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Clerico A, Zaninotto M, Aimo A, Galli C, Sandri MT, Correale M, Dittadi R, Migliardi M, Fortunato A, Belloni L, Plebani M. Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes. Clin Chem Lab Med 2024; 0:cclm-2024-0596. [PMID: 39016272 DOI: 10.1515/cclm-2024-0596] [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: 05/14/2024] [Accepted: 06/11/2024] [Indexed: 07/18/2024]
Abstract
The first part of this Inter-Society Document describes the mechanisms involved in the development of cardiovascular diseases, particularly arterial hypertension, in adults and the elderly. It will also examine how consistent physical exercise during adolescence and adulthood can help maintain blood pressure levels and prevent progression to symptomatic heart failure. The discussion will include experimental and clinical evidence on the use of specific exercise programs for preventing and controlling cardiovascular diseases in adults and the elderly. In the second part, the clinical relevance of cardiac-specific biomarkers in assessing cardiovascular risk in the general adult population will be examined, with a focus on individuals engaged in sports activities. This section will review recent studies that suggest a significant role of biomarkers in assessing cardiovascular risk, particularly the presence of cardiac damage, in athletes who participate in high-intensity sports. Finally, the document will discuss the potential of using cardiac-specific biomarkers to monitor the effectiveness of personalized physical activity programs (Adapted Physical Activity, APA). These programs are prescribed for specific situations, such as chronic diseases or physical disabilities, including cardiovascular diseases. The purposes of this Inter-Society Document are the following: 1) to discuss the close pathophysiological relationship between physical activity levels (ranging from sedentary behavior to competitive sports), age categories (from adolescence to elderly age), and the development of cardiovascular diseases; 2) to review in detail the experimental and clinical evidences supporting the role of cardiac biomarkers in identifying athletes and individuals of general population at higher cardiovascular risk; 3) to stimulate scientific societies and organizations to develop specific multicenter studies that may take into account the role of cardiac biomarkers in subjects who follow specific exercise programs in order to monitor their cardiovascular risk.
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Affiliation(s)
- Aldo Clerico
- Coordinator of the Study Group on Cardiac Biomarkers of the Italian Societies SIBioC and ELAS, Pisa, Italy
| | | | - Alberto Aimo
- Fondazione CNR - Regione Toscana G. Monasterio, Pisa, Italy
| | | | | | - Mario Correale
- UOC Medical Pathology, IRCCS De Bellis, Castellana Grotte, Bari, Italy
| | | | - Marco Migliardi
- Primario Emerito S.C. Laboratorio Analisi Chimico-Cliniche e Microbiologia, Ospedale Umberto I, A.O. Ordine Mauriziano di Torino, Turin, Italy
| | | | - Lucia Belloni
- Dipartimento di Diagnostica - per Immagini e Medicina di Laboratorio, Laboratorio Autoimmunità, Allergologia e Biotecnologie Innovative, Azienda USL-IRCCS di Reggio Emilia, Emilia-Romagna, Italy
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Alpert JS. Aristotle's Golden Mean in the Clinic. Am J Med 2024; 137:1-2. [PMID: 37156349 DOI: 10.1016/j.amjmed.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Joseph S Alpert
- University of Arizona School of Medicine, Tucson, Editor in Chief, The American Journal of Medicine.
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Cosh SM, McNeil DG, Tully PJ. Compulsive exercise and its relationship with mental health and psychosocial wellbeing in recreational exercisers and athletes. J Sci Med Sport 2023:S1440-2440(23)00086-5. [PMID: 37296060 DOI: 10.1016/j.jsams.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Better understanding of compulsive exercise is needed in sports medicine. Whilst compulsive exercise may impact mental health, the limited research exploring the relationship between compulsive exercise and psychosocial outcomes is equivocal. The majority of studies have examined eating disorder populations where the eating disorder pathology might account for distress. This study explores relationships between compulsive exercise and mental health. DESIGN Cross-sectional observational study. METHODS Australian recreational exercisers and athletes (N = 1157; Mage 36.4, standard deviation = 12.9, 77 % female) recruited through sporting organisations, clubs, and gyms, completed measures of compulsive exercise, depression, anxiety, stress, life satisfaction, social physique anxiety, and self-esteem. Regression analyses examined relationships between dimensions of compulsive exercise and wellbeing. RESULTS After adjustment for eating disorder symptoms and sporting level, compulsive exercise was associated with increased risk of clinically-significant anxiety, depression, and stress symptoms. Compulsive exercise was also associated with lower life satisfaction and self-esteem, and higher social physique anxiety. Notably, different dimensions of compulsive exercise had varying relationships with outcomes, and avoidance and rule-driven behaviour and lack of exercise enjoyment were associated with poorer mental health and wellbeing. CONCLUSIONS Results suggest that compulsive exercise is uniquely associated with a range of psychosocial and mental health outcomes. Results support the need to improve identification and treatment of compulsive exercise in sport and exercise settings. Results highlight that mental health intervention is an important component of treatment, and treatments targeting symptoms related to avoidance and rule-driven behaviour, and anhedonia may be valuable treatment components for those with compulsive exercise.
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Affiliation(s)
- S M Cosh
- School of Psychology, University of New England, Australia.
| | - D G McNeil
- Institute of Health and Wellbeing, Federation University, Australia
| | - P J Tully
- School of Psychology, University of New England, Australia
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Saviñon-Flores AI, Saviñon-Flores F, Trejo G, Méndez E, Ţălu Ş, González-Fuentes MA, Méndez-Albores A. A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing. Front Chem 2022; 10:1017305. [PMID: 36311415 PMCID: PMC9608872 DOI: 10.3389/fchem.2022.1017305] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022] Open
Abstract
Cardiac troponin I (cTnI) is a biomarker widely related to acute myocardial infarction (AMI), one of the leading causes of death around the world. Point-of-care testing (POCT) of cTnI not only demands a short turnaround time for its detection but the highest accuracy levels to set expeditious and adequate clinical decisions. The analytical technique Surface-enhanced Raman spectroscopy (SERS) possesses several properties that tailor to the POCT format, such as its flexibility to couple with rapid assay platforms like microfluidics and paper-based immunoassays. Here, we analyze the strategies used for the detection of cTnI by SERS considering POCT requirements. From the detection ranges reported in the reviewed literature, we suggest the diseases other than AMI that could be diagnosed with this technique. For this, a section with information about cardiac and non-cardiac diseases with cTnI release, including their release kinetics or cut-off values are presented. Likewise, POCT features, the use of SERS as a POCT technique, and the biochemistry of cTnI are discussed. The information provided in this review allowed the identification of strengths and lacks of the available SERS-based point-of-care tests for cTnI and the disclosing of requirements for future assays design.
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Affiliation(s)
- Anel I. Saviñon-Flores
- Centro de Química-ICUAP- Posgrado en Ciencias Ambientales, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - G. Trejo
- Laboratory of Composite Materials and Functional Coatings, Center for Research and Technological Development in Electrochemistry (CIDETEQ), Querétaro, Mexico
| | - Erika Méndez
- Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Ştefan Ţălu
- Technical University of Cluj-Napoca, The Directorate of Research, Development and Innovation Management (DMCDI), Cluj-Napoca, Romania
| | - Miguel A. González-Fuentes
- Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
- *Correspondence: Miguel A. González-Fuentes, ; Alia Méndez-Albores,
| | - Alia Méndez-Albores
- Centro de Química-ICUAP- Posgrado en Ciencias Ambientales, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
- *Correspondence: Miguel A. González-Fuentes, ; Alia Méndez-Albores,
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Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex. J Am Coll Cardiol 2022; 80:598-609. [PMID: 35926933 DOI: 10.1016/j.jacc.2022.05.031] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is inversely associated with all-cause mortality. However, the association of CRF and mortality risk for different races, women, and elderly individuals has not been fully assessed. OBJECTIVES The aim of this study was to evaluate the association of CRF and mortality risk across the spectra of age, race, and sex. METHODS A total of 750,302 U.S. veterans aged 30 to 95 years (mean age 61.3 ± 9.8 years) were studied, including septuagenarians (n = 110,637), octogenarians (n = 26,989), African Americans (n = 142,798), Hispanics (n = 35,197), Native Americans (n = 16,050), and women (n = 45,232). Age- and sex-specific CRF categories (quintiles and 98th percentile) were established objectively on the basis of peak METs achieved during a standardized exercise treadmill test. Multivariable Cox models were used to estimate HRs and 95% CIs for mortality across the CRF categories. RESULTS During follow-up (median 10.2 years, 7,803,861 person-years of observation), 174,807 subjects died, averaging 22.4 events per 1,000 person-years. The adjusted association of CRF and mortality risk was inverse and graded across the age spectrum, sex, and race. The lowest mortality risk was observed at approximately 14.0 METs for men (HR: 0.24; 95% CI: 0.23-0.25) and women (HR: 0.23; 95% CI: 0.17-0.29), with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher (HR: 4.09; 95% CI: 3.90-4.20) compared with extremely fit individuals. CONCLUSIONS The association of CRF and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness. Being unfit carried a greater risk than any of the cardiac risk factors examined.
