boas JP, Castro FADS, Pyne DB, Fernandes RJ. Monitoring Age-Group Swimmers Over a Training Macrocycle: Energetics, Technique, and Anthropometrics. J Strength Cond Res 2020; 34:818-827. [PMID: 30113917 DOI: 10.1519/jsc.0000000000002762] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zacca, R, Azevedo, R, Chainok, P, Vilas-Boas, JP, Castro, FAdS, Pyne, DB, and Fernandes, RJ. Monitoring age-group swimmers over a training macrocycle: energetics, technique, and anthropometrics. J Strength Cond Res 34(3): 818-827, 2020-The aim of this study was to quantify changes and contributions of energetic, technique, and anthropometric profiles across the first training macrocycle (16-week) in a traditional 3-peak swimming season. Twenty-four age-group swimmers (10 boys and 14 girls age 14.4 ± 0.9 years) of equal maturational stage were monitored through a 400-m test in front crawl (T400). Energetic, technique, and anthropometric characteristics were compared before (experimental testing 1, E1) and after the preparatory (E2), specific (E3), and competitive (E4) training periods. Sex interaction was not significant for any variable. Multiple linear regressions and principal component analysis were used to identify the most influential variables and the relative contribution of each domain (energetics, technique, and anthropometrics) to changes in swimming performance of T400. The relative contributions for performance of T400 at E1, E2, E3, and E4 were 15, 12, 6, and 13% for energetics, 78, 85, 75, and 70% for technique, and 7, 3, 19 and 17% for anthropometrics, respectively. Technique played the main role during the first 16-week macrocycle in a competitive season, regardless of small fluctuations in the influence of energetics and anthropometrics. Changes and influence of energetics, technique, and anthropometric on age-group swimmers' performance could be described by the T400 swimming test, providing a comprehensive biophysical overview of the main contributors to swimming performance.
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Affiliation(s)
- Rodrigo Zacca
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
| | - Rui Azevedo
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra PRD, Portugal
| | - Phornpot Chainok
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Faculty of Sport Sciences, Burapha University, Chonburi, Thailand
| | - João Paulo Vilas-Boas
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - Flávio A de S Castro
- Aquatic Sports Research Group, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - David B Pyne
- Physiology, Australian Institute of Sport, Canberra, Australia; and.,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Ricardo J Fernandes
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
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10
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Al-Abbasi FA, Kumar V, Anwar F. Biochemical and toxicological effect of diazepam in stress-induced cardiac dysfunctions. Toxicol Rep 2020; 7:788-794. [PMID: 32642445 PMCID: PMC7334438 DOI: 10.1016/j.toxrep.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022] Open
Abstract
Evaluation of diazepam in stress-induced cardiac dysfunction in rats. Alteration of cardiac biomarkers and ionic concentrations by stress. Restoration of altered cardiac biomarkers and ionic concentrations by diazepam. Restoration of architectures of cardiomyocytes by diazepam.
Diazepam is a medicine of the family benzodiazepine, used to treat various CNS disorders. To date, no study is available for biochemical analysis of diazepam in cardiac dysfunction. This study aimed to determine the effect of diazepam in stress-induced cardiac dysfunctions in rats. Male Wistar Albino rats were divided into four groups with six animals in each group for 90 days of the experimental protocol. Group1 served as a Normal Control (NC), Groups 2, as a Disease Control (DC), Group 3 as a Diazepam Control (DIC), and Group 4 as a Disease + Diazepam Treatment (DDT). Disease Control and Disease + Diazepam Treatment animals exposed to regular stress by forced swimming exercise method for 3 months. Diazepam Control and Disease + Diazepam Treatment received 5 mg/kg/p.o the daily dose of diazepam. At the end of the protocol, animals were sacrificed, heart preserved, blood collected, and utilized for biochemical estimations. Heart weight was increased in DC as compared to NC. Serum levels of cardiac biomarkers, creatine phosphokinase (CPK), creatine kinase-MB (CPK-MB), lactate dehydrogenase (LDH), High sensitivity C-reactive protein (hs-CRP) and troponin I (TnI) were significantly increased in DC as compared to NC. Heart tissue examined for histological changes. The altered serum levels of CPK, CPK-MB, LDH, hs-CRP, and TnI were significantly restored by the treatment of diazepam. Serum levels of Sodium, Potassium, Calcium, and Magnesium was increased in DC animals as compared to NC. The altered ionic level was also restored by the treatment of diazepam. Level of various cardiac markers and ions in the plasma were also slightly elevated in DIC. Histopathological studies are also in agreement with serological examinations and bonafide cardioprotective influences of diazepam in cardiac dysfunction. Conclusively research findings endorse the cardioprotective effect of diazepam in stress-induced cardiac dysfunction in rats.
