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Costa ADS, Ghouri I, Johnston A, McGlynn K, McNair A, Bowman P, Malik N, Hurren J, Bingelis T, Dunne M, Smith GL, Kemi OJ. Electrically stimulated in vitro heart cell mimic of acute exercise reveals novel immediate cellular responses to exercise: Reduced contractility and metabolism, but maintained calcium cycling and increased myofilament calcium sensitivity. Cell Biochem Funct 2023; 41:1147-1161. [PMID: 37665041 PMCID: PMC10947300 DOI: 10.1002/cbf.3847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
Cardiac cellular responses to acute exercise remain undescribed. We present a model for mimicking acute aerobic endurance exercise to freshly isolated cardiomyocytes by evoking exercise-like contractions over prolonged periods of time with trains of electrical twitch stimulations. We then investigated immediate contractile, Ca2+ , and metabolic responses to acute exercise in perfused freshly isolated left ventricular rat cardiomyocytes, after a matrix-design optimized protocol and induced a mimic for acute aerobic endurance exercise by trains of prolonged field twitch stimulations. Acute exercise decreased cardiomyocyte fractional shortening 50%-80% (p < .01). This was not explained by changes to intracellular Ca2+ handling (p > .05); rather, we observed a weak insignificant Ca2+ transient increase (p = .11), while myofilament Ca2+ sensitivity increased 20%-70% (p < .05). Acidic pH 6.8 decreased fractional shortening 20%-70% (p < .05) because of 20%-30% decreased Ca2+ transients (p < .05), but no difference occurred between control and acute exercise (p > .05). Addition of 1 or 10 mM La- increased fractional shortening in control (1 mM La- : no difference, p > .05; 10 mM La- : 20%-30%, p < .05) and acute exercise (1 mM La- : 40%-90%, p < .01; 10 mM La- : 50%-100%, p < .01) and rendered acute exercise indifferent from control (p > .05). Intrinsic autofluorescence showed a resting NADstate of 0.59 ± 0.04 and FADstate of 0.17 ± 0.03, while acute exercise decreased NADH/FAD ratio 8% (p < .01), indicating intracellular oxidation. In conclusion, we show a novel approach for studying immediate acute cardiomyocyte responses to aerobic endurance exercise. We find that acute exercise in cardiomyocytes decreases contraction, but Ca2+ handling and myofilament Ca2+ sensitivity compensate for this, while acidosis and reduced energy substrate and mitochondrial ATP generation explain this.
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Affiliation(s)
- Ana Da Silva Costa
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- Graduate School, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Iffath Ghouri
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Alexander Johnston
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Karen McGlynn
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Andrew McNair
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Peter Bowman
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Natasha Malik
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Johanne Hurren
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Tomas Bingelis
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Michael Dunne
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Godfrey L. Smith
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Ole J. Kemi
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
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Wang M, Lv C, Zhang Y, Liu K, Yan X, Liu L, Zheng Y, Guo X. Analysis and recognition of post-exercise cardiac state based on heart sound features and cardiac troponin I. Eur J Appl Physiol 2023; 123:2461-2471. [PMID: 37294516 DOI: 10.1007/s00421-023-05245-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 05/27/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Excessive intensity exercises can bring irreversible damage to the heart. We explore whether heart sounds can evaluate cardiac function after high-intensity exercise and hope to prevent overtraining through the changes of heart sound in future training. METHODS The study population consisted of 25 male athletes and 24 female athletes. All subjects were healthy and had no history of cardiovascular disease or family history of cardiovascular disease. The subjects were required to do high-intensity exercise for 3 days, with their blood sample and heart sound (HS) signals being collected and analysed before and after exercise. We then developed a Kernel extreme learning machine (KELM) model that can distinguish the state of heart by using the pre- and post-exercise data. RESULTS There was no significant change in serum cardiac troponin I after 3 days of load cross-country running, which indicates that there was no myocardial injury after the race. The statistical analysis of time-domain characteristics and multi-fractal characteristic parameters of HS showed that the cardiac reserve capacity of the subjects was enhanced after the cross-country running, and the KELM is an effective classifier to recognize HS and the state of the heart after exercise. CONCLUSION Through the results, we can draw the conclusion that this intensity of exercise will not cause profound damage to the athlete's heart. The findings of this study are of great significance for evaluating the condition of the heart with the proposed index of heart sound and prevention of excessive training that causes damage to the heart.
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Affiliation(s)
- Menglu Wang
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Chengcong Lv
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Yao Zhang
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Kai Liu
- Communications Sergeant School, Army Engineering University of PLA, Chongqing, China.
| | - Xiaobo Yan
- College of Physical Education, Chongqing University, Chongqing, 401331, China
| | - Leichu Liu
- College of Physical Education, Chongqing University, Chongqing, 401331, China
| | - Yineng Zheng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xingming Guo
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China.
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Graziano F, Juhasz V, Brunetti G, Cipriani A, Szabo L, Merkely B, Corrado D, D’Ascenzi F, Vago H, Zorzi A. May Strenuous Endurance Sports Activity Damage the Cardiovascular System of Healthy Athletes? A Narrative Review. J Cardiovasc Dev Dis 2022; 9:jcdd9100347. [PMID: 36286299 PMCID: PMC9604467 DOI: 10.3390/jcdd9100347] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022] Open
Abstract
The positive effects of physical activity are countless, not only on the cardiovascular system but on health in general. However, some studies suggest a U-shape relationship between exercise volume and effects on the cardiovascular system. On the basis of this perspective, moderate-dose exercise would be beneficial compared to a sedentary lifestyle, while very high-dose physical activity would paradoxically be detrimental. We reviewed the available evidence on the potential adverse effects of very intense, prolonged exercise on the cardiovascular system, both acute and chronic, in healthy athletes without pre-existing cardiovascular conditions. We found that endurance sports activities may cause reversible electrocardiographic changes, ventricular dysfunction, and troponin elevation with complete recovery within a few days. The theory that repeated bouts of acute stress on the heart may lead to chronic myocardial damage remains to be demonstrated. However, male veteran athletes with a long sports career show an increased prevalence of cardiovascular abnormalities such as electrical conduction delay, atrial fibrillation, myocardial fibrosis, and coronary calcifications compared to non-athletes. It must be underlined that the cause-effect relationship between such abnormalities and the exercise and, most importantly, the prognostic relevance of such findings remains to be established.