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Matorras R, Navarro A, Ramos D, Malaina I, Irazusta J, Vendrell A, Fernandez A, Ferrando M, Quintana F. Physical activity and sperm quality: influence in sperm donors. Reprod Biol Endocrinol 2022; 20:83. [PMID: 35610619 PMCID: PMC9128101 DOI: 10.1186/s12958-022-00946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To ascertain whether physical activity (PA) is associated with better sperm quality in sperm donors. METHODS A prospective case-control study was designed in an IVF center setting. A total of 207 sperm donation candidates from a relatively small geographical area were included in the study with no intervention. Donor candidates were subjected to conventional sperm analysis according to WHO criteria. Moreover, they answered a standardized questionnaire regarding their last week PA (IPAQ), with PA expressed in metabolic equivalents (METs)-min/week. Donors were classified into 4 groups: low, moderate, high and very high PA. Specific sports were included in the questionnaire. Semen samples from 43 accepted donors were used in artificial insemination by donor (AID) and IVF. The fertilization rates (FR) and pregnancy rates (PR) were studied. RESULTS Semen volume, sperm concentration, progressive spermatozoa, non-progressive spermatozoa, total motile progressive spermatozoa and sperm morphology were similar in the four PA groups. No correlation between various semen parameters studied and METs was found. Running or cycling > 1 h/week did not influence sperm parameters. The AID PR was similar in the different PA groups. However, in IVF the mean donor FR was significantly higher in the high PA group and in the very high PA group. CONCLUSIONS No detrimental effect was associated with PA, or even very high PA, regarding conventional sperm parameters. Moreover, a better FR was associated with high and very high PA in IVF cycles, which merits more studies.
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Affiliation(s)
- Roberto Matorras
- IVIRMA BILBAO, Lejona, Spain
- Obstetrics and Gynecology Department, Department of Medical-Surgical Specialties, Cruces University Hospital, Basque Country University, Baracaldo, Spain
- Biocruces Health Research Institute, Baracaldo, Spain
| | | | | | - Iker Malaina
- Department of Mathematics, Basque Country University, Lejona, Spain
| | - Jon Irazusta
- Department of Physiology, Basque Country University, Lejona, Spain
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The Impact of Marathons on the Recovery of Heart Rate and Blood Pressure in Non-Professional Male Marathoners’ (≥45 Years). Medicina (B Aires) 2021; 57:medicina57121346. [PMID: 34946292 PMCID: PMC8703998 DOI: 10.3390/medicina57121346] [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: 11/08/2021] [Revised: 11/27/2021] [Accepted: 12/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Physical activity has a positive impact on health, and the participation in exercise and sports, including marathons, has increased in popularity. This kind of sport requires extreme endurance, which can cause different health problems and even lead to death. Participants without sufficient preparation and, in particular, men 45 years of age and older belong to a high risk group. The aim of this study was to determine the impact of marathons and cofactors associated with marathons on the recovery of heart rate (HR) and blood pressure (BP) of non-professional ≥ 45 years old male marathoners. Materials andMethods: A total of 136 ≥ 45 year old, non-professional (amateur marathoner), male participants were recruited. Data collection involved a questionnaire, body composition measures, and BP and HR results before and after finishing the marathon. Descriptive data, t-test, Mann–Whitney or χ2 test, and Pearson’s correlation were applied. Results: Participants (skiing n = 81, cycling n = 29, running n = 26; mean age 51.7 ± 7.1 years old) had previously attended a median of 35 (IQR 17.5–66) marathons and travelled 2111.5 (IQR 920–4565) km. Recovery of HR and BP after finishing and recovery time was insufficient and not associated with marathon preparation. Running was the most burdensome for HR, and cycling was most taxing for BP. Chronic diseases did not influence participation in the marathon. Conclusions: The preparation for the marathon was mainly sufficient, but recovery after the marathon was worrisome. Marathons are demanding for ≥45 year old males and may be too strenuous an activity that has deleterious effects on health.
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Schnohr P, O'Keefe JH, Lavie CJ, Holtermann A, Lange P, Jensen GB, Marott JL. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clin Proc 2021; 96:3012-3020. [PMID: 34412854 DOI: 10.1016/j.mayocp.2021.05.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/16/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the association between the duration of weekly leisure-time sports activity and all-cause mortality. METHODS As part of the prospective Copenhagen City Heart Study, 8697 healthy adults completed a comprehensive questionnaire about leisure-time sports activities. Duration (minutes per week) of leisure-time sports activities was recorded for tennis, badminton, soccer, handball, cycling, swimming, jogging, calisthenics, health club activities, weightlifting, and other sports. The primary end point was all-cause mortality, and the median follow-up was 25.6 years. The association between duration of leisure-time sports activities and all-cause mortality was studied using multivariable Cox proportional hazards regression analysis. RESULTS Compared with the reference group of 2.6 to 4.5 hours of weekly leisure-time sports activities, we found an increased risk for all-cause mortality for those with 0 hours (hazard ratio [HR], 1.51; 95% CI, 1.29 to 1.76), for those with 0.1 to 2.5 hours (HR, 1.24; 95% CI, 1.05 to 1.46), and for those with more than 10 hours (HR, 1.18; 95% CI, 1.00 to 1.39) of weekly leisure-time sports activities. These relationships were generally consistent with additional adjustments for potential confounders among subgroups of age, sex, education, smoking, alcohol intake, and body mass index, when the first 5 years of follow-up were excluded, and for cardiovascular disease mortality. CONCLUSION We observed a U-shaped association between weekly duration of leisure sports activities and cardiovascular and all-cause mortality, with lowest risk for those participating in 2.6 to 4.5 weekly hours, being consistent across subgroups. Participation in sport activities should be promoted, but the potential risk of very high weekly hours of sport participation should be considered for inclusion in guidelines and recommendations.
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Affiliation(s)
- Peter Schnohr
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Peter Lange
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark; Medical Department, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Gorm Boje Jensen
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Chauin A. The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis. Vasc Health Risk Manag 2021; 17:601-617. [PMID: 34584417 PMCID: PMC8464585 DOI: 10.2147/vhrm.s327661] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
The causes and mechanisms of increased cardiac troponin T and I (cTnT and cTnI) concentrations are numerous and are not limited to acute myocardial infarction (AMI) (ischemic necrosis of cardiac myocytes). Any type of reversible or irreversible cardiomyocyte injury can result in elevated serum cTnT and cTnI levels. Researchers and practitioners involved in the diagnosis and treatment of cardiovascular disease, including AMI, should know the key causes and mechanisms of elevated serum cTnT and cTnI levels. This will allow to reduce or completely avoid diagnostic errors and help to choose the most correct tactics for further patient management. The purpose of this article is to discuss the main causes and mechanisms of increase in cardiac troponins concentrations in frequently occurring physiological (physical exertion, psycho-emotional stress) and pathological conditions (inflammatory heart disease, pulmonary embolism, chronic renal failure and sepsis (systemic inflammatory response)) not related to myocardial infarction.
