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Echocardiographic Screening of Anomalous Origin of Coronary Arteries in Athletes with a Focus on High Take-Off. Healthcare (Basel) 2021; 9:healthcare9020231. [PMID: 33672577 PMCID: PMC7924023 DOI: 10.3390/healthcare9020231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/07/2021] [Accepted: 02/14/2021] [Indexed: 01/13/2023] Open
Abstract
Anomalous aortic origin of coronary arteries (AAOCA) represents a rare congenital heart disease. However, this disease is the second most common cause of sudden cardiac death in apparently healthy athletes. The aim of this systematic review is to analyze the feasibility and the detection rate of AAOCA by echocardiography in children and adults. A literature search was performed within the National Library of Medicine using the following keywords: coronary artery origin anomalies and echocardiography; then, the search was redefined by adding the keywords: athletes, children, and high take-off. Nine echocardiographic studies investigating AAOCA and a total of 33,592 children and adults (age range: 12–49 years) were included in this review. Of these, 6599 were athletes (12–49 years). All studies demonstrated a high feasibility and accuracy of echocardiography for the evaluation of coronary arteries origin as well as their proximal tracts. However, some limitations exist: the incidence of AAOCA varied from 0.09% to 0.39% (up to 0.76%) and was lower than described in computed tomography series (0.3–1.8%). Furthermore, echocardiographic views for the evaluation of AAOCA and the definition of “minor” defects (e.g., high take-off coronary arteries) have not been standardized. An echocardiographic protocol to diagnose the high take-off of coronary arteries is proposed in this article. In conclusion, the screening of AAOCA by echocardiography is feasible and accurate when appropriate examinations are performed; however, specific acoustic windows and definitions of defects other than AAOCA need to be standardized to improve sensitivity and specificity.
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Price KJ, Gordon BA, Bird SR, Benson AC. Acute cardiovascular responses to interval exercise: A systematic review and meta-analysis. J Sports Sci 2020; 38:970-984. [PMID: 32154760 DOI: 10.1080/02640414.2020.1737395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Interval exercise training is increasingly recommended to improve health and fitness; however, it is not known if cardiovascular risk is different from continuous exercise protocols. This systematic review with meta-analyses assessed the effect of a single bout of interval exercise on cardiovascular responses that indicate risk of cardiac fibrillation and infarction compared to continuous exercise. Electronic databases Medline, CINAHL, Embase, Scopus and Cochrane were searched. Key inclusion criteria were: (1) intervals of the same intensity and duration followed by a recovery period and (2) reporting at least one of blood pressure, heart rate variability, arterial stiffness or function. Cochrane Risk of Bias tool and GRADE approach were used. Meta-analyses found that systolic blood pressure responses to interval exercise did not differ from responses to continuous exercise immediately (MD 8 mmHg [95% CI -32, 47], p = 0.71) or at 60 min following exercise (MD 0 mmHg [95% CI -2, 1], p = 0.79). However, reductions in diastolic blood pressure and flow-mediated dilation with interval exercise were observed 10-15 min post-exercise. The available evidence indicates that interval exercise does not convey higher cardiovascular risk than continuous exercise. Further investigation is required to establish the safety of interval exercise for clinical populations.
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Affiliation(s)
- Kym Joanne Price
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Brett Ashley Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Stephen Richard Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Amanda Clare Benson
- Department of Health and Medical Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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Hernández Martínez JJ, Sánchez Duran E, Menchón Bofill M, Collado Cañas A. [Postanoxic encaphalopathy after and episode of resuscitated sudden death. Minimizing sequelae]. Rehabilitacion (Madr) 2019; 53:111-115. [PMID: 31186092 DOI: 10.1016/j.rh.2019.01.003] [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: 06/06/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 11/16/2022]
Abstract
Sudden death in young people while performing intense physical activity has a very low prevalence but a significant burden in terms of loss of years of life in society and a strong social impact. We present the case of a 19-year-old man who had a cardiac arrest while playing a football match, with prolonged resuscitation, and multiple subsequent complications (acute renal failure, coagulopathy, digestive bleeding, ischaemic colitis, and need for implantable cardioverter-defibrillator placement and hemicolectomy). The onset of intensive early rehabilitation in a specialised centre minimised the sequels, improving the Rankin score from 4 to 2 and Barthel index from 0 to 95 points, allowing the patient to lead an almost autonomous life.