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Affiliation(s)
- Francesca Graziano
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
| | - Vencel Juhasz
- Heart and Vascular Center of Semmelweis University, Hataror Rd. 18, 1122 Budapest, Hungary
| | - Giulia Brunetti
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
| | - Liliana Szabo
- Heart and Vascular Center of Semmelweis University, Hataror Rd. 18, 1122 Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center of Semmelweis University, Hataror Rd. 18, 1122 Budapest, Hungary
- Department of Sports Medicine, Semmelweis University, Gaal Jozsef Str. 9-11, 1122 Budapest, Hungary
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
| | - Flavio D’Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Hajnalka Vago
- Heart and Vascular Center of Semmelweis University, Hataror Rd. 18, 1122 Budapest, Hungary
- Department of Sports Medicine, Semmelweis University, Gaal Jozsef Str. 9-11, 1122 Budapest, Hungary
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy
- Correspondence: ; Tel.: +39-049-8212322
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Ivonin AG, Smirnova SL, Roshchevskaya IM. Heart Electrical Activity during Ventricular Repolarization in Rats after Acute Exhaustive Treadmill Running. J EVOL BIOCHEM PHYS+ 2022. [DOI: 10.1134/s0022093022050313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Xiong Y, Xu J, Cao W, Zhang J, Feng Z, Cao K, Liu J. Hydroxytyrosol improves strenuous exercise-associated cardiac pathological changes via modulation of mitochondrial homeostasis. Food Funct 2022; 13:8676-8684. [PMID: 35904366 DOI: 10.1039/d2fo00839d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Strenuous exercise is reported to provoke deleterious consequences including cardiac impairments, while the detailed mechanisms and effective interventions remain limited. The current study aims to explore the profitable effects of hydroxytyrosol (HT), one of the most abundant polyphenols derived from olive oil, on strenuous exercise-induced pathological changes in the heart and its underlying mechanisms. Sprague-Dawley male rats at the age of 8-week-old were supplemented with 25 mg kg-1 day-1 of HT 45 min before the beginning of strenuous exercise for a total of 8 weeks. HT treatment obviously improved the heart weight and morphology with lowered serum cardiac hypertrophy markers as well as cardiac oxidative stress. Moreover, the down-regulated mitochondrial biogenesis pathway, impaired mitochondrial complex activity, dysregulated expression of mitochondrial dynamics-related proteins and activated apoptotic pathway induced by Exe were all improved by HT. In vitro, 10 μM HT effectively reduced the reactive oxygen species level, promoted mitochondrial biogenesis, and inhibited apoptosis and cardiomyocyte hypertrophy in an angiotensin II-induced cardiomyocyte hypertrophy model. In addition, knockdown of the peroxisome proliferator-activated receptor gamma coactivator-1 alpha, the key regulator of mitochondrial biogenesis, partially abolished the benefits of HT. Our results demonstrate that the disturbance of mitochondrial homeostasis plays a substantial role in strenuous exercise-induced pathological cardiac hypertrophy, and HT presents as an effective intervention strategy targeting mitochondrial homeostasis for cardiac health.
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Affiliation(s)
- Yue Xiong
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
| | - Jie Xu
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
| | - Wenli Cao
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
| | - Jiawei Zhang
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
| | - Zhihui Feng
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, Shandong, China
| | - Ke Cao
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
| | - Jiankang Liu
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China. .,School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, Shandong, China
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Zhang Y, Zheng Y, Wang M, Guo X. Prediction of exercise sudden death in rabbit exhaustive swimming using deep neural network. Biomed Eng Online 2021; 20:87. [PMID: 34461905 PMCID: PMC8404258 DOI: 10.1186/s12938-021-00925-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background and objective Moderate exercise contributes to good health. However, excessive exercise may lead to cardiac fatigue, myocardial damage and even exercise sudden death. Monitoring the heart health has important implication to prevent exercise sudden death. Diagnosis methods such as electrocardiogram, echocardiogram, blood pressure and histological analysis have shown that arrhythmia and left ventricular fibrosis are early warning symptoms of exercise sudden death. Heart sounds (HS) can reflect the changes of cardiac valve, cardiac blood flow and myocardial function. Deep learning has drawn wide attention because of its ability to recognize disease. Therefore, a deep learning method combined with HS was proposed to predict exercise sudden death in New Zealand rabbits. The objective is to develop a method to predict exercise sudden death in New Zealand rabbits. Methods This paper proposed a method to predict exercise sudden death in New Zealand rabbits based on convolutional neural network (CNN) and gated recurrent unit (GRU). The weight-bearing exhaustive swimming experiment was conducted to obtain the HS of exercise sudden death and surviving New Zealand rabbits (n = 11/10) at four different time points. Then, the improved Viola integral method and double threshold method were employed to segment HS signals. The segmented HS frames at different time points were taken as the input of a combined CNN and GRU called CNN–GRU network to complete the prediction of exercise sudden death. Results In order to evaluate the performance of proposed network, CNN and GRU were used for comparison. When the fourth time point segmented HS frames were taken as input, the result shows that the proposed network has better performance with an accuracy of 89.57%, a sensitivity of 89.38% and a specificity of 92.20%. In addition, the segmented HS frames at different time points were input into CNN–GRU network, and the result shows that with the progress of the experiment, the prediction accuracy of exercise sudden death in New Zealand rabbits increased from 50.98 to 89.57%. Conclusion The proposed network shows good performance in classifying HS, which proves the feasibility of deep learning in exploring exercise sudden death. Further, it may have important implications in helping humans explore exercise sudden death.
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Affiliation(s)
- Yao Zhang
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Yineng Zheng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Menglu Wang
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Xingming Guo
- Key Laboratory of Biorheology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China.