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Affiliation(s)
- Aleksey Chauin
- Department of Cardiology and Cardiovascular Surgery, Samara State Medical University, Samara, 443099, Russia.,Department of Histology and Embryology, Samara State Medical University, Samara, 443099, Russia
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Fenn N, Reyes C, Monahan K, Robbins ML. How Ready Are Young Adults to Participate in Community Service? An Application of the Transtheoretical Model of Behavior Change. Am J Health Promot 2021; 36:64-72. [PMID: 34296641 DOI: 10.1177/08901171211034742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Engaging in community service, or unpaid work intended to help people in a community, is generally associated with greater overall well-being. However, the process of beginning and maintaining community service engagement has been sparsely examined. The current study applied the Transtheoretical Model (TTM) of behavior change to understanding community service readiness among young adults. DESIGN Cross-sectional design using an online survey. SETTING Participants were undergraduate students recruited at a mid-sized Northeastern US university in Spring 2018. SAMPLE Participants (N = 314) had a mean age of 20.36 years (SD = 3.69), were primarily White (78%), female (72%), and from moderately high socioeconomic backgrounds (as measured by parental level of education). MEASURES Socio-demographics including age, gender, race-ethnicity, and parental level of education; readiness, pros, cons, and self-efficacy for community service; civic engagement behavior; well-being. ANALYSIS Participants were classified into very low (n = 62), low (n = 59), moderate (n = 92), high (n = 46), and very high (n = 55) readiness for community service groupings. A MANOVA was conducted to assess relationships between groupings and community service TTM constructs, civic engagement, and well-being. RESULTS There were significant differences between readiness groupings on all main outcome variables, F(20, 1012) = 10.34, p < .001; Wilks' Λ = 0.54, η2 = .14. Post-hoc Games-Howell tests showed that those exhibiting higher levels of readiness reported fewer cons, greater pros, higher self-efficacy, more overall civic engagement, and greater well-being compared to lower readiness individuals. CONCLUSION Consistent with previous TTM applications, self-efficacy and the importance of pros increased across readiness groupings while the importance of cons decreased. Study findings may be used to inform readiness-tailored interventional work for increasing community service. This area of study would benefit from longitudinal research examining community service readiness beyond the college environment.
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Affiliation(s)
- Natalie Fenn
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Kathleen Monahan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Sangha GS, Goergen CJ, Prior SJ, Ranadive SM, Clyne AM. Preclinical techniques to investigate exercise training in vascular pathophysiology. Am J Physiol Heart Circ Physiol 2021; 320:H1566-H1600. [PMID: 33385323 PMCID: PMC8260379 DOI: 10.1152/ajpheart.00719.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Atherosclerosis is a dynamic process starting with endothelial dysfunction and inflammation and eventually leading to life-threatening arterial plaques. Exercise generally improves endothelial function in a dose-dependent manner by altering hemodynamics, specifically by increased arterial pressure, pulsatility, and shear stress. However, athletes who regularly participate in high-intensity training can develop arterial plaques, suggesting alternative mechanisms through which excessive exercise promotes vascular disease. Understanding the mechanisms that drive atherosclerosis in sedentary versus exercise states may lead to novel rehabilitative methods aimed at improving exercise compliance and physical activity. Preclinical tools, including in vitro cell assays, in vivo animal models, and in silico computational methods, broaden our capabilities to study the mechanisms through which exercise impacts atherogenesis, from molecular maladaptation to vascular remodeling. Here, we describe how preclinical research tools have and can be used to study exercise effects on atherosclerosis. We then propose how advanced bioengineering techniques can be used to address gaps in our current understanding of vascular pathophysiology, including integrating in vitro, in vivo, and in silico studies across multiple tissue systems and size scales. Improving our understanding of the antiatherogenic exercise effects will enable engaging, targeted, and individualized exercise recommendations to promote cardiovascular health rather than treating cardiovascular disease that results from a sedentary lifestyle.
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Affiliation(s)
- Gurneet S Sangha
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana.,Purdue University Center for Cancer Research, Purdue University, West Lafayette, Indiana
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland.,Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center, Baltimore, Maryland
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Alisa M Clyne
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
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Ferrari D, Lombardi G, Strollo M, Pontillo M, Motta A, Locatelli M. A Possible Antioxidant Role for Vitamin D in Soccer Players: A Retrospective Analysis of Psychophysical Stress Markers in a Professional Team. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3484. [PMID: 32429456 PMCID: PMC7277111 DOI: 10.3390/ijerph17103484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 12/20/2022]
Abstract
The health benefits of physical activity are recognized, however, high levels of exercise may lead to metabolic pathway imbalances that could evolve into pathological conditions like the increased risk of neurological disease observed in professional athletes. We analyzed the plasma/serum levels of 29 athletes from a professional soccer team playing in the Italian first league and tested the levels of psychophysical stress markers (vitamin D, creatine kinase, reactive oxygen species (ROS) and testosterone/cortisol ratio) during a period of 13 months. The testosterone/cortisol ratio was consistent with an appropriate training program. However, most of the athletes showed high levels of creatine kinase and ROS. Despite the large outdoor activity, vitamin D values were often below the sufficiency level and, during the "vitamin D winter", comparable with those of the general population. Interestingly, high vitamin D values seemed to be associated to low levels of ROS. Based on the results of our study we proposed a vitamin D supplementation as a general practice for people who perform high levels of physical exercise. Beside the known effect on calcium and phosphate homeostasis, vitamin D supplementation should mitigate the high reactivity of ROS which might be correlated to higher risk of neurodegenerative diseases observed in professional athletes.
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Affiliation(s)
- Davide Ferrari
- SCVSA Department, University of Parma, 43125 Parma, Italy
- Laboratory Medicine Service, San Raffaele Hospital, 20132 Milano, Italy; (M.S.); (M.P.); (A.M.); (M.L.)
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milano, Italy;
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, 61-871 Poznań, Poland
| | - Marta Strollo
- Laboratory Medicine Service, San Raffaele Hospital, 20132 Milano, Italy; (M.S.); (M.P.); (A.M.); (M.L.)
| | - Marina Pontillo
- Laboratory Medicine Service, San Raffaele Hospital, 20132 Milano, Italy; (M.S.); (M.P.); (A.M.); (M.L.)
| | - Andrea Motta
- Laboratory Medicine Service, San Raffaele Hospital, 20132 Milano, Italy; (M.S.); (M.P.); (A.M.); (M.L.)
| | - Massimo Locatelli
- Laboratory Medicine Service, San Raffaele Hospital, 20132 Milano, Italy; (M.S.); (M.P.); (A.M.); (M.L.)
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13
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Laukkanen JA, Kunutsor SK, Ozemek C, Mäkikallio T, Lee DC, Wisloff U, Lavie CJ. Cross-country skiing and running's association with cardiovascular events and all-cause mortality: A review of the evidence. Prog Cardiovasc Dis 2019; 62:505-514. [PMID: 31505192 DOI: 10.1016/j.pcad.2019.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022]
Abstract
A large body of evidence demonstrates positive, graded effects of PA on cardiovascular disease (CVD) morbidity and mortality with increasing intensity compared with lower PA intensity. Running is often designated as a high-intensity PA with substantial evidence supporting its health benefits. Cross-country skiing is among the most demanding aerobic endurance exercises and requires engaging the upper- and lower-body. Cross-country skiing is often regarded as high-intensity PA, which has been associated with significant health benefits. However, a robust body of evidence identifying the dose-response relation between cross-country skiing volume and health outcomes is sparse. Therefore, this review aims to summarize the available evidence linking cross-country skiing with CVD morbidity and all-cause mortality; postulated pathways that may elucidate the relation between these associations; outline areas of ongoing uncertainty; and the implications for primary and secondary CVD prevention. To put the findings into perspective, we also summarized the evidence linking running with CVD morbidity and all-cause mortality. Though a head-to-head comparison is not available, the evidence indicates that performing PA as cross-country skiing associates with lower mortality risk when compared with that observed in those undertaking their PA as running. Potential adverse effects of extreme high weekly doses of cross-country skiing over decades may be cardiac arrhythmias, such as atrial fibrillation. Evidence suggests that cross-country skiing may reduce the risk of CVD events and all-cause mortality via anti-inflammatory pathways, improvements in endothelial function and reduced levels of CVD risk factors, such as lipids, glucose, and blood pressure; and enhancement of cardiorespiratory fitness.
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Affiliation(s)
- Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland.
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Timo Mäkikallio
- Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, USA
| | - Ulrik Wisloff
- Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
| | - Carl J Lavie
- Department of Cardiovascular Diseases, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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Wanner M, Lohse T, Braun J, Cabaset S, Bopp M, Krause N, Rohrmann S, for the Swiss National Cohort Study. Occupational physical activity and all-cause and cardiovascular disease mortality: Results from two longitudinal studies in Switzerland. Am J Ind Med 2019; 62:559-567. [PMID: 31111529 DOI: 10.1002/ajim.22975] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Research regarding the effects of occupational physical activity on health remains inconsistent. We analyzed the association of occupational physical activity with all-cause and cardiovascular disease (CVD) mortality. METHODS We analyzed two cohorts with baseline assessments from 1977 to 1993 ("National Research Program 1A" (NRP1A) and "MONItoring of trends and determinants in CArdiovascular disease" [MONICA]) and mortality follow-up until 2015 using adjusted Cox regression models. RESULTS We included 4396 NRP1A participants (137 793 person-years of follow-up, 1541 deaths) and 5780 MONICA participants (135 410 person-years, 1158 deaths). All-cause mortality was higher for men in the high compared with the low occupational physical activity category according to NRP1A (hazard ratio [HR] 1.25, 95% confidence intervals [CI] 1.05-1.50). CVD mortality was higher for men in the moderate compared with the low occupational physical activity category according to MONICA (HR, 1.41; 95% CI, 1.03-1.91). Results for women were not statistically significant. CONCLUSIONS We observed higher total and CVD mortality risks in men with higher occupational physical activity but inconsistent results for women and across cohorts.