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Affiliation(s)
| | | | | | - A Collado Cañas
- Servicio de Médicina Física y Rehabilitación, Hospital Casaverde Mutxamel, Alicante, España
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Braschi A. Acute exercise-induced changes in hemostatic and fibrinolytic properties: analogies, similarities, and differences between normotensive subjects and patients with essential hypertension. Platelets 2019; 30:675-689. [DOI: 10.1080/09537104.2019.1615611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Martin-Beaulieu JP, Myrick KM, Martin T, Pata RW, Feinn RS. Common electrocardiogram variations pre- and post-marathon. Clin Case Rep 2016; 4:944-947. [PMID: 27761243 PMCID: PMC5054467 DOI: 10.1002/ccr3.650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 07/11/2016] [Indexed: 11/12/2022] Open
Abstract
Electrocardiographic changes can be present in marathon runners. These findings may be misinterpreted as malignant by healthcare providers. For example, incomplete right bundle branch block, early ventricular repolarization, and left ventricular hypertrophy by voltage criteria alone are quite common in athletes, yet considered benign.
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Affiliation(s)
- John P Martin-Beaulieu
- Department of Nursing Quinnipiac University North Haven Campus, 370 Bassett Rd - Room 470M North Haven Connecticut 06473 USA
| | - Karen M Myrick
- Department of Nursing Joint Appointment Frank Netter School of Medicine Quinnipiac University North Haven Campus, 370 Bassett Rd - Room 470M North Haven Connecticut 06473 USA
| | - Thomas Martin
- Department of Biomedical Sciences Quinnipiac University North Haven Campus, 370 Bassett Rd - Room 270G North Haven Connecticut 06473 USA
| | - Rachel W Pata
- Department of Physical Therapy Quinnipiac University North Haven Campus, 370 Bassett Rd - Room 300B North Haven Connecticut 06473 USA
| | - Richard S Feinn
- Department of Medical Sciences Quinnipiac University North Haven Campus, 370 Bassett Rd - Room 307F North Haven Connecticut 06473 USA
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Solberg EE, Borjesson M, Sharma S, Papadakis M, Wilhelm M, Drezner JA, Harmon KG, Alonso JM, Heidbuchel H, Dugmore D, Panhuyzen-Goedkoop NM, Mellwig KP, Carre F, Rasmusen H, Niebauer J, Behr ER, Thiene G, Sheppard MN, Basso C, Corrado D. Sudden cardiac arrest in sports – need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Prev Cardiol 2015; 23:657-67. [DOI: 10.1177/2047487315599891] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- EE Solberg
- Diakonhjemmet Hospital, Department of Medicine, Oslo, Norway
| | - M Borjesson
- Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska University Hospital
| | - S Sharma
- St George’s University of London, UK
| | | | - M Wilhelm
- University Clinic for Cardiology, Cardiovascular Prevention, Rehabilitation & Sports Medicine, Inselspital, Bern, Switzerland
| | - JA Drezner
- Department of Family Medicine, University of Washington, Seattle, USA
| | - KG Harmon
- Department of Family Medicine, University of Washington, Seattle, USA
| | - JM Alonso
- Aspetar, Qatar Orthopedics and Sports Medicine Hospital, Sports Medicine Department, Doha, Qatar
| | - H Heidbuchel
- Cardiology – Arrhythmology, University Hospital Leuven, Belgium
| | - D Dugmore
- Department of Sports medicine, Perform Sports medicine centre, Burton upon Trent, UK
| | - NM Panhuyzen-Goedkoop
- Radboud University Nijmegen MC, The Netherlands; Sports Medical Centre Papendal Arnhem, The Netherlands
| | - K-P Mellwig
- Department of Cardiology, Heart and Diabetes Centre NRW, Ruhr University of Bochum, Bad Oeynhausen, Germany
| | - F Carre
- Pontchaillou Hospital, Rennes, France; INSERM U1099, Rennes, France
| | - H Rasmusen
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - ER Behr
- St George’s University of London, UK
| | - G Thiene
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | | | - C Basso
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - D Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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Massilamany C, Huber SA, Cunningham MW, Reddy J. Relevance of molecular mimicry in the mediation of infectious myocarditis. J Cardiovasc Transl Res 2013; 7:165-71. [PMID: 24263348 DOI: 10.1007/s12265-013-9519-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 11/11/2013] [Indexed: 01/09/2023]
Abstract
Heart disease, the leading cause of death in humans, is estimated to affect one in four American adults in some form. One predominant cause of heart failure in young adults is myocarditis, which can lead to the development of dilated cardiomyopathy, a major indication for heart transplantation. Environmental microbes, including viruses, bacteria, and fungi that are otherwise innocuous, have the potential to induce inflammatory heart disease. As the list is growing, it is critical to determine the mechanisms by which microbes can trigger heart autoimmunity and, importantly, to identify their target antigens. This is especially true as microbes showing structural similarities with the cardiac antigens can predispose to heart autoimmunity by generating cross-reactive immune responses. In this review, we discuss the relevance of molecular mimicry in the mediation of infectious myocarditis.