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Exercise-Induced Hyperhomocysteinemia Is Not Related to Oxidative Damage or Impaired Vascular Function in Amateur Middle-Aged Runners under Controlled Nutritional Intake. Nutrients 2021; 13:nu13093033. [PMID: 34578910 PMCID: PMC8471188 DOI: 10.3390/nu13093033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
To determine the influence of different doses of maximal acute exercise on the kinetics of plasma homocysteine (tHcy) and its relationship with oxidative status and vascular function, nine recreational runners completed a 10 km race (10K) and a marathon (M). Blood samples were collected before (Basal), immediately post-exercise (Post0), and after 24 h (Post24). Nutritional intake was controlled at each sample point. A significant increase in tHcy was observed after both races, higher after M. Basal levels were recovered at Post24 after 10K, but remained elevated at Post 24 for M. A significant decrease in GSH/GSSG ratio was observed in Post0, especially marked after M. Furthermore, this increase in pro-oxidant status remained at Post24 only after M. Other oxidative status markers failed to confirm this exercise-induced pro-oxidant status except glutathione peroxidase activity that was lower in Post24 compared to Basal in 10K and in Post0 and Post24 in M. No statistical correlation was found between oxidative markers and tHcy. No significant changes were observed in the concentration of endothelial cell adhesion molecules (VCAM-1 and E-Selectin) and VEGF. In conclusion, tHcy increases in an exercise–dose–response fashion but is not related to endothelial dysfunction mediated by oxidative stress mechanisms.
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Vergara P, Pannone L, Calvo F, Falasconi G, Foppoli L, Cireddu M, D'Angelo G, Limite L, Boccellino A, Palmisano A, Capogrosso C, Stella S, Esposito A, Agricola E, Gulletta S, Della Bella P. Physical activity volume in patients with arrhythmogenic cardiomyopathy is associated with recurrence after ventricular tachycardia ablation. J Interv Card Electrophysiol 2021; 65:15-24. [PMID: 34313898 DOI: 10.1007/s10840-021-01019-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the role of intense physical activity (PA) on recurrence after ventricular tachycardia (VT) ablation in arrhythmogenic cardiomyopathy (ACM). METHODS We retrospectively analyzed 63 patients with definite diagnosis of ACM who underwent to catheter ablation (CA) of VT. PA was quantified in METs per week by IPAQ questionnaire in 51 patients. VT-free survival time after ablation was analyzed by Kaplan-Meier's curves. RESULTS The weekly amount of PA was higher in patients with VT recurrence (2303.1 METs vs 1043.5 METs, p = 0.042). The best cutoff to predict VT recurrence after CA was 584 METs/week (AUC = 0.66, sensibility = 85.0%, specificity = 45.2%). Based on this cutoff, 34 patients were defined as high level athletes (Hi-PA) and 17 patients as low-level athletes (Lo-PA). During a median follow-up of 32.0 months (11.5-65.5), 22 patients (34.9%) experienced VT recurrence. Lo-PA patients had a longer VT-free survival, compared with Hi-PA patients (82.4% vs 50.0%, log-rank p = 0.025). At Cox multivariate analysis, independent predictors of the VT recurrence were PA ≥ 584 METs/week (Hi-PA) (HR = 2.61, CI 95% 1.03-6.58, p = 0.04) and late potential (LP) abolition (HR = 0.38, CI 95% 0.16-0.89, p = 0.03). CONCLUSIONS PA ≥ 584 METs/week and LP abolition were independent predictors of VT recurrence after ablation.
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Affiliation(s)
- Pasquale Vergara
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Luigi Pannone
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Calvo
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Falasconi
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Foppoli
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Manuela Cireddu
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe D'Angelo
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Limite
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Boccellino
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Stefano Stella
- Cardiac Imaging Unit, Ospedale San Raffaele, Milan, Italy
| | - Antonio Esposito
- Radiology Unit, Ospedale San Raffaele, Milan, Italy.,Vita-Salute University, Milan, Italy
| | - Eustachio Agricola
- Cardiac Imaging Unit, Ospedale San Raffaele, Milan, Italy.,Vita-Salute University, Milan, Italy
| | - Simone Gulletta
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Della Bella
- Arrhythmology Unit and Clinical Electrophysiology Laboratories, Ospedale San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Cardiac Biomarkers Following Marathon Running: Is Running Time a Factor for Biomarker Change? Int J Sports Physiol Perform 2021; 16:1253-1260. [PMID: 33647880 DOI: 10.1123/ijspp.2020-0352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T levels show a transient increase after marathon running. The aim of this study was to investigate whether running duration influences the patterns of changes in cardiac biomarkers. METHODS Twenty participants with fast and slow finishing times were included in the study. Blood samples were taken before the marathon race, immediately after, and 24 hours after the race. Samples were analyzed for NT-proBNP and cardiac troponin T concentration. Furthermore, a complete blood cell count was performed. RESULTS After the marathon race, the fast and slow runners showed similar changes of NT-proBNP and cardiac troponin T (ie, a transient increase). Curve estimation regression analysis showed a curvilinear relationship (quadratic model) between running times and NT-proBNP increments immediately after the race, with less of an increase in the very fast and the very slow runners (r2 = .359, P = .023). NT-proBNP increments immediately after the race were correlated to the decline 24 hours after the marathon (r = -.612, P = .004). CONCLUSIONS This study indicates that NT-proBNP release immediately after marathon running varies in a curvilinear fashion with running time. It is speculated that low NT-proBNP release is associated with training adaptation in most elite runners and the relatively low cardiac stress in the slowest (but experienced) runners. The combination of less adaptation and relatively large cardiac wall and metabolic stress may explain the highest NT-proBNP values in runners with average running times. In addition, NT-proBNP decrements 24 hours after the race depend primarily on the values reached after the marathon and not on running time.