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Affiliation(s)
- Miriam Wanner
- Department of Epidemiology, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
| | - Tina Lohse
- Department of Epidemiology, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
| | - Julia Braun
- Department of Biostatistics, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
| | - Sophie Cabaset
- Department of Epidemiology, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
| | - Matthias Bopp
- Department of Epidemiology, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
| | - Niklas Krause
- Departments of Epidemiology and Environmental Health Sciences, Fielding School of Public HealthUniversity of California Los AngelesLos Angeles California
| | - Sabine Rohrmann
- Department of Epidemiology, Epidemiology, Biostatistics, and Prevention InstituteUniversity of ZurichZurich Switzerland
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Dose-response relationship between very vigorous physical activity and cardiovascular health assessed by heart rate variability in adults: Cross-sectional results from the EPIMOV study. PLoS One 2019; 14:e0210216. [PMID: 30703127 PMCID: PMC6354985 DOI: 10.1371/journal.pone.0210216] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
The minimum amount of physical activity needed to obtain health benefits has been widely determined. Unlikely, the impact of extreme amounts of very vigorous physical activity (VVPA, ≥ 8 metabolic equivalents) to the heart remains controversial. We aimed to evaluate the dose-response relationship between VVPA and heart rate variability (HRV) in adults. We selected 1040 asymptomatic individuals (60% women, 42 ± 15 years, 28 ± 6 kg/m2) from the Epidemiology and Human Movement Study (EPIMOV). Participants remained in the supine position for 10 min, and we selected an intermediate 5-min window for HRV analysis. The standard deviation of the RR intervals, root mean square of RR intervals, successive RR intervals that differ > 50 ms, powers of the low-and high-frequency bands and Poincaré plot standard deviations were quantified. Participants used a triaxial accelerometer (Actigraph GT3x+) above the dominant hip for 4-7 consecutive days for quantifying their physical activity. We also evaluated the maximum oxygen uptake ([Formula: see text]) during an exercise test. We stratified participants into five groups according to the VVPA in min/week (group 1, ≤ 1.50; 2, 1.51-3.16; 3, 3.17-3.54; 4, 3.55-20.75; and 5, > 20.75). The linear trends of the HRV through the quintiles of VVPA were investigated. We used logarithmic transformations to compare the five groups adjusted for age, sex, cardiovascular risk, and [Formula: see text]. We found a better HRV with increased VVPA for all HRV indices studied (p trend < 0.05). However, group 5 did not differ from group 4 (p > 0.05) for none of the indices. We conclude that there is an incremental benefit of VVPA on HRV of asymptomatic adults. Since we found neither additional benefits nor the harmful impact of amounts of VVPA as high as 22 min/week on HRV, our results should not discourage asymptomatic adults to perform VVPA.
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Fletcher GF, Landolfo C, Niebauer J, Ozemek C, Arena R, Lavie CJ. Reprint of: Promoting Physical Activity and Exercise. J Am Coll Cardiol 2018; 72:3053-3070. [DOI: 10.1016/j.jacc.2018.10.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 12/12/2022]
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Sarcevic Z, Tepavcevic A. Competitive Endurance Activities of Middle-aged Athletes as a Risk Factor for Atrial Fibrillation. Curr Sports Med Rep 2018; 17:391-395. [PMID: 30407947 DOI: 10.1249/jsr.0000000000000535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia in athletes. Epidemiological studies have documented a greater prevalence of AF in athletes engaged in long-term endurance sports. Several mechanisms were proposed to underlie the association between exercise and AF, but the exact pathophysiology remains unclear. The studies up to now have been concentrated on the competitive middle-aged endurance athletes, but there is no evidence of AF prevalence among highly active noncompetitive athletes of the same age. Endurance athletes who do not compete might be at a lower risk for AF than their competitive peers. This hypothesis is theoretically examined, and the current evidence summarized in this article.
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Affiliation(s)
- Zoran Sarcevic
- Novi Sad Health Care Centre, Sports Medicine Centre, Novi Sad, Serbia.,Faculty of Medicine, University of Novi Sad, Serbia
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Fletcher GF, Landolfo C, Niebauer J, Ozemek C, Arena R, Lavie CJ. Promoting Physical Activity and Exercise. J Am Coll Cardiol 2018; 72:1622-1639. [DOI: 10.1016/j.jacc.2018.08.2141] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/03/2023]
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Antero-Jacquemin J, Pohar-Perme M, Rey G, Toussaint JF, Latouche A. The heart of the matter: years-saved from cardiovascular and cancer deaths in an elite athlete cohort with over a century of follow-up. Eur J Epidemiol 2018; 33:531-543. [PMID: 29730745 DOI: 10.1007/s10654-018-0401-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/25/2018] [Indexed: 12/21/2022]
Abstract
To quantify the years of life saved from cardiovascular (CVD), cancer and overall deaths among elite athletes according to their main type of physiological effort performed in the Olympic Games. All French athletes participating in the Games from 1912 to 2012, with vital status validated and cause of death (if concerned) identified by the national registries were included (n = 2814, 455 died) and classified according to 6 groups of effort: POWER (continuous effort < 45 s); INTERMEDIATE (45 s ≤ continuous effort < 600 s); ENDURANCE (continuous effort ≥ 600 s); POLYVALENT (participating in different events entering different classifications), INTERMITTENT (intermittent effort, i.e. team sports); PRECISION (targeting events). The theoretical years-lost method was adapted to calculate gains in longevity (years-saved) according to specific-risks under the competing risks model and was implemented in R software. Considering overall-deaths, all groups significantly saved, on average, 6.5 years of life (95% CI 5.8-7.2) compared to the general population. This longevity advantage is mainly driven by a lower risk of cancer which, isolated, contributed to significantly save 2.3 years of life (95% CI 1.2-1.9) on average in each group. The risk of CVD-related mortality in the ENDURANCE and PRECISION groups is not significantly different from the general population. The other groups significantly saved, on average, 1.6 years of life (95% CI 1.2-1.9) from CVD death. The longevity benefits in elite athletes are associated with the type of effort performed during their career, mainly due to differences on the CVD-risk of death.
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Affiliation(s)
- Juliana Antero-Jacquemin
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport, de l'Expertise et de la Performance (INSEP), 11 Avenue du Tremblay, 75012, Paris, France.
| | - Maja Pohar-Perme
- Institute of Biostastistics and Medical Informatics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Grégoire Rey
- Inserm CépiDc, Epidemiology Centre on Medical Causes of Death, Le Kremlin-Bicêtre, France
| | - Jean-François Toussaint
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport, de l'Expertise et de la Performance (INSEP), 11 Avenue du Tremblay, 75012, Paris, France.,University Paris Descartes, Sorbonne Paris Cité, Paris, France.,CIMS, Hôtel-Dieu, AP-HP, 1 Parvis Notre Dame, 75184, Paris Cedex 04, France
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Arena R, McNeil A, Lavie CJ, Ozemek C, Forman D, Myers J, Laddu DR, Popovic D, Rouleau CR, Campbell TS, Hills AP. Assessing the Value of Moving More—The Integral Role of Qualified Health Professionals. Curr Probl Cardiol 2018. [DOI: 10.1016/j.cpcardiol.2017.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Cavalcante PAM, Gregnani MF, Henrique JS, Ornellas FH, Araújo RC. Aerobic but not Resistance Exercise Can Induce Inflammatory Pathways via Toll-Like 2 and 4: a Systematic Review. SPORTS MEDICINE - OPEN 2017; 3:42. [PMID: 29185059 PMCID: PMC5705532 DOI: 10.1186/s40798-017-0111-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/15/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Only a few studies have addressed the relationship between toll-like receptors 2 and 4 (TLR2 and TLR4) and the production of local and systemic cytokines in response to physical exercise, and they have produced conflicting results. We aimed to determine whether acute and chronic exercise outcomes are associated with changes in TLR2 and TLR4 expression and signaling and if so, the mechanisms that connect them. METHODS PubMed database were consulted. This systematic review selected 39 articles, 26 involving humans and 13 based on rodents. RESULTS In acute resistance exercise studies, 75% reported a decrease in TLR4 or TLR2 expression and 25% did not find differences. For chronic resistance exercise studies, 67% reported a reduction of expression and 33% did not find differences. Studies of both types reported reductions in pro-inflammatory cytokines. In acute aerobic exercise studies, 40% revealed a decline in the expression of the receptors, 7% reported no significant difference, 40% showed an increase, and 13% did not evaluate their expression. Fifty-eight percent of studies of chronic aerobic exercise revealed a reduction in expression, 17% did not find a difference, and 25% reported increases; they also suggested that the expression of the receptors might be correlated with that of inflammatory cytokines. In studies on combined exercise, 50% reported a decline in receptors expression and 50% did not find a difference. CONCLUSIONS The majority of the articles (54%) link different types of exercise to a decline in TLR4 and TLR2 expression. However, aerobic exercise may induce inflammations through its influence on these receptor pathways. Higher levels of inflammation were seen in acute sessions (40%) than regular sessions (25%).