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Affiliation(s)
- Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Saudi Arabia
| | - Vikas Kumar
- Department of Pharmaceutical Sciences, Shalom Institute of Health and Allied Sciences (SIHAS), Sam Higginbottom University of Agriculture, Technology & Sciences (SHUATS), Allahabad, India
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Saudi Arabia
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11
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Pieles GE, Stuart AG. The adolescent athlete's heart; A miniature adult or grown-up child? Clin Cardiol 2020; 43:852-862. [PMID: 32643161 PMCID: PMC7403711 DOI: 10.1002/clc.23417] [Citation(s) in RCA: 16] [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: 12/13/2019] [Revised: 06/16/2020] [Accepted: 06/26/2020] [Indexed: 12/18/2022] Open
Abstract
The systematic development of early age talent in sports academies has led to the professionalization of pediatric sport and the sports physician need to be aware of pediatric cardiological problems. Research into the medical cardiac care and assessment of the pediatric athlete are accumulating, but specific pediatric international guidelines are not available yet and reference data for ECG and echocardiography are incomplete, in particular for the age group <12 years of age. This article is an introduction to the physiological and diagnostics specifics of the pediatric athlete. The focus lies in the differences in presentation and diagnosis between pediatric and adult athletes for the most common pathologies. Reference data for electrical and structural adaptations to intensive exercise are sparse particularly in athletes aged below 12 years old. Training related changes include decrease of resting heart rate, increase of cardiac output, ventricular cavity size, and wall thickness. Cardiac hypertrophy is less pronounced in pediatric athletes, as HR mediated cardiac output increase to endurance exercise is the dominant mechanism in peripubertal children. As in adults, the most pronounced cardiovascular adaptations appear in classical endurance sports like rowing, triathlon, and swimming, but the specifics of pediatric ECG and echocardiographic changes need to be considered.
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Affiliation(s)
- Guido E Pieles
- National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre, Congenital Heart Unit, Bristol Heart Institute, Bristol, UK.,Institute of Sport, Exercise and Health, University College London, London, UK
| | - A Graham Stuart
- National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre, Congenital Heart Unit, Bristol Heart Institute, Bristol, UK
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12
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Bjerring AW, Landgraff HE, Leirstein S, Haugaa KH, Edvardsen T, Sarvari SI, Hallén J. From talented child to elite athlete: The development of cardiac morphology and function in a cohort of endurance athletes from age 12 to 18. Eur J Prev Cardiol 2020; 28:1061-1067. [PMID: 33611558 DOI: 10.1177/2047487320921317] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/02/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Adult athletes undergo cardiac adaptions in what is known as the "athlete's heart". Cardiac adaptations in young athletes have not been described in longitudinal studies but have previously been believed to be uniform in nature. METHODS Seventy-six cross-country skiers were assessed at age 12. Forty-eight (63%) completed the first follow-up at age 15 and 36 (47%) the second follow-up at age 18. Comprehensive exercise data were collected. Echocardiography with three-dimensional measurements and cardiopulmonary exercise testing were performed at all time points. The cohort was divided into active and former endurance athletes, with an eight hours of weekly endurance exercise cut-off at age 18. RESULTS The athletes underwent eccentric remodelling between ages 12 and 15, and concentric remodelling between ages 15 and 18. At age 18, the active endurance athletes had greater increases in inter-ventricular wall thickness (1.8 ± 1.4 Δmm vs 0.6 ± 1.0 Δmm, p < 0.05), left ventricular (LV) posterior wall thickness (1.6 ± 1.2 Δmm vs 0.8 ± 0.8 Δmm, p < 0.05), LV mass (63 ± 30 Δg vs 27 ± 21 Δg, p < 0.01), right ventricular (RV) end-diastolic area (3.4 ± 4.0 Δcm2 vs 0.6 ± 3.5Δ cm2, p < 0.05), RV end-systolic area (1.0 ± 2.3 Δcm2 vs -0.9 ± 2.0 Δcm2, p < 0.05) and left atrial volume (24 ± 21 ΔmL vs 6±10 ΔmL, p < 0.05) and had greater indexed maximal oxygen uptake (66.3 ± 7.4 mL/min/kg vs 57.1 ± 8.2 mL/min/kg, p < 0.01). There was no significant difference for LV volumes. CONCLUSION This study finds a shift in the development of the young athlete's heart. Between ages 12 and 15, the active endurance athletes underwent eccentric remodelling. This dynamic switched to concentric remodelling between ages 15 and 18.