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Rossi TM, Kavsak PA, Maxie MG, Pearl DL, Pyle WG, Physick-Sheard PW. Effect of racing on cardiac troponin I concentration and associations with cardiac rhythm disturbances in Standardbred racehorses. J Vet Cardiol 2021; 35:14-24. [PMID: 33789181 DOI: 10.1016/j.jvc.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION/OBJECTIVES Accumulating evidence indicates intense exercise can be associated with myocardial damage. Investigating the impact of maximal effort on myocardium and exploring possible association of injury with rhythm disturbance requires a high-sensitivity cardiac troponin assay. The objectives of this study were: (1) to determine the effect of racing on serum cardiac troponin I (cTnI) in Standardbred horses using a high-sensitivity assay; (2) to determine the 99th percentile of cTnI in healthy horses and investigate the effect of demographic variables on cTnI prevailing pre-race in Standardbred horses using a validated high-sensitivity assay and a contemporary assay, and; (3) to explore associations between exercise-associated arrhythmia and cTnI concentration. ANIMALS Racehorses (n = 145). MATERIALS AND METHODS ≤ 2 h pre-race, cTnI concentrations were measured in 158 race starts. Electrocardiogram (ECG) monitoring was applied during racing and race recovery and screened for complex ventricular arrhythmia. Associations between cTnI prevailing before racing concentration, age, sex, and gait were investigated. Demographic and performance variables were evaluated for associations with cTnI concentration post-race and rhythm disturbance. RESULTS Incidence of arrhythmia was 11.6% (16 horses). A significant increase in median (interquartile range) cTnI concentration of 1.36 (0.49-2.81) ng/L was found post-race (p < 0.0001). Serum cardiac troponin I (cTnI) concentration prevailing pre-race was positively associated with increasing age, and gait. Serum cardiac troponin I prevailing post-race was positively associated with concentration prevailing pre-race. Interaction between arrhythmia and finishing distanced revealed horses finishing distanced and experiencing arrhythmia displayed higher cTnI release than with the presence of either alone. CONCLUSIONS Racing increased cTnI concentration. Horses finishing distanced and also exhibiting arrhythmia may be experiencing myocardial compromise.
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Affiliation(s)
- T M Rossi
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Ontario, N1G 2W1, Canada.
| | - P A Kavsak
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, HSC-2N16, Hamilton, ON, L8S 4K1, Canada
| | - M G Maxie
- Animal Health Laboratory, Laboratory Services Division, University of Guelph, Laboratory Services Division, Building 89, 419 Gordon St., Ontario, N1G 2W1, Canada
| | - D L Pearl
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Ontario, N1G 2W1, Canada
| | - W G Pyle
- Centre for Cardiovascular Research, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Ontario, N1G 2W1, Canada
| | - P W Physick-Sheard
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Ontario, N1G 2W1, Canada
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11
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Tiller NB, Stewart GM, Illidi CR, Levine BD. Exercise Is Medicine? The Cardiorespiratory Implications of Ultra-marathon. Curr Sports Med Rep 2021; 19:290-297. [PMID: 32769665 DOI: 10.1249/jsr.0000000000000738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Regular physical activity decreases the risk of cardiovascular disease, type II diabetes, obesity, certain cancers, and all-cause mortality. Nevertheless, there is mounting evidence that extreme exercise behaviors may be detrimental to human health. This review collates several decades of literature on the physiology and pathophysiology of ultra-marathon running, with emphasis on the cardiorespiratory implications. Herein, we discuss the prevalence and clinical significance of postrace decreases in lung function and diffusing capacity, respiratory muscle fatigue, pulmonary edema, biomarkers of cardiac injury, left/right ventricular dysfunction, and chronic myocardial remodeling. The aim of this article is to inform risk stratification for ultra-marathon and to edify best practice for personnel overseeing the events (i.e., race directors and medics).
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - Glenn M Stewart
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Camilla R Illidi
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, UNITED KINGDOM
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TX
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Late Exercise Preconditioning Promotes Autophagy against Exhaustive Exercise-Induced Myocardial Injury through the Activation of the AMPK-mTOR-ULK1 Pathway. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5697380. [PMID: 32656262 PMCID: PMC7322587 DOI: 10.1155/2019/5697380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/10/2019] [Indexed: 02/02/2023]
Abstract
Accumulating evidence shows that the AMPK-mTOR pathway modulates autophagy via coordinated phosphorylation of ULK1. The aim of the present study was to investigate the relationship between AMPK, mTOR, and ULK1 during late exercise preconditioning (LEP), and to explore whether LEP-induced myocardial protection is related to the autophagy. The exercise preconditioning (EP) protocol was as follows: rats were instructed to for run four repeated in duration of 10 minutes (including 10 minutes rest between each period) on a treadmill. Exhaustive exercise (EE) after LEP pretreatment and administration of wortmannin (an autophagy inhibitor that suppresses Class III PI3K-kinase (PI3KC3) activity) were added to test the protective effect. Cardiac troponin I (cTnI), and transmission electron microscopy (TEM), along with hematoxylin-basic fuchsin-picric acid (HBFP) staining, were used to evaluate the myocardial ischemic-hypoxic injury and protection. Western blot was used to analyze the relationship of autophagy-associated proteins. Exhaustive exercise caused severe myocardial ischemic-hypoxic injury, which led to an increase in cTnI levels, changes of ischemia–hypoxia, and cells ultrastructure. Compared with the EE group, LEP significantly suppressed exhaustive exercise-induced myocardial injury. However, wortmannin attenuated LEP-induced myocardial protection by inhibiting autophagy. Compared with the C group, AMPK was increased in the LEP, EE, and LEP+EE groups, but phosphorylation of AMPK at Thr172 was not significantly changed. Exercise did not have any effect on mTOR expression. Compared with the C group, ULK1 was increased and the ULK1ser757/ULK1 ratio was decreased in the LEP and LEP+EE groups. ULK1 was not significantly affected in the EE group, however, phosphorylation of ULK1 at Ser757 was remarkably decreased. To sum up, our results suggested that LEP promoted autophagy through the activation of AMPK-mTOR-ULK1 pathway, and that activated autophagy was partially involved in myocardial protection against EE-induced myocardial ischemic-hypoxic injury.