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Affiliation(s)
- Paula Andréa Malveira Cavalcante
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- , Rua Pedro de Toledo, 669/9and., 04039-032, São Paulo, SP, Brazil.
| | - Marcos Fernandes Gregnani
- Molecular Biology Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jessica Salles Henrique
- Neurology/Neuroscience Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Exercise Neurophysiology Laboratory, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Fábio Henrique Ornellas
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ronaldo Carvalho Araújo
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Molecular Biology Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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Roberts WO, Schwartz RS, Kraus SM, Schwartz JG, Peichel G, Garberich RF, Lesser JR, Oesterle SN, Wickstrom KK, Knickelbine T, Harris KM. Long-Term Marathon Running Is Associated with Low Coronary Plaque Formation in Women. Med Sci Sports Exerc 2017; 49:641-645. [PMID: 27824692 DOI: 10.1249/mss.0000000000001154] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High-resolution coronary computed tomography angiography and cardiac risk factor assessment were completed in women with long-term marathon running histories to compare to sedentary women with similar risk factors. METHODS Women who had run at least one marathon per year for 10-25 yr underwent coronary computed tomography angiography, 12-lead ECG, blood pressure and heart rate measurement, lipid panel, and a demographic/health risk factor survey. Sedentary matched controls were derived from a contemporaneous clinical study database. CT scans were analyzed for calcified and noncalcified plaque prevalence, volume, stenosis severity, and calcium score. RESULTS Women marathon runners (n = 26), age 42-82 yr, with combined 1217 marathons (average 47) exhibited significantly lower coronary plaque prevalence and less calcific plaque volume. The marathon runners also had less risk factors (smoking, hypertension, and hyperlipidemia); significantly lower resting heart rate, body weight, body mass index, and triglyceride levels; and higher high-density lipoprotein cholesterol levels compared with controls (n = 28). The five women runners with coronary plaque had run marathons for more years and were on average 12 yr older (65 vs 53) than the runners without plaque. CONCLUSION Women marathon runners had minimal coronary artery calcium counts, lower coronary artery plaque prevalence, and less calcified plaque volume compared with sedentary women. Developing coronary artery plaque in long-term women marathon runners appears related to older age and more cardiac risk factors, although the runners with coronary artery plaque had accumulated significantly more years running marathons.
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Affiliation(s)
- William O Roberts
- 1Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; 2Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN; 3The Integra Group, Brooklyn Park, MN; 4Stanford University School of Medicine, Stanford, CA; 5Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN; 6Retired Medtronic Inc., Minneapolis, MN; and 7Department of Internal Medicine, University of Arizona, Tucson, AZ
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23
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Laddu DR, Rana JS, Murillo R, Sorel ME, Quesenberry CP, Allen NB, Gabriel KP, Carnethon MR, Liu K, Reis JP, Lloyd-Jones D, Carr JJ, Sidney S. 25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Mayo Clin Proc 2017; 92:1660-1670. [PMID: 29050797 PMCID: PMC5679779 DOI: 10.1016/j.mayocp.2017.07.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC). PATIENTS AND METHODS This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age. RESULTS We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants. CONCLUSION White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.
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Affiliation(s)
- Deepika R. Laddu
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL
| | - Jamal S. Rana
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
- Department of Medicine, University of California, San Francisco, San Francisco, CA
- Division of Cardiology, Kaiser Permanente Northern California, Oakland, CA
| | - Rosenda Murillo
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Michael E. Sorel
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Norrina B. Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kelley P. Gabriel
- Department of Epidemiology, Human Genetics and Environmental Sciences. University of Texas Health Science Center at Houston, School of Public Health – Austin Campus, Austin, TX
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jared P. Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - J. Jeffrey Carr
- Departments of Radiology and Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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Dalle Carbonare L, Manfredi M, Caviglia G, Conte E, Robotti E, Marengo E, Cheri S, Zamboni F, Gabbiani D, Deiana M, Cecconi D, Schena F, Mottes M, Valenti MT. Can half-marathon affect overall health? The yin-yang of sport. J Proteomics 2017; 170:80-87. [PMID: 28887210 DOI: 10.1016/j.jprot.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/18/2017] [Accepted: 09/05/2017] [Indexed: 12/16/2022]
Abstract
Physical activity improves overall health and counteracts metabolic pathologies. Adipose tissue and bone are important key targets of exercise; the prevalence of diseases associated with suboptimal physical activity levels has increased in recent times as a result of lifestyle changes. Mesenchymal stem cells (MSCs) differentiation in either osteogenic or adipogenic lineage is regulated by many factors. Particularly, the expression of master genes such as RUNX2 and PPARγ2 is essential for MSC commitment to osteogenic or adipogenic differentiation, respectively. Besides various positive effects on health, some authors have reported stressful outcomes as a consequence of endurance in physical activity. We looked for further clues about MSCs differentiation and serum proteins modulation studying the effects of half marathon in runners by means of gene expression analyses and a proteomic approach. Our results demonstrated an increase in osteogenic commitment and a reduction in adipogenic commitment of MSCs. In addition, for the first time we have analyzed the proteomic profile changes in runners after half-marathon activity in order to survey the related systemic adjustments. The shotgun proteomic approach, performed through the immuno-depletion of the 14 most abundant serum proteins, allowed the identification of 23 modulated proteins after the half marathon. Interestingly, proteomic data showed the activation of both inflammatory response and detoxification process. Moreover, the involvement of pathways associated to immune response, lipid transport and coagulation, was elicited. Notably, positive and negative effects may be strictly linked. Data are available via ProteomeXchange with identifier PXD006704. SIGNIFICANCE We describe gene expression and proteomic studies aiming to an in-depth understanding of half-marathon effects on bone and adipogenic differentiation as well as biological phenomena involved in sport activity. We believe that this novel approach suggests the physical effects on overall health and show the different pathways involved during half marathon. Contents of the paper have not been published or submitted for publication elsewhere. The authors declare no conflict of interest.
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Affiliation(s)
- Luca Dalle Carbonare
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy
| | - Marcello Manfredi
- Department of Sciences and Technological Innovation, University of Piemonte Orientale, Italy; ISALIT, Spin-off of DISIT, University of Piemonte Orientale, Italy
| | - Giuseppe Caviglia
- Department of Sciences and Technological Innovation, University of Piemonte Orientale, Italy
| | - Eleonora Conte
- ISALIT, Spin-off of DISIT, University of Piemonte Orientale, Italy
| | - Elisa Robotti
- Department of Sciences and Technological Innovation, University of Piemonte Orientale, Italy
| | - Emilio Marengo
- Department of Sciences and Technological Innovation, University of Piemonte Orientale, Italy
| | - Samuele Cheri
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy; Dep. of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Francesco Zamboni
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy
| | - Daniele Gabbiani
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy
| | - Michela Deiana
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy; Dep. of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Daniela Cecconi
- Department of Biotechnology, Mass Spectrometry & Proteomics Lab, University of Verona, Italy
| | - Federico Schena
- Dep. of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Monica Mottes
- Dep. of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Maria Teresa Valenti
- Department of Medicine, Internal Medicine, Section D, University of Verona, Italy.