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Affiliation(s)
- Anders W Bjerring
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sebastian I Sarvari
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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13
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WASFY MEAGANM, WEINER RORYB, WANG FRANCIS, BERKSTRESSER BRANT, DELUCA JAMES, HUTTER ADOLPHM, PICARD MICHAELH, BAGGISH AARONL. Myocardial Adaptations to Competitive Swim Training. Med Sci Sports Exerc 2019; 51:1987-1994. [DOI: 10.1249/mss.0000000000002022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Bjerring AW, Landgraff HEW, Stokke TM, Murbræch K, Leirstein S, Aaeng A, Brun H, Haugaa KH, Hallén J, Edvardsen T, Sarvari SI. The developing athlete's heart: a cohort study in young athletes transitioning through adolescence. Eur J Prev Cardiol 2019; 26:2001-2008. [DOI: 10.1177/2047487319862061] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Athlete's heart is a term used to describe physiological changes in the hearts of athletes, but its early development has not been described in longitudinal studies. This study aims to improve our understanding of the effects of endurance training on the developing heart. Methods Cardiac morphology and function in 48 cross-country skiers were assessed at age 12 years (12.1 ± 0.2 years) and then again at age 15 years (15.3 ± 0.3 years). Echocardiography was performed in all subjects including two-dimensional speckle-tracking strain echocardiography and three-dimensional echocardiography. All participants underwent cardiopulmonary exercise testing at both ages 12 and 15 years to assess maximal oxygen uptake and exercise capacity. Results Thirty-one (65%) were still active endurance athletes at age 15 years and 17 (35%) were not. The active endurance athletes had greater indexed maximal oxygen uptake (62 ± 8 vs. 57 ± 6 mL/kg/min, P < 0.05) at follow-up. There were no differences in cardiac morphology at baseline. At follow-up the active endurance athletes had greater three-dimensional indexed left ventricular end-diastolic (84 ± 11 mL/m2 vs. 79 ± 10 mL/m2, P < 0.05) and end-systolic volumes (36 ± 6 mL/m2 vs. 32 ± 3 mL/m2, P < 0.05). Relative wall thickness fell in the active endurance athletes, but not in those who had quit (–0.05 ΔmL/m2 vs. 0.00 mL/m2, P = 0.01). Four active endurance athletes had relative wall thickness above the upper reference values at baseline; all had normalised at follow-up. Conclusion After an initial concentric remodelling in the pre-adolescent athletes, those who continued their endurance training developed eccentric changes with chamber dilatation and little change in wall thickness. Those who ceased endurance training maintained a comparable wall thickness, but did not develop chamber dilatation.