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Hohl R, Nazário de Rezende F, Millet GY, Ribeiro da Mota G, Marocolo M. Blood cardiac biomarkers responses are associated with 24 h ultramarathon performance. Heliyon 2019; 5:e01913. [PMID: 31338451 PMCID: PMC6607063 DOI: 10.1016/j.heliyon.2019.e01913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/22/2019] [Accepted: 06/03/2019] [Indexed: 01/08/2023] Open
Abstract
Purpose Clinical significance of cardiac biomarkers response in ultra-endurance runners are not completely elucidated because events vary in distance/duration and competitors modulate running intensity according to individual running capacity. The aim of this study was to examine the relationship between self-selected exercise intensity with cardiac biomarkers comparing experienced (EXP, N = 11) and novice (NOV, N = 14) runners able to finish a 24h ultramarathon (24UM) with significant differences in performance. Methods Cardiac biomarkers (i.e. CKMB/totalCK, cTnT and NT-proBNP), inflammatory markers (i.e. leukocytes and CRP) and cortisol were analyzed before and after a 24UM. Results EXP finished the race with significant (p < 0.05) longer distance than NOV (158.8 ± 15.8 vs 116.8 ± 10.3 Km). Two-way mixed ANOVA showed significant time × performance level interaction with greater increase of cTnT (F(1,23) = 6.18, p = 0.021), NT-proBNP (F(1,23) = 9.27, p = 0.006) and cortisol (F(1, 23) = 5.13, p = 0.03) in the EXP group. CKMB/totalCK (F(1, 23) = 71.90, p < 0.0001) decreased while leukocytes (F(1, 23) = 100.06, p < 0.0001) and CRP (F(1, 23) = 93.37, p < 0.0001) increased in both groups (main effect of time). Correlations were found between 24UM distance and cortisol (r = 0.58; p = 0.002), CKMB (r = 0.47; p = 0.017), cTnT (r = 0.44; p = 0.027) or NT-proBNP (r = 0.56; p = 0.003). Cortisol and NT-proBNP were also significantly correlated (r = 0.51; p = 0.01). Conclusions Although there is no clear evidence of cardiac risk when comparing cardiac biomarkers levels with clinical cut-off values, cardiac biomarkers are associated with running performance and pituitary-adrenocortical system response. In EXP runners, higher levels of cardiac biomarkers and cortisol suggest a more hemodynamically challenged heart during prolonged endurance exercise.
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Affiliation(s)
- Rodrigo Hohl
- Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | - Guillaume Y Millet
- Univ Lyon, UJM-Saint-Etienne, LIBM, EA 7424, F-42023, Saint-Etienne, France.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Gustavo Ribeiro da Mota
- Human Performance and Sport Research Group, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Moacir Marocolo
- Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
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Li JY, Pan SS, Wang JY, Lu J. Changes in Autophagy Levels in Rat Myocardium During Exercise Preconditioning-Initiated Cardioprotective Effects. Int Heart J 2019; 60:419-428. [PMID: 30745541 DOI: 10.1536/ihj.18-310] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The role of autophagy in the cardioprotection conferred by ischemic preconditioning (IPC) has been well described. This study aimed to investigate the changes in autophagy levels during the cardioprotective effects initiated by exercise preconditioning (EP).Rats were randomly divided into 4 groups: group C (control), group EP, group EE (exhaustive exercise), and group EP + EE (EP pretreatment at 0.5 hours before EE). The EP protocol included 4 periods of 10 minutes of treadmill running each at 30 m/minute with intervening 10 minute periods of rest. Hematoxylin-basic fuchsin-picric acid (HBFP) staining and plasma levels of cardiac troponin I (cTnI) were used to evaluate the ischemia-hypoxia injury in rat myocardium. Alteration levels in several autophagy proteins in the left ventricular myocardium were analyzed by Western blot. The phasic alterations of autophagy levels during EP-initiated cardioprotective phase were also examined.Compared with group C, the ischemia-hypoxia positive areas and IOD value in HBFP-staining and cTnI plasma levels increased significantly in group EE. Compared with group EE, the ischemia-hypoxia injury was markedly attenuated in group EP + EE. Compared with group C, the LC3-II/LC3-I ratio, a marker of autophagosome formation, was reduced in group EE, but the LC3-II/LC3-I ratio remained unaltered in group EP + EE. Furthermore, the LC3-II/LC3-I ratio increased significantly at 2 hours during the cardioprotective phase after EP.These results suggest that the activated autophagy level during the EP-initiated cardioprotective phase may be partly involved in the cardioprotective effects by maintaining a normal autophagy basal level during the subsequent exhaustive exercise in rat myocardium.
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Affiliation(s)
- Ji-Yong Li
- School of Kinesiology, Shanghai University of Sport
| | | | - Jia-Yin Wang
- School of Kinesiology, Shanghai University of Sport
| | - Jiao Lu
- School of Kinesiology, Shanghai University of Sport
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de Gonzalo-Calvo D, Dávalos A, Fernández-Sanjurjo M, Amado-Rodríguez L, Díaz-Coto S, Tomás-Zapico C, Montero A, García-González Á, Llorente-Cortés V, Heras ME, Boraita Pérez A, Díaz-Martínez ÁE, Úbeda N, Iglesias-Gutiérrez E. Circulating microRNAs as emerging cardiac biomarkers responsive to acute exercise. Int J Cardiol 2018; 264:130-136. [DOI: 10.1016/j.ijcard.2018.02.092] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/27/2018] [Accepted: 02/22/2018] [Indexed: 02/07/2023]
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Rossi TM, Kavsak PA, Maxie MG, Pearl DL, Pyle WG, Physick-Sheard PW. Post-exercise cardiac troponin I release and clearance in normal Standardbred racehorses. Equine Vet J 2018. [DOI: 10.1111/evj.12967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T. M. Rossi
- Department of Population Medicine; Ontario Veterinary College; University of Guelph; Guelph Ontario Canada
| | - P. A. Kavsak
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
| | - M. G. Maxie
- Animal Health Laboratory; Laboratory Services Division; University of Guelph; Guelph Ontario Canada
| | - D. L. Pearl
- Department of Population Medicine; Ontario Veterinary College; University of Guelph; Guelph Ontario Canada
| | - W. G. Pyle
- Centre for Cardiovascular Research; Department of Biomedical Sciences; Ontario Veterinary College; University of Guelph; Guelph Ontario Canada
| | - P. W. Physick-Sheard
- Department of Population Medicine; Ontario Veterinary College; University of Guelph; Guelph Ontario Canada
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Olcina G, Timón R, Brazo-Sayavera J, Martínez-Guardado I, Marcos-Serrano M, Crespo C. Changes in physiological and performance variables in non-professional triathletes after taking part in an Olympic distance triathlon. Res Sports Med 2018; 26:323-331. [PMID: 29504836 DOI: 10.1080/15438627.2018.1447472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Given increasing popularity of triathlon, the objective of this study was to evaluate the acute effects upon the health of triathletes. To do so, with a sample of 23 male athletes (34.4 ± 7.9 years old), an assessment was carried out both before and after an Olympic distance triathlon, of the bodily composition, the jumping ability and the BORG and VAS scales, as well as a blood analysis of the following: Lactate (mmol/L), Hematrocrit (%), Glucose (mg/dL), Total proteins (mg/dL), Triglycerides (mg/dL), Bilirubin (mg/dL), GOT (IU/L), GPT (IU/L), LDH (IU/L), CPK (IU/L). The results showed an increase (p < 0.001) in the different markers of metabolic stress and muscular damage following the triathlon, but always within a normal range considered to be healthy, with the exception of CPK (IU/L) (PRE 149.33 ± 108.16 vs POST 290.10 ± 102.48). Therefore, it would seem that competing in an Olympic-distance triathlon does not pose health risks for trained subjects.