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Sarzynski MA, Loos RJF, Lucia A, Pérusse L, Roth SM, Wolfarth B, Rankinen T, Bouchard C. Advances in Exercise, Fitness, and Performance Genomics in 2015. Med Sci Sports Exerc 2017; 48:1906-16. [PMID: 27183119 DOI: 10.1249/mss.0000000000000982] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review of the exercise genomics literature encompasses the highest-quality articles published in 2015 across seven broad topics: physical activity behavior, muscular strength and power, cardiorespiratory fitness and endurance performance, body weight and adiposity, insulin and glucose metabolism, lipid and lipoprotein metabolism, and hemodynamic traits. One study used a quantitative trait locus for wheel running in mice to identify single nucleotide polymorphisms (SNPs) in humans associated with physical activity levels. Two studies examined the association of candidate gene ACTN3 R577X genotype on muscular performance. Several studies examined gene-physical activity interactions on cardiometabolic traits. One study showed that physical inactivity exacerbated the body mass index (BMI)-increasing effect of an FTO SNP but only in individuals of European ancestry, whereas another showed that high-density lipoprotein cholesterol (HDL-C) SNPs from genome-wide association studies exerted a smaller effect in active individuals. Increased levels of moderate-to-vigorous-intensity physical activity were associated with higher Matsuda insulin sensitivity index in PPARG Ala12 carriers but not Pro12 homozygotes. One study combined genome-wide and transcriptome-wide profiling to identify genes and SNPs associated with the response of triglycerides (TG) to exercise training. The genome-wide association study results showed that four SNPs accounted for all of the heritability of △TG, whereas the baseline expression of 11 genes predicted 27% of △TG. A composite SNP score based on the top eight SNPs derived from the genomic and transcriptomic analyses was the strongest predictor of ΔTG, explaining 14% of the variance. The review concludes with a discussion of a conceptual framework defining some of the critical conditions for exercise genomics studies and highlights the importance of the recently launched National Institutes of Health Common Fund program titled "Molecular Transducers of Physical Activity in Humans."
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Affiliation(s)
- Mark A Sarzynski
- 1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC; 2The Genetics of Obesity and Related Metabolic Traits Program, The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, The Icahn School of Medicine at Mount Sinai, New York, NY; 3Universidad Europea and Research Institute, Hospital 12 de Octubre (i+12), Madrid, SPAIN; 4Faculty of Medicine, Department of Kinesiology, Laval University, Ste-Foy, Québec, CANADA; 5Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD; 6Department of Sport Medicine, Humboldt University and Charité University School of Medicine, Berlin, GERMANY; and 7Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
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Bakker EA, Lee DC, Sui X, Artero EG, Ruiz JR, Eijsvogels TMH, Lavie CJ, Blair SN. Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome. Mayo Clin Proc 2017; 92. [PMID: 28622914 PMCID: PMC5546793 DOI: 10.1016/j.mayocp.2017.02.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the association of resistance exercise, independent of and combined with aerobic exercise, with the risk of development of metabolic syndrome (MetS). PATIENTS AND METHODS The study cohort included adults (mean ± SD age, 46±9.5 years) who received comprehensive medical examinations at the Cooper Clinic in Dallas, Texas, between January 1, 1987, and December, 31, 2006. Exercise was assessed by self-reported frequency and minutes per week of resistance and aerobic exercise and meeting the US Physical Activity Guidelines (resistance exercise ≥2 d/wk; aerobic exercise ≥500 metabolic equivalent min/wk) at baseline. The incidence of MetS was based on the National Cholesterol Education Program Adult Treatment Panel III criteria. We used Cox regression to generate hazard ratios (HRs) and 95% CIs. RESULTS Among 7418 participants, 1147 (15%) had development of MetS during a median follow-up of 4 years (maximum, 19 years; minimum, 0.1 year). Meeting the resistance exercise guidelines was associated with a 17% lower risk of MetS (HR, 0.83; 95% CI, 0.73-0.96; P=.009) after adjusting for potential confounders and aerobic exercise. Further, less than 1 hour of weekly resistance exercise was associated with 29% lower risk of development of MetS (HR, 0.71; 95% CI, 0.56-0.89; P=.003) compared with no resistance exercise. However, larger amounts of resistance exercise did not provide further benefits. Individuals meeting both recommended resistance and aerobic exercise guidelines had a 25% lower risk of development of MetS (HR, 0.75; 95% CI, 0.63-0.89; P<.001) compared with meeting neither guideline. CONCLUSION Participating in resistance exercise, even less than 1 hour per week, was associated with a lower risk of development of MetS, independent of aerobic exercise. Health professionals should recommend that patients perform resistance exercise along with aerobic exercise to reduce MetS.
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Affiliation(s)
- Esmée A Bakker
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA.
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | | | - Jonatan R Ruiz
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
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Abstract
Background Short-term cardiovascular effects from ambient pressure exposure are known. However, long-term cardiovascular effects from diving in humans have been less studied. Aims To examine possible long-term cardiovascular health effects from occupational diving. Methods We compared the prevalence of cardiovascular disease in former divers to non-divers. We obtained data on male former divers with a certificate valid for professional diving after 1980, from the Norwegian Diver 2011 project, and matched data on the general male population from the HUNT3 Survey. We also compared former divers with high and low grades of diving exposure. Results Data were available on 768 former divers. The prevalence of self-reported high blood pressure in former divers who often omitted a dive-free day after 3 days of strenuous diving was 28% compared with 18% in those who rarely violated these regulations [relative risk (RR) 1.47, confidence interval (CI) 1.01–2.15]. Also, the prevalence of myocardial infarction/angina pectoris was 11% in divers with >150 professional dives/year compared with 4% in divers with ≤50 professional dives/year [RR adj. 2.91 (CI 1.23–6.87)] and 16% in divers with >2000 air dives in total relative to 3% in divers with ≤2000 dives [RR adj. 3.05 (CI 1.47–6.34)]. Conclusions The prevalence of some cardiovascular symptoms and diseases may be higher in male former divers than in the general population. Diving might have adverse long-term cardiovascular effects. Whether this is associated with diving per se or strenuous physical activity requires further studies.
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Affiliation(s)
- K Åsmul
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, 7491 Trondheim, Norway
| | - Å Irgens
- Norwegian Centre for Diving Medicine, Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - M Grønning
- Norwegian Centre for Diving Medicine, Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway.,Department of Clinical Medicine (K1), University of Bergen, 5021 Bergen, Norway
| | - A Møllerløkken
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, 7491 Trondheim, Norway
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Rosin B. Is marathon running toxic? An observational study of cardiovascular disease prevalence and longevity in 54 male marathon runners. PHYSICIAN SPORTSMED 2017; 45:105-109. [PMID: 28136131 DOI: 10.1080/00913847.2017.1288545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recent literature suggests reduced benefits associated with high intensity (HIT) and or sustained intensity exercise training (SIT). While important, they tend to contrast with other studies of HIT and SIT and may not be representative of all individuals wishing to participate in activities such as marathon running. The purpose of this observational report is to describe a 45-year history of 54 long distance runners, their incidence of death from cardiovascular disease and their ages at death compared to the normal population. METHODS Data were collected longitudinally on all 54 members of a Southern California mens running club by the author, a cardiologist with 45 years of experience, member of the running club, and personal physician for most of the men for over 40 years. Retrospective and observational data were collected from direct professional and personal contact with the 54 men in the running club. RESULTS Closely monitored group of marathon runners with extreme HIT and SIT revealed a low incidence of cardiovascular disease (CVD) with an extended longevity relative to the general population. CONCLUSION The benefits of exercise for reducing risk of chronic disease, including CVD, are well known. Whether these benefits extend to the more intense and prolonged exercise associated with marathon running is unclear. However, as evidenced in the observational data presented here, at least in some populations, years of high-intensity, prolonged exercise may not be as toxic as suggested by others. Whether this is due to self-selection or predisposition is not well understood but merits further study.