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Affiliation(s)
- Anders W Bjerring
- Center for Cardiological Innovation, Oslo University Hospital, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Hege EW Landgraff
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
| | - Thomas M Stokke
- Center for Cardiological Innovation, Oslo University Hospital, Norway
| | - Klaus Murbræch
- Center for Cardiological Innovation, Oslo University Hospital, Norway
| | - Svein Leirstein
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
| | - Anette Aaeng
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
| | - Henrik Brun
- Department of Pediatric Cardiology, Oslo University Hospital, Norway
| | - Kristina H Haugaa
- Center for Cardiological Innovation, Oslo University Hospital, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Jostein Hallén
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
| | - Thor Edvardsen
- Center for Cardiological Innovation, Oslo University Hospital, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Sebastian I Sarvari
- Center for Cardiological Innovation, Oslo University Hospital, Norway
- Faculty of Medicine, University of Oslo, Norway
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15
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Zacca R, Toubekis A, Freitas L, Silva AF, Azevedo R, Vilas-Boas JP, Pyne DB, Castro FADS, Fernandes RJ. Effects of detraining in age-group swimmers performance, energetics and kinematics. J Sports Sci 2019; 37:1490-1498. [DOI: 10.1080/02640414.2019.1572434] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Rodrigo Zacca
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
- CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | | | - Laura Freitas
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
| | - Ana Filipa Silva
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - Rui Azevedo
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra, Portugal
| | - João Paulo Vilas-Boas
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - David B. Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Flávio A. De S. Castro
- School of Physical Education, Physiotherapy and Dance, Aquatic Sports Research Group, Universidade Federal do Rio Grande do Sul, Brazil
| | - Ricardo J. Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
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16
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Stavrou V, Tsarouhas K, Karetsi E, Michos P, Daniil Z, I Gourgoulianis K. Adolescent Finswimmers: Early Myocardial Adaptations in Different Swimming Styles. Sports (Basel) 2018; 6:sports6030078. [PMID: 30103388 PMCID: PMC6162589 DOI: 10.3390/sports6030078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of our study was to investigate early differences in the adolescent female finswimmers’ echocardiography parameters, possibly associated with different swimming-style training and different training equipment (monofin (MF) versus bifin (BF)). Method: Forty-three female finswimmers participated in our study (age: 15.6 ± 2.1 years, body mass index: 20.4 ± 2.2 kg/m2, body surface area: 1.56 ± 0.04 m2, body fat: 11.2 ± 0.6%) and were divided into two groups, according to the swimming style practiced (MF vs BF). Anthropometric characteristics, echocardiography and arterial pressure were measured. The independent t-test was used for statistical comparisons between groups. Stepwise multivariate regression analysis was applied to investigate associations between various variables. Results: The two groups used training equipment with different weights (p < 0.001). Female adolescent finswimmers presented signs of myocardial hypertrophy depicted by the increased left ventricle myocardial mass indexed to body surface area (101.34 ± 23.65). Different patterns of myocardial hypertrophy were observed for the two groups; MF swimmers presented concentric hypertrophy, while BF swimmers presented eccentric hypertrophy (relative wall thickness MF = 0.46 ± 0.08 vs BF = 0.39 ± 0.06 cm, p < 0.05). MF swimmers had also higher left ventricular posterior wall diameters (p < 0.05), lower stroke volume values (p < 0.05) and lower ejection fraction (p < 0.05) compared to BF athletes. Conclusion: Adolescent female finswimmers presented different patterns of myocardial hypertrophy possibly related to different training protocols and modes of exercise.
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Affiliation(s)
- Vasileios Stavrou
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, 41110 Larissa, Greece.
- School of Physical Education and Sports Science, University of Thessaly, Karyes, 42100 Trikala, Greece.
| | - Konstantinos Tsarouhas
- Cardiological Department, General University Hospital of Larissa, 41222 Larissa, Greece.
| | - Eleni Karetsi
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, 41110 Larissa, Greece.
| | - Panagiotis Michos
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, 41110 Larissa, Greece.
| | - Zoe Daniil
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, 41110 Larissa, Greece.
| | - Konstantinos I Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, 41110 Larissa, Greece.