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Affiliation(s)
- Guillermo Olcina
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain
| | - Rafael Timón
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain
| | - Javier Brazo-Sayavera
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain.,b Departamento de Educación Física y Deportes , Instituto Superior de Educación Física, Universidad de la República , Rivera , Uruguay
| | - Ismael Martínez-Guardado
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain
| | - Marta Marcos-Serrano
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain
| | - Carmen Crespo
- a Research group on advances in sport training and physical conditioning, University of Extremadura , Cáceres , Spain
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18
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Abela M, Sammut L. Cardiac troponin: more than meets the eye. Postgrad Med J 2017; 93:762-765. [PMID: 28778950 DOI: 10.1136/postgradmedj-2017-134984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/20/2017] [Accepted: 06/27/2017] [Indexed: 11/03/2022]
Abstract
Exercise is known to have a vast array of health benefits. It may however confer delirious effects on most body systems, with the cardiovascular system taking particular prominence. Athletes in particular are known to be at a higher risk for sudden cardiac death as a result of several cardiac adaptations which take place. Myocardial damage as a result of extreme exertional activities is thought to play a very important role in this risk. Cardiac troponin I is widely known to be an excellent diagnostic marker which is used in patients suspected of having acute coronary syndrome. Its release during exercise has been routinely studied, with many hypotheses currently being proposed as to its role and potential complications once released. Whether or not it implies that myocardial damage is taking place as a result of exercise is debatable, but its release might have some role in the development of cardiotoxic states which predisposes athletes to significant cardiac risk. This review aims to discuss the proposed mechanisms in exercise-induced troponin release, while also goes into its clinical relevance and potential early and late sequelae.
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Affiliation(s)
- Mark Abela
- Department of Cardiology, Cardiac Medical Ward, Mater Dei Hospital, Msida, Malta
| | - Luke Sammut
- Department of Rheumatology, University of Salford, Salford, UK
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19
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Zhang X, Gao F. Exercise is good for the heart, but the intensity matters. Am J Physiol Heart Circ Physiol 2017. [PMID: 28646028 DOI: 10.1152/ajpheart.00323.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Xing Zhang
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Feng Gao
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
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Clifford T, Wood MJ, Stocks P, Howatson G, Stevenson EJ, Hilkens CMU. T-regulatory cells exhibit a biphasic response to prolonged endurance exercise in humans. Eur J Appl Physiol 2017. [PMID: 28646302 PMCID: PMC5506211 DOI: 10.1007/s00421-017-3667-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose T-regulatory cells (Tregs) are a sub-population of lymphocytes that act to suppress aberrant immune responses. We investigated changes in the numbers of naïve and terminally differentiated Tregs in the peripheral blood to establish their role in the immuno-suppressive response to prolonged exercise. Methods Blood was drawn from seventeen experienced runners (age 40 ± 12 years; height 1.75 ± 0.08 m; mass 71.4 ± 10.8 kg) before, ~1 h after (POST-1h), and on the day following the marathon (POST-1d). Tregs (CD3+CD4+Foxp3+CD25++CD127−) were analysed in peripheral blood mononuclear cells using flow cytometry. The markers CD45RA and HLA-DR were included to define naïve and terminally differentiated Tregs, respectively. Results The absolute number of Tregs decreased (27%) POST-1h marathon (P < 0.001) but increased (21%) at POST-1d (P < 0.01). Naïve CD45RA+ Tregs fell by 39% POST-1h (P < 0.01) but were unaffected POST-1d (P > 0.05). In contrast, an increased number of Tregs expressing HLA-DR was observed at POST-1d (P < 0.01). Interleukin (IL)-1β, IL-6, IL-8 and IL-10 levels in the serum all increased POST-1h (P > 0.05) but returned to pre-exercise levels POST-1d. The suppressive cytokine, transforming growth factor-beta, was unaffected by the marathon (P > 0.05). Conclusions These results suggest that Tregs do not play a major role in immune suppression in the early hours of recovery from a marathon. However, terminally differentiated HLA-DR+ Tregs are mobilized the following day, which could represent a compensatory attempt by the host to restore immune homeostasis and limit excessive cell damage.
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Affiliation(s)
- Tom Clifford
- School of Biomedical Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
| | - Matthew J Wood
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Philip Stocks
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.,Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
| | - Emma J Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Catharien M U Hilkens
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Acute exhaustive aerobic exercise training impair cardiomyocyte function and calcium handling in Sprague-Dawley rats. PLoS One 2017; 12:e0173449. [PMID: 28273177 PMCID: PMC5342256 DOI: 10.1371/journal.pone.0173449] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 02/22/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction Recent data from long-distance endurance participants suggest that cardiac function is impaired after completion. Existing data further indicate that right ventricular function is more affected than left ventricular function. The cellular mechanisms underpinning cardiac deterioration are limited and therefore the aim of this study was to examine cardiomyocyte and molecular responses of the right and left ventricle to an acute bout of exhaustive endurance exercise. Materials and methods Male Sprague-Dawley rats were assigned to sedentary controls or acute exhaustive endurance exercise consisting of a 120 minutes long forced treadmill run. The contractile function and Ca2+ handling properties in isolated cardiomyocytes, protein expression levels of sarcoplasmic reticulum Ca2+-ATPase and phospholamban including two of its phosphorylated states (serine 16 and threonine 17), and the mitochondrial respiration in permeabilized cardiac muscle fibers were analyzed. Results The exercise group showed a significant reduction in cardiomyocyte fractional shortening (right ventricle 1 Hz and 3 Hz p<0.001; left ventricle 1 Hz p<0.05), intracellular Ca2+ amplitude (right ventricle 1 and 3 Hz p<0.001; left ventricle 1 Hz p<0.01 and 3 Hz p<0.05) and rate of diastolic Ca2+ decay (right ventricle 1 Hz p<0.001 and 3 Hz p<0.01; left ventricle 1 and 3 Hz p<0.01). Cardiomyocyte relaxation during diastole was only significantly prolonged at 3 Hz in the right ventricle (p<0.05) compared to sedentary controls. We found an increase in phosphorylation of phospholamban at serine 16 and threonine 17 in the left (p<0.05), but not the right, ventricle from exhaustively exercised animals. The protein expression levels of sarcoplasmic reticulum Ca2+-ATPase and phospholamban was not changed. Furthermore, we found a reduction in maximal oxidative phosphorylation and electron transport system capacities of mitochondrial respiration in the right (p<0.01 and p<0.05, respectively), but not the left ventricle from rats subjected to acute exhaustive treadmill exercise. Conclusion Acute exhaustive treadmill exercise is associated with impairment of cardiomyocyte Ca2+ handling and mitochondrial respiration that causes depression in both contraction and diastolic relaxation of cardiomyocytes.