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Affiliation(s)
- Benjamin Rosin
- a Cardiology Department , Torrance Memorial Medical Center , Torrance , CA , USA
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Kleiven Ø, Bjørkavoll-Bergseth M, Melberg T, Skadberg Ø, Bergseth R, Selvåg J, Auestad B, Aukrust P, Aarsland T, Ørn S. High physical fitness is associated with reduction in basal- and exercise-induced inflammation. Scand J Med Sci Sports 2017; 28:172-179. [PMID: 28314078 DOI: 10.1111/sms.12878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/29/2022]
Abstract
C-reactive protein (CRP) increases after strenuous exercise. It has been a concern that prolonged strenuous exercise may be harmful and induce a deleterious inflammatory response. The purpose of this study was to (a) assess and quantify the magnitude of CRP response following an endurance cycling competition in healthy middle-aged recreational cyclists. (b) Identify important determinants of this response. (c) Identify the relationship between CRP, myocardial damage (cardiac Troponin I (cTnI)), and myocardial strain (B-type natriuretic peptide [BNP]). (d) Identify the relationship between CRP and clinical events, defined as utilization of healthcare services or self-reported unusual discomfort. Race time was used as a measure of physical fitness. A total of 97 individuals (43±10 years of age, 74 [76%] males) were assessed prior to and 0, 3, and 24 hours following the 91-km mountain bike race "Nordsjørittet" (Sandnes, Norway, June 2013). There was a highly significant increase in CRP from baseline to 24 hours (0.9 (0.5-1.8) mg/L vs. 11.6 (6.0-17.5) mg/L (median[IQR]), P<.001), with no correlation of CRP to cTnI and BNP at any time-point. CRP was strongly correlated to race time at baseline (r=.38, P<.001) and at 24 hours following the race (r=.43, P<.001), In multivariate models, race time was an independent predictor of CRP both at baseline and at 24 hours (P<.01). There was no relationship between CRP levels and clinical events. In conclusion, high physical fitness was associated with reduction in both basal- and exercise-induced CRP. No adverse relationship was found between high intensity physical exercise, CRP levels, and outcomes.
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Affiliation(s)
- Ø Kleiven
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway
| | | | - T Melberg
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway
| | - Ø Skadberg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - R Bergseth
- Senior medical officer, North Sea Race, Sandnes, Norway
| | - J Selvåg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - B Auestad
- Research Department, Stavanger University Hospital, Stavanger, Norway.,Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway
| | - P Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - T Aarsland
- Research Department, Stavanger University Hospital, Stavanger, Norway
| | - S Ørn
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway.,Department of Electrical Engineering and Computer Science, University of Stavanger, Kjell Arholms Gate 41, Stavanger 4036, Norway
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Sanchis-Gomar F, Pérez LM, Joyner MJ, Löllgen H, Lucia A. Endurance Exercise and the Heart: Friend or Foe? Sports Med 2016; 46:459-66. [PMID: 26586557 DOI: 10.1007/s40279-015-0434-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although low- to moderate-intensity exercise has well-known cardiovascular benefits, it has been increasingly suggested that prolonged strenuous endurance exercise (SEE) could have potential deleterious cardiac effects. In effect, the term 'cardiac overuse injury' (or 'over-exercise') has been recently reported to group all the possible deleterious cardiac consequences of repeated exposure to SEE or 'over-exercise'. In this article, we provide a balanced overview of the current state of knowledge regarding the 'pros' and 'cons' of SEE from a cardiological point of view.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Research Institute Hospital 12 de Octubre ('i+12'), Edificio Actividades Ambulatorias, 6ª Planta, Avda. de Córdoba s/n, 28041, Madrid, Spain.
| | - Laura M Pérez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Herbert Löllgen
- European Federation of Sports Medicine Associations (EFSMA) and German Federation of Sports Medicine, Remscheid, Germany
| | - Alejandro Lucia
- Research Institute Hospital 12 de Octubre ('i+12'), Edificio Actividades Ambulatorias, 6ª Planta, Avda. de Córdoba s/n, 28041, Madrid, Spain.,European University, Madrid, Spain
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Morin DP, Lavie CJ. The Many Faces of Sudden Death. Mayo Clin Proc 2016; 91:S0025-6196(16)30512-2. [PMID: 27810087 DOI: 10.1016/j.mayocp.2016.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel P Morin
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA.
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
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Niemelä M, Kangastupa P, Niemelä O, Bloigu R, Juvonen T. Individual responses in biomarkers of health after marathon and half-marathon running: is age a factor in troponin changes? Scandinavian Journal of Clinical and Laboratory Investigation 2016; 76:575-580. [DOI: 10.1080/00365513.2016.1225122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Markus Niemelä
- Department of Cardiac Surgery, Oulu University Hospital, Oulu, Finland
| | - Päivikki Kangastupa
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, and University of Tampere, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, and University of Tampere, Finland
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Finland
| | - Tatu Juvonen
- Department of Cardiac Surgery, Oulu University Hospital, Oulu, Finland
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Association between cardiorespiratory fitness and submaximal systolic blood pressure among young adult men: a reversed J-curve pattern relationship. J Hypertens 2016; 33:2239-44. [PMID: 26372317 DOI: 10.1097/hjh.0000000000000715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Exercise blood pressure is a marker of future cardiovascular morbidity and mortality among individuals with or without high resting BP or any other cardiovascular disease (CVD) signs and symptoms at present. The purpose of this study was to evaluate the association between SBP during submaximal exercise and cardiorespiratory fitness (CRF) among young men. Further, we investigated the trend displayed by submaximal SBP (SSBP) across different levels of CRF. METHODS Graded exercise test (GXT) using a Modified Bruce protocol was performed on 204 men; SSBP was recorded at each stage of the protocol. Quintiles of CRF were established on the basis of peak oxygen consumption (VO2), with the first quintile (Q) being the lowest fit group and fifth Q the most fit. RESULTS The mean VO2 peaks in Q 1 through 5 were 32.3, 39.1, 43.4, 48.1 and 55.5 ml/kg per min, respectively. In a model adjusted for age, race, body fat percentage, resting SBP, alcohol intake and smoking, the largest difference in SSBP was observed between men in Q 1 and 2, with 7.6 mmHg (P = 0.05), 9.4 mmHg (P = 0.02) and 9.5 mmHg (P = 0.04) lower SSBP at minutes 6, 8 and 10 of GXT, respectively. SSBP plateaus at Q 3, followed by an increase in the higher Qs, although still lower than Q1. CONCLUSION There was a reverse J-curve pattern relationship between SSBP and CRF, with the lowest SSBP among men with fair or good CRF and highest among those with poor CRF. VIDEO ABSTRACT http://links.lww.com/HJH/A538.
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Faselis C, Kokkinos P, Tsimploulis A, Pittaras A, Myers J, Lavie CJ, Kyritsi F, Lovic D, Karasik P, Moore H. Exercise Capacity and Atrial Fibrillation Risk in Veterans: A Cohort Study. Mayo Clin Proc 2016; 91:558-66. [PMID: 27068670 DOI: 10.1016/j.mayocp.2016.03.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/29/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess the association between exercise capacity and the risk of developing atrial fibrillation (AF). PATIENTS AND METHODS A symptom-limited exercise tolerance test was conducted to assess exercise capacity in 5962 veterans (mean age, 56.8±11.0 years) from the Veterans Affairs Medical Center, Washington, DC. None had evidence of AF or ischemia at the time of or before undergoing their exercise tolerance test. We established 4 fitness categories based on age-stratified quartiles of peak metabolic equivalent task (MET) achieved: least fit (4.9±1.10 METs; n=1446); moderately fit (6.7±1.0 METs; n=1490); fit (7.9±1.0 METs; n=1585), and highly fit (9.3±1.2 METs; n=1441). Multivariable Cox proportional hazards regression models were used to compare the AF-exercise capacity association between fitness categories. RESULTS During a median follow-up period of 8.3 years, 722 (12.1%) individuals developed AF (14.5 per 1000 person-years; 95% CI, 13.9-15.9 per 1000 person-years). Exercise capacity was inversely related to AF incidence. The risk was 21% lower (hazard ratio, 0.79; 95% CI, 0.76-0.82) for each 1-MET increase in exercise capacity. Compared with the least fit individuals, hazard ratios were 0.80 (95% CI, 0.67-0.97) for moderately fit individuals, 0.55 (95% CI, 0.45-0.68) for fit individuals, and 0.37 (95% CI, 0.29-0.47) for highly fit individuals. Similar trends were observed in those younger than 65 years and those 65 years or older. CONCLUSION Increased fitness is inversely and independently associated with the reduced risk of developing AF. The decrease in risk was graded and precipitous with only modest increases in exercise capacity. These findings counter previous suggestions that even moderate increases in physical activity, as recommended by national and international guidelines, increase the risk of AF, with marked protection against AF noted with increasing levels of fitness.