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17
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Bjerring AW, Landgraff HEW, Leirstein S, Aaeng A, Ansari HZ, Saberniak J, Murbræch K, Bruun H, Stokke TM, Haugaa KH, Hallén J, Edvardsen T, Sarvari SI. Morphological changes and myocardial function assessed by traditional and novel echocardiographic methods in preadolescent athlete’s heart. Eur J Prev Cardiol 2018; 25:1000-1007. [DOI: 10.1177/2047487318776079] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Athlete’s heart is a term used to describe the morphological and functional changes in the hearts of athletes. Recent studies suggest that these changes may occur even in preadolescent athletes. This study aims to improve our understanding of the changes occurring in the preadolescent athlete’s heart. Design and methods Cardiac morphology and function in 76 preadolescent cross-country skiers (aged 12.1 ± 0.2 years) were compared with 25 age-matched non-competing preadolescents. Echocardiography was performed in all subjects, including 2D speckle-tracking strain echocardiography and 3D echocardiography. All participants underwent cardiopulmonary exercise testing to assess oxygen uptake and exercise capacity. Results Athletes had greater indexed VO2 max (62 ± 7 vs. 44 ± 5 mL/kg per min, p < 0.001), indexed left ventricular end-diastolic volume (79 ± 7 vs. 68 ± 7 mL/m2, p < 0.001), left ventricular mass (69 ± 12 vs. 57 ± 13 g/m2, p < 0.001), indexed right ventricular basal diameter (28.3 ± 3.0 vs. 25.4 ± 3.5 mm/m2, p < 0.001) and right atrial area (10.6 ± 1.4 vs. 9.7 ± 1.2 cm2/m2, p < 0.01). There was no difference in left ventricular ejection fraction, global longitudinal strain, and global circumferential strain and right ventricular fractional area change between the groups. Controls had higher right ventricular global longitudinal strain (−28.1 ± 3.5 vs. −31.1 ± 3.3%, p < 0.01). VO2 max was highly correlated to left ventricular end-diastolic volume ( r = 0.76, p < 0.001). Conclusion Athletes had greater left ventricular mass and greater left and right ventricular chamber dimensions compared with controls, while left ventricular function did not differ. Interestingly, right ventricular deformation was significantly lower compared with controls. This supports the notion that there is physiological, adaptive remodelling in preadolescent athlete’s heart.
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Affiliation(s)
- Anders W Bjerring
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
| | - Hege EW Landgraff
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Svein Leirstein
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Anette Aaeng
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hamza Z Ansari
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
| | - Jørg Saberniak
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
| | - Klaus Murbræch
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
| | - Henrik Bruun
- Department of Paediatric Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Thomas M Stokke
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
- University of Oslo, Norway
| | - Jostein Hallén
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
- University of Oslo, Norway
| | - Sebastian I Sarvari
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
- Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Norway
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18
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The role of echocardiography in the evaluation of cardiac re-modelling and differentiation between physiological and pathological hypertrophy in teenagers engaged in competitive amateur sports. Cardiol Young 2017; 27:706-712. [PMID: 27751193 DOI: 10.1017/s1047951116001116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
UNLABELLED Aims "Athlete's heart" is a cardiac adaptation to long-term intensive training. The aims of this study were to show the prevalence of left ventricular hypertrophy in teenagers who participate in sports, to define the different types of cardiac re-modelling, and to differentiate between physiological and pathological hypertrophy. METHOD Echocardiographic measurements were obtained by M-mode, two dimensional, and Doppler techniques of participants from sports and control groups. RESULTS The echocardiographic examinations included 100 healthy teenagers taking part in dynamic sports such as football and basketball and 100 healthy teenagers taking part in static sports such as karate and judo. The control group (n=100) included healthy, sedentary teenagers. Sports participants had significantly higher left ventricular mass when compared with the control group, (p0.05). Respondents from both groups had E/A ratios (transmitral flow velocity ratio)>1, preserved diastolic function, and statistically they did not differ from the control group. CONCLUSION Echocardiographic parameters show that physiological hypertrophy and cardiac re-modelling are present in teenagers who play sports. Unexpectedly, the prevalence of concentric and eccentric types of re-modelling is equally possible in the group of static sports participants.