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Navas de Solis C. Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects. Equine Vet J 2016; 48:406-13. [DOI: 10.1111/evj.12580] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 03/28/2016] [Indexed: 12/25/2022]
Affiliation(s)
- C. Navas de Solis
- Swiss Institute of Equine Medicine; Faculty of Veterinary Science (Vetsuisse); University of Bern and Agroscope; Bern Switzerland
- Texas Veterinary Medical Center; Texas A&M University; College Station USA
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Eijsvogels TMH, Fernandez AB, Thompson PD. Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise? Physiol Rev 2016; 96:99-125. [PMID: 26607287 PMCID: PMC4698394 DOI: 10.1152/physrev.00029.2014] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including "myocardial" creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination.
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Affiliation(s)
- Thijs M H Eijsvogels
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antonio B Fernandez
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul D Thompson
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Schnell F, Claessen G, La Gerche A, Bogaert J, Lentz PA, Claus P, Mabo P, Carré F, Heidbuchel H. Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie? Br J Sports Med 2015. [DOI: 10.1136/bjsports-2014-094546] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Oláh A, Németh BT, Mátyás C, Horváth EM, Hidi L, Birtalan E, Kellermayer D, Ruppert M, Merkely G, Szabó G, Merkely B, Radovits T. Cardiac effects of acute exhaustive exercise in a rat model. Int J Cardiol 2015; 182:258-66. [DOI: 10.1016/j.ijcard.2014.12.045] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 10/31/2014] [Accepted: 12/20/2014] [Indexed: 12/21/2022]
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Park CH, Kim KB, Han J, Ji JG, Kwak YS. Cardiac Damage Biomarkers Following a Triathlon in Elite and Non-elite Triathletes. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2014; 18:419-23. [PMID: 25352762 PMCID: PMC4211126 DOI: 10.4196/kjpp.2014.18.5.419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 06/18/2014] [Accepted: 08/18/2014] [Indexed: 11/22/2022]
Abstract
The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n=7) and non-elite athlete group (NEG: n=8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.
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Affiliation(s)
- Chan-Ho Park
- Department of Physical Education, Pusan National University, Busan 609-735, Korea
| | - Kwi-Baek Kim
- Department of Sports & Health Management, Youngsan University, Yangsan 626-790, Korea
| | - Jin Han
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 614-735, Korea
| | - Jin-Goo Ji
- Department of Physical Education, Dong-Eui University, Busan 614-714, Korea
| | - Yi-Sub Kwak
- Department of Physical Education, Dong-Eui University, Busan 614-714, Korea
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D'Souza A, Bucchi A, Johnsen AB, Logantha SJRJ, Monfredi O, Yanni J, Prehar S, Hart G, Cartwright E, Wisloff U, Dobryznski H, DiFrancesco D, Morris GM, Boyett MR. Exercise training reduces resting heart rate via downregulation of the funny channel HCN4. Nat Commun 2014; 5:3775. [PMID: 24825544 PMCID: PMC4024745 DOI: 10.1038/ncomms4775] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/01/2014] [Indexed: 12/14/2022] Open
Abstract
Endurance athletes exhibit sinus bradycardia, that is a slow resting heart rate, associated with a higher incidence of sinus node (pacemaker) disease and electronic pacemaker implantation. Here we show that training-induced bradycardia is not a consequence of changes in the activity of the autonomic nervous system but is caused by intrinsic electrophysiological changes in the sinus node. We demonstrate that training-induced bradycardia persists after blockade of the autonomous nervous system in vivo in mice and in vitro in the denervated sinus node. We also show that a widespread remodelling of pacemaker ion channels, notably a downregulation of HCN4 and the corresponding ionic current, If. Block of If abolishes the difference in heart rate between trained and sedentary animals in vivo and in vitro. We further observe training-induced downregulation of Tbx3 and upregulation of NRSF and miR-1 (transcriptional regulators) that explains the downregulation of HCN4. Our findings provide a molecular explanation for the potentially pathological heart rate adaptation to exercise training. Endurance athletes are known to have a low resting heart rate. Here, D'Souza et al. propose that training-induced bradycardia is the result of electrophysiological changes in the sinus node, challenging the classical view that training-induced bradycardia is caused by increased activity of the autonomic nervous system.