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Affiliation(s)
- Chandirasegaran Massilamany
- School of Veterinary Medicine and Biomedical Sciences, University of Nebraska-Lincoln, Room 202, Bldg VBS, Lincoln, NE, 68583, USA
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Stuckey MI, Tordi N, Mourot L, Gurr LJ, Rakobowchuk M, Millar PJ, Toth R, MacDonald MJ, Kamath MV. Autonomic recovery following sprint interval exercise. Scand J Med Sci Sports 2011; 22:756-63. [DOI: 10.1111/j.1600-0838.2011.01320.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Farahmand B, Hållmarker U, Brobert GP, Ahlbom A. Acute mortality during long-distance ski races (Vasaloppet). Scand J Med Sci Sports 2006; 17:356-61. [PMID: 16903898 DOI: 10.1111/j.1600-0838.2006.00582.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We studied mortality during long-distance ski races in Sweden. DESIGN The cohort comprised all subjects who participated in ski races during the Vasaloppet week from 1970 through 2005. All deaths during the races were identified and compared with the corresponding expected numbers based on national death rates. RESULTS In total, 698 102 starters generated altogether 581 person-years of skiing. Overall, 13 deaths occurred compared with 1.68 expected during the skiing time, yielding a standardized mortality ratio (SMR) of 7.7 [95% confidence interval (CI) 4.1-13.2]. Twelve of the deaths were caused by cardiovascular disease (SMR=22.1, 95% CI 11.4-38.6). Interviews of relatives revealed that two to four victims had medical conditions of the sort that they probably would have been recommended to avoid participation for medical reasons had they consulted a physician. CONCLUSION Our study showed a clearly increased risk of acute mortality during long-distance skiing. However, as physically active people spend only a minority of their time in races, in that population the short-term excess mortality during these periods is by far outweighed by the long-term protective effects of exercise on mortality.
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Affiliation(s)
- B Farahmand
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Abstract
This article focuses on anabolic steroid adverse effects on the cardiovascular system and mental health issues as well as the possible increase in the incidence of neoplasms in anabolic steroid users. On the basis of findings in the literature, the authors consider these three issues as the most significant concerning morbidity and mortality among anabolic steroid users. A study by Pärssinen et al. (2000) has shown an increased incidence of premature mortality among power lifters. Anabolic steroids and other concomitantly used drugs are the probable cause of this increased mortality, as power training itself does not increase health risks and all types of physical activity promote health.
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Affiliation(s)
- Miia Pärssinen
- Laboratory of Substance Abuse, National Public Health Institute, Helsinki, Finland.
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¿Morir por el deporte? Med Clin (Barc) 2002. [DOI: 10.1016/s0025-7753(02)72431-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Vuori I. Reducing the number of sudden deaths in exercise. Scand J Med Sci Sports 1995; 5:267-8. [PMID: 8581568 DOI: 10.1111/j.1600-0838.1995.tb00043.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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