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McClean G, Riding NR, Ardern CL, Farooq A, Pieles GE, Watt V, Adamuz C, George KP, Oxborough D, Wilson MG. Electrical and structural adaptations of the paediatric athlete’s heart: a systematic review with meta-analysis. Br J Sports Med 2017; 52:230. [DOI: 10.1136/bjsports-2016-097052] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 01/27/2023]
Abstract
AimTo describe the electrocardiographic (ECG) and echocardiographic manifestations of the paediatric athlete’s heart, and examine the impact of age, race and sex on cardiac remodelling responses to competitive sport.DesignSystematic review with meta-analysis.Data sourcesSix electronic databases were searched to May 2016: MEDLINE, PubMed, EMBASE, Web of Science, CINAHL and SPORTDiscus.Inclusion criteria(1) Male and/or female competitive athletes, (2) participants aged 6–18 years, (3) original research article published in English language.ResultsData from 14 278 athletes and 1668 non-athletes were included for qualitative (43 articles) and quantitative synthesis (40 articles). Paediatric athletes demonstrated a greater prevalence of training-related and training-unrelated ECG changes than non-athletes. Athletes ≥14 years were 15.8 times more likely to have inferolateral T-wave inversion than athletes <14 years. Paediatric black athletes had significantly more training-related and training-unrelated ECG changes than Caucasian athletes. Age was a positive predictor of left ventricular (LV) internal diameter during diastole, interventricular septum thickness during diastole, relative wall thickness and LV mass. When age was accounted for, these parameters remained significantly larger in athletes than non-athletes. Paediatric black athletes presented larger posterior wall thickness during diastole (PWTd) than Caucasian athletes. Paediatric male athletes also presented larger PWTd than females.ConclusionsThe paediatric athlete’s heart undergoes significant remodelling both before and during ‘maturational years’. Paediatric athletes have a greater prevalence of training related and training-unrelated ECG changes than non-athletes, with age, race and sex mediating factors on cardiac electrical and LV structural remodelling.
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Charfeddine S, Mallek S, Triki F, Hammami R, Abid D, Abid L, Kammoun S. Echocardiographic analysis of the left ventricular function in young athletes: a focus on speckle tracking imaging. Pan Afr Med J 2017; 25:171. [PMID: 28292133 PMCID: PMC5326024 DOI: 10.11604/pamj.2016.25.171.9095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/17/2016] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION The objectives were to assess the left ventricular (LV) structure and function in regularly trained young athletes, using 2 D conventional echocardiographic (echo) methods and speckle tracking echocardiography (STE). An observational cross-sectional study. METHODS Thirty-three footballers and 20 healthy untrained subjects were included in the study. The systolic and diastolic LV functions were evaluated by 2D conventional echo parameters, Doppler method and STE. RESULTS All the found values were within the normal range. The LV End Diastolic Diameter (LVED 37.24±2.08 mm/m2) and the LV Mass index (LVMi 97.93±15.58 g/m2) were significantly higher in young athletes as compared with controls. There was no difference regarding the LV systolic function assessed by conventional echo parameters in the 2 study groups. Regarding the diastolic function, the transmitral inflow velocities ratio was significantly higher in athletes (E/A = 2.10±0.49 versus 1.64±0.26, p< 0.001) but there was no difference in the filling pressure in the 2 groups. The STE demonstrated a different pattern of LV deformation in the different groups. A significant lower LV global longitudinal strain (GLS -20.68±2.05 versus -22.99±2.32 %, p<0.001) and higher radial and circumferential strains have been found in the young athletes as compared with controls. A significant relationship between the GLS values and LVED (r= 0.299, p = 0.03) and LVMi was also reported in athletes. CONCLUSION While conventional morphological and functional echocardiographic parameters failed to distinguish the adaptations in the athlete's heart, deformation parameters showed a different pattern of LV mechanics in young footballers versus controls.
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Affiliation(s)
- Salma Charfeddine
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Souad Mallek
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Faten Triki
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Rania Hammami
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Dorra Abid
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Leila Abid
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Samir Kammoun
- Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia
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Bartkevičienė A. Echocardiographic Characteristic Of Left Ventricular Geometry Of 12-17 Years Athletes. ACTA ACUST UNITED AC 2015. [DOI: 10.5200/sm-hs.2015.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aim. To compare the type of left ventricular geometry associated with training among 12-17 years athletes currently competing in cycling, rowing and basketball playing and to determine the factors influencing left ventricular geometry. Methods. A total 167 male athletes 12-17 year-old, involved in basketball (n = 62), academic rowing (n =51) and cycling (n = 54) and 168 sedentary non-athletes, matched for age and sex were involved in this study. All participants underwent twodimensional, M-mode and Doppler echocardiography. To estimate left ventricular geometry relative wall thickness and left ventricular mass index were calculated. Left ventricular geometry was assessed as normal, eccentric ventricular hypertrophy, concentric left ventricular hypertrophy, concentric left ventricular remodeling. Results. Left ventricular hypertrophy was present in 48 % of all athletes, predominantly (34 %) eccentric hypertrophy. 16% of athletes had concentric hypertrophy. Only 7% of athletes manifested concentric remodeling. The prevalence of eccentric hypertrophy was more common in cyclists (54%), concentric hypertrophy was more frequent in rowers (38%), and normal left ventricular geometry was more common in basketball players (53%). Multivariate regression analysis showed that age was the important determinant of eccentric and concentric left ventricular hypertrophy. Eccentric left ventricular hypertrophy also was independently associated to training volume (hour per week) and cycling sporting discipline. Conclusion. Almost half of athletes (48%) had left ventricular hypertrophy, predominantly eccentric hypertrophy, and the age was the important determinant of left ventricular hypertrophy (eccentric and concentric). Training volume and cycling sporting discipline were significantly associated with eccentric left ventricular hypertrophy.