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Affiliation(s)
- Charles Faselis
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC; George Washington University School of Medicine, Washington, DC
| | - Peter Kokkinos
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC; Georgetown University School of Medicine, Washington, DC; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
| | | | - Andreas Pittaras
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC
| | - Jonathan Myers
- Veterans Affairs Palo Alto Health Care System, Cardiology Division, Palo Alto, CA; Stanford University, Stanford, CA
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University Queensland School of Medicine, New Orleans, LA
| | - Fiorina Kyritsi
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC
| | - Dragan Lovic
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC
| | - Pamela Karasik
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC; George Washington University School of Medicine, Washington, DC; Georgetown University School of Medicine, Washington, DC
| | - Hans Moore
- Cardiology Division, Veterans Affairs Medical Center, Washington, DC; Georgetown University School of Medicine, Washington, DC
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Niemelä M, Kangastupa P, Niemelä O, Bloigu R, Juvonen T. Acute Changes in Inflammatory Biomarker Levels in Recreational Runners Participating in a Marathon or Half-Marathon. SPORTS MEDICINE-OPEN 2016; 2:21. [PMID: 27747777 PMCID: PMC5005625 DOI: 10.1186/s40798-016-0045-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/22/2016] [Indexed: 12/30/2022]
Abstract
Background Strenuous physical activity activates the participant’s immune responses; however, few studies exist, observing exercise-induced simultaneous changes in mediators of inflammation. Methods We examined individual responses in soluble urokinase-type plasminogen activator receptor (suPAR), a marker of immune activation, soluble endocytic receptor for haptoglobin-hemoglobin complexes (CD163), a marker of monocyte-macrophage activation, C-reactive protein (CRP), and pro- and anti-inflammatory cytokines from blood samples drawn at baseline, at 3- and 48-h post-races from recreational runners who successfully completed the marathon (199 ± 8 min, n = 4) or half-marathon (132 ± 4 min, n = 4) run. For comparisons, biomarkers reflecting muscle, heart, kidney, and liver functions were measured. Results Significant 3-h post-race increases occurred in levels of suPAR (p < 0.01), CD163 (p < 0.05), white blood cells (p < 0.001), pro-inflammatory cytokines, interleukin-6 (IL-6) (p < 0.001), IL-8 (p < 0.05), and anti-inflammatory cytokine IL-10 (p < 0.05), whereas tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) remained relatively stable. Full-marathon running lead to more pronounced increases in suPAR, CD163, IL-8, and IL-10 than half-marathon running. In addition, 3-h post-race increases of all these parameters correlated significantly with changes in serum TNF-α and cortisol. The 48-h levels of serum suPAR and both pro- and anti-inflammatory cytokines had decreased to baseline levels, whereas CRP, a marker of acute phase response, increased in those with the most prominent IL-6 and IL-10 elevations in their preceding samples. The highest suPAR, CRP, IL-6, TNF-α, IL-10, and cortisol levels were noted in the individual with the most severe post-race fatigue. Conclusions Prolonged running increases mediators of inflammation in an exercise-dose-dependent manner which should be considered in the assessment of health status of physically active individuals after recent acute bouts of strenuous exercise.
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Affiliation(s)
- Markus Niemelä
- Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029 OYS, Oulu, Finland
| | - Päivikki Kangastupa
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Hanneksenrinne 7, 60220, Seinäjoki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Tatu Juvonen
- Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029 OYS, Oulu, Finland
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Parto P, O'Keefe JH, Lavie CJ. The Exercise Rehabilitation Paradox: Less May Be More? Ochsner J 2016; 16:297-303. [PMID: 27660580 PMCID: PMC5024813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Debatably, the most commonly prescribed lifestyle modification for cardiovascular health involves daily exercise training (ET) and physical activity. Exercise has numerous known health benefits on blood pressure, lipid profile, weight loss, and glucose metabolism. However, controversy exists regarding the link between excessive endurance ET and harmful cardiac effects. METHODS We review the current literature and discuss the numerous known adverse effects of endurance ET on cardiac function. RESULTS Excessive endurance ET may negatively affect cardiac anatomy, play a role in osteoarthritis and coronary artery disease development, and increase the risks of cardiac arrhythmia and sudden cardiac death. CONCLUSION More ET may not always be better when it comes to endurance ET, and optimal ET dosing regimens are clearly needed.
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Affiliation(s)
- Parham Parto
- Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA
| | - James H. O'Keefe
- Department of Cardiology, St. Luke's Mid America Heart Institute, Kansas City, MO
| | - Carl J. Lavie
- Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
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Lavie CJ, Lee DC, Sui X, Arena R, O'Keefe JH, Church TS, Milani RV, Blair SN. Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality. Mayo Clin Proc 2015; 90:1541-52. [PMID: 26362561 DOI: 10.1016/j.mayocp.2015.08.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/10/2015] [Accepted: 08/03/2015] [Indexed: 12/25/2022]
Abstract
Considerable evidence has established the link between high levels of physical activity (PA) and all-cause and cardiovascular disease (CVD)-specific mortality. Running is a popular form of vigorous PA that has been associated with better overall survival, but there is debate about the dose-response relationship between running and CVD and all-cause survival. In this review, we specifically reviewed studies published in PubMed since 2000 that included at least 500 runners and 5-year follow-up so as to analyze the relationship between vigorous aerobic PA, specifically running, and major health consequences, especially CVD and all-cause mortality. We also made recommendations on the optimal dose of running associated with protection against CVD and premature mortality, as well as briefly discuss the potential cardiotoxicity of a high dose of aerobic exercise, including running (eg, marathons).
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Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, LA.
| | - Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Timothy S Church
- Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Richard V Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, LA
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
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Sanchis-Gomar F, Alis R, Rampinini E, Bosio A, Romagnoli M, Lombardi G, Lippi G. Hs-cTnT levels in professional soccer players throughout a season: No evidence of sustained cardiac damage. Int J Cardiol 2015; 197:292-3. [PMID: 26142978 DOI: 10.1016/j.ijcard.2015.06.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/26/2015] [Indexed: 11/19/2022]
Affiliation(s)
| | - Rafael Alis
- Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | | | - Andrea Bosio
- Human Performance Laboratory, MAPEI Sport Research Center, Italy
| | - Marco Romagnoli
- Research Institute of the Hospital 12 de Octubre ("i+12"), Madrid, Spain; Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Lemez S, Baker J. Do Elite Athletes Live Longer? A Systematic Review of Mortality and Longevity in Elite Athletes. SPORTS MEDICINE - OPEN 2015; 1:16. [PMID: 26301178 PMCID: PMC4534511 DOI: 10.1186/s40798-015-0024-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 06/16/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding of an athlete's lifespan is limited with a much more sophisticated knowledge of their competitive careers and little knowledge of post-career outcomes. In this review, we consider the relationship between participation at elite levels of sport and mortality risk relative to other athletes and age- and sex-matched controls from the general population. Our objective was to identify, collate, and disseminate a comprehensive list of risk factors associated with longevity and trends and causes of mortality among elite athletes. METHODS English language articles were searched using the Web of Science database. Keywords athletes, death, elite, "high performance" life expect*, longevity, mortality, players, professional, and sport were used to locate research articles. Seventeen additional articles were retrieved from reference lists found in these papers and a general web search. The inclusion criteria were the following: (1) publication year 1980 or later; (2) the study examined elite-level athletes; and (3) outcome data measured mortality/longevity trends and/or causes. RESULTS Fifty-four peer-reviewed publications and three articles from online sources met the criteria for inclusion. Baseball, football, soccer, basketball, and cycling had the most reported data on elite athletes' lifespan longevities. A variety of mechanisms have attempted to explain mortality risk (e.g., handedness, playing position, achievement, etc.). Considerable support was found for superior longevity outcomes for elite athletes, particularly those in endurance and mixed sports. CONCLUSIONS Future research into the mechanisms that may affect mortality risk is important for a better understanding of life expectancies in both eminent and non-eminent populations. Participation in elite sport is generally favorable to lifespan longevity. KEY POINTS A majority of studies included in this review reported superior lifespan longevity outcomes for elite athletes compared to age- and sex-matched controls from the general population and other athletes.Several mechanisms within and between sports may have powerful effects on the overall lifespan longevities of players (e.g., type of sport, playing position, race, and energy system).Future research on mortality in elite athletes would benefit from more comprehensive statistical measures and reliable databases to determine potential mechanisms that may influence mortality trends and causes in both athlete and non-athlete samples.
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Affiliation(s)
- Srdjan Lemez
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, M3J 1P3 ON Canada
| | - Joseph Baker
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, M3J 1P3 ON Canada
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