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Bergeron MF, Mountjoy M, Armstrong N, Chia M, Côté J, Emery CA, Faigenbaum A, Hall G, Kriemler S, Léglise M, Malina RM, Pensgaard AM, Sanchez A, Soligard T, Sundgot-Borgen J, van Mechelen W, Weissensteiner JR, Engebretsen L. International Olympic Committee consensus statement on youth athletic development. Br J Sports Med 2015; 49:843-51. [PMID: 26084524 DOI: 10.1136/bjsports-2015-094962] [Citation(s) in RCA: 408] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Michael F Bergeron
- Youth Sports of the Americas, Birmingham, Alabama, USA Lemak Sports Medicine, Birmingham, Alabama, USA
| | - Margo Mountjoy
- Department of Family Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada IOC Medical Commission-Games Group
| | - Neil Armstrong
- Children's Health and Exercise Research Centre, St Luke's Campus, University of Exeter, Exeter, UK
| | - Michael Chia
- Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore
| | - Jean Côté
- Queen's University, School of Kinesiology and Health Studies, Kingston, Ontario, Canada
| | - Carolyn A Emery
- Alberta Children's Hospital Research Institute for Child and Maternal Health Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Avery Faigenbaum
- Department of Health & Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
| | - Gary Hall
- Hallway Consulting, Los Olivos, California, USA
| | - Susi Kriemler
- Institut für Epidemiologie, Biostatistik und Prävention, Gruppe Children, Physical Activity and Health (CHIPAH), Universität Zürich, Switzerland
| | - Michel Léglise
- International Gymnastics Federation (FIG), Paris, France
| | - Robert M Malina
- University of Texas at Austin, Austin, Texas, USA Tarleton State University, Stephenville, Texas, USA
| | - Anne Marte Pensgaard
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Alex Sanchez
- International Basketball Federation (FIBA), Switzerland
| | - Torbjørn Soligard
- Medical & Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | | | - Willem van Mechelen
- Department of Public & Occupational Health and EMGO+ Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | | | - Lars Engebretsen
- Medical & Scientific Department, International Olympic Committee, Lausanne, Switzerland Orthopaedic Center, Ullevaal University Hospital, Oslo, Norway
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23
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Castanheira J, Valente-dos-Santos J, Duarte J, Vaz V, Figueiredo AJ, Leite N, Cyrino ES, Coelho-e-Silva MJ. Morfologia do ventrículo esquerdo em adolescentes: comparação entre atletas e não atletas. REV BRAS MED ESPORTE 2014. [DOI: 10.1590/1517-86922014200601888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introdução: A morfologia do ventrículo esquerdo altera-se com o crescimento e desenvolvimento, durante a infância e adolescência. Contudo, são escassos os estudos comparativos entre não atletas e jovens atletas de elite.Objetivo: Analisar possíveis diferenças na morfologia do ventrículo esquerdo entre jovens atletas de elite e não atletas, do sexo masculino.Métodos: Trinta atletas de elite (15,4±0,6 anos; 68,0±11,3 kg; 175,2±7,5 cm) e 28 adolescentes saudáveis sem experiência com a prática esportiva (15,2±1,3 anos; 62,9± 3,8 kg; 168,8±7,7 cm) foram submetidos a medidas antropométricas (estatura, massa corporal e espessura de dobras cutâneas) e avaliações ecocardiográficas.Resultados: Diferenças estatisticamente significantes foram encontradas nos diâmetros telediastólico e telesistólico do ventrículo esquerdo, na espessura do septo interventricular em diástole, na espessura da parede posterior do ventrículo esquerdo, no diâmetro do átrio esquerdo e na relação entre o diâmetro do átrio esquerdo e o diâmetro da raiz da aorta, com os jovens atletas de elite apresentando valores superiores aos não atletas (P<0,01), mesmo após ajuste pela estatura. Correlações positivas e de moderada magnitude entre a massa do ventrículo esquerdo e a estatura foram encontradas em atletas (r=0,57) e não atletas (r=0,40).Conclusão: Os resultados do presente estudo sugerem que os valores superiores nas medidas da cavidade e de espessura da parede ventricular esquerda, encontrados no coração de jovens atletas de elite não podem ser explicados pela maior estatura, destacando a importância da exploração de modelos alométricos simples e multiplicativos que integrem medidas de maturação biológica em futuras investigações.
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Affiliation(s)
| | - João Valente-dos-Santos
- Universidade de Coimbra, Portugal; Universidade Lusófona de Humanidades e Tecnologias, Portugal
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24
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Pavlik G, Major Z, Csajági E, Jeserich M, Kneffel Z. The athlete’s heart Part II Influencing factors on the athlete’s heart: Types of sports and age (Review). ACTA ACUST UNITED AC 2013; 100:1-27. [DOI: 10.1556/aphysiol.100.2013.1.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Hauser M, Petzuch K, Kühn A, Schön P, Elmenhorst J, Schönfelder M, Oberhoffer R, Vogt MO. The Munich Triathlon Heart Study: ventricular function, myocardial velocities, and two-dimensional strain in healthy children before and after endurance stress. Pediatr Cardiol 2013; 34:576-82. [PMID: 22961347 DOI: 10.1007/s00246-012-0500-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 08/26/2012] [Indexed: 10/27/2022]
Abstract
Intense exercise has been shown to have negative effects on systolic and diastolic ventricular function in adults. Very little is known about the normal reaction of the growing heart to endurance stress. For this study, 26 healthy children (18 males) with a mean age of 12.61 years (range, 7.92-16.42 years) took part in an age-adapted triathlon circuit. The athletes were investigated by two-dimensional (2D) echocardiographic/speckle tracking, M-mode, pulse-wave Doppler, color Doppler, and color-coded tissue Doppler at 2-4 weeks before and immediately after the race. After the competition, cardiac output increased, mediated by an increase in heart rate and not by an elevated preload, according the Frank-Starling mechanism. Two-dimensional speckle tracking showed a reduced longitudinal strain in the right and left ventricles and additionally reduced circumferential strain in the left ventricle. The late diastolic inflow velocities were increased in both ventricles, indicating reduced diastolic function due to an impairment of myocardial relaxation. Immediately after endurance exercise, systolic and diastolic functions were attenuated in children and adolescents. In contrast to adult studies, this study could show a heart rate-mediated increase in cardiac output. The sequelae of these alterations are unclear, and the growing heart especially may be more susceptible to myocardial damage caused by intense endurance stress.
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Affiliation(s)
- Michael Hauser
- Department of Paediatric Cardiology and Congenital Heart Disease, German Heart Centre, Lazarettstrasse 36, 80636, Munich, Germany.
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26
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McNarry M, Jones A. The influence of training status on the aerobic and anaerobic responses to exercise in children: A review. Eur J Sport Sci 2012; 14 Suppl 1:S57-68. [DOI: 10.1080/17461391.2011.643316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Influence of training status and exercise modality on pulmonary O2 uptake kinetics in pubertal girls. Eur J Appl Physiol 2010; 111:621-31. [DOI: 10.1007/s00421-010-1681-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2010] [Indexed: 11/25/2022]
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28
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Dencker M, Thorsson O, Karlsson MK, Lindén C, Wollmer P, Andersen LB. Objectively measured daily physical activity related to cardiac size in young children. Scand J Med Sci Sports 2009; 19:664-8. [DOI: 10.1111/j.1600-0838.2008.00842.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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