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Affiliation(s)
- Alicia D'Souza
- 1] Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK [2]
| | - Annalisa Bucchi
- 1] Department of Biosciences, University of Milano, Milano 20133, Italy [2]
| | - Anne Berit Johnsen
- 1] Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway [2]
| | - Sunil Jit R J Logantha
- 1] Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK [2]
| | - Oliver Monfredi
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Joseph Yanni
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Sukhpal Prehar
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - George Hart
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Elizabeth Cartwright
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Ulrik Wisloff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Halina Dobryznski
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Dario DiFrancesco
- Department of Biosciences, University of Milano, Milano 20133, Italy
| | - Gwilym M Morris
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Mark R Boyett
- Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, UK
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Abstract
Physical activity is a potent therapy for both the prevention and treatment of cardiovascular disease. Exercise appears to most benefit people who are the least active. There is some evidence to suggest that a curvilinear relationship exists between exercise and survival, whereby beyond an optimal level of fitness, the principle of diminishing returns applies. Indeed, some go further in suggesting that there is evidence that extreme athletic training may be harmful in some individuals. The incidence of sudden cardiac death in athletes is greater than in matched, nonathletic counterparts, and this finding is driven by the provocation of an underlying cardiac abnormality by strenuous exertion. The task of detecting pathological myocardial substrate in athletes is made difficult by physiological adaptations to exercise that can mimic the appearance of cardiomyopathies and ion channelopathies in some individuals. This article details the clinical evaluation of the athlete with reference limits for cardiac physiological remodeling and discusses the diagnostic dilemmas that arise.
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Affiliation(s)
- Andrew D'Silva
- Department of Cardiovascular Sciences, St. George's University of London, London, UK
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29
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Cote AT, Bredin SSD, Phillips AA, Koehle MS, Glier MB, Devlin AM, Warburton DER. Left ventricular mechanics and arterial-ventricular coupling following high-intensity interval exercise. J Appl Physiol (1985) 2013; 115:1705-13. [PMID: 24052036 DOI: 10.1152/japplphysiol.00576.2013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
High-intensity exercise induces marked physiological stress affecting the secretion of catecholamines. Sustained elevations in catecholamines are thought to desensitize cardiac beta receptors and may be a possible mechanism in impaired cardiac function following strenuous exercise. In addition, attenuated arterial-ventricular coupling may identify vascular mechanisms in connection with postexercise attenuations in ventricular function. Thirty-nine normally active (NA) and endurance-trained (ET) men and women completed an echocardiographic evaluation of left ventricular function before and after an acute bout of high-intensity interval exercise (15 bouts of 1:2 min work:recovery cycling: 100% peak power output and 50 W, respectively). Following exercise, time to peak twist and peak untwisting velocity were delayed (P < 0.01) but did not differ by sex or training status. Interactions for sex and condition (rest vs. exercise) were found for longitudinal diastolic strain rate (men, 1.46 ± 0.19 to 1.28 ± 0.23 s(-1) vs. women, 1.62 ± 0.25 to 1.63 ± 0.26 s(-1); P = 0.01) and arterial elastance (men 2.20 ± 0.65 to 3.24 ± 1.02 mmHg · ml(-1) · m(-2) vs. women 2.51 ± 0.61 to 2.93 ± 0.68 mmHg · ml(-1) · m(-2); P = 0.04). No cardiac variables were found associated with catecholamine levels. The change in twist mechanics was associated with baseline aortic pulse-wave velocity (r(2) = 0.27, P = 0.001). We conclude that males display greater reductions in contractility in response to high-intensity interval exercise, independent of catecholamine concentrations. Furthermore, a novel association of arterial stiffness and twist mechanics following high-intensity acute exercise illustrates the influence of vascular integrity on cardiac mechanics.
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Affiliation(s)
- Anita T Cote
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, Canada
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30
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Abstract
Physical activity and exercise have been associated with reduced cardiovascular risk, morbidity, and mortality, as well as all-cause mortality, both in the general population and in patients with various forms of cardiovascular disease. Increasing amounts of exercise are associated with incremental reductions in mortality, but considerable benefits have been found even with a low level of exercise. Exercise is beneficial for most individuals, but risks exist. Exercise is associated with reduced long-term morbidity and mortality, but acute exercise can transiently increase the risk of fatal or nonfatal cardiovascular events. Although tragic, these events are very rare, and even to some extent preventable with screening programmes. Low-intensity physical activity is important and beneficial to all individuals, including those with a high risk of adverse cardiovascular events. In individuals who are physically fit and who do not have genetic predisposition to, or signs of, cardiovascular disease, the greater the intensity and amount of exercise, the greater the health benefits. Nevertheless, effective strategies to encourage exercise in the population are lacking. A sustained increase in physical activity is likely to require more than individual advice, and needs to include urban planning and possibly even legislation.
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Poussel M, Djaballah K, Laroppe J, Brembilla-Perrot B, Marie PY, Chenuel B. Left ventricle fibrosis associated with nonsustained ventricular tachycardia in an elite athlete: is exercise responsible? A case report. J Athl Train 2012; 47:224-7. [PMID: 22488290 PMCID: PMC3418136 DOI: 10.4085/1062-6050-47.2.224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To emphasize the potentially harmful effects of high-intensity exercise on cardiac health and the fine line between physiologic and pathologic adaptation to chronic exercise in the elite athlete. This case also highlights the crucial need for regular evaluation of symptoms that suggest cardiac abnormality in athletes. BACKGROUND Sudden cardiac death (SCD) of young athletes is always a tragedy because they epitomize health. However, chronic, high-intensity exercise sometimes has harmful effects on cardiac health, and pathologic changes, such as myocardial fibrosis, have been observed in endurance athletes. In this case, a highly trained 30-year-old cyclist reported brief palpitations followed by presyncope feeling while exercising. Immediate investigations revealed nonsustained ventricular tachycardia originating from the left ventricle on a stress test associated with myocardial fibrosis of the left ventricle as shown with magnetic resonance imaging. Despite complete cessation of exercise, life-threatening arrhythmia and fibrosis persisted, leading to complete restriction from competition. Differential Diagnosis: Hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, myocarditis, postmyocarditis, use of drugs and toxic agents, doping, and systemic disease. TREATMENT The arrhythmia could not be treated with catheter ablation procedure or drug suppression. Therefore, the athlete was instructed to withdraw completely from sport participation and to have a medical follow-up twice each year. UNIQUENESS To our knowledge, no other report of left ventricle exercise-induced fibrosis associated with life-threatening arrhythmia in a living young elite athlete exists. Only postmortem evidence supports such myocardial pathologic adaptation to exercise. CONCLUSIONS To prevent SCD in young athletes, careful attention must be paid to exercise-related symptoms that suggest a cardiac abnormality because they more often are linked to life-threatening cardiovascular disease.
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Affiliation(s)
- Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Test, CHU of Nancy, Rue du Morvan, 54500 Vandoeuvre, France.
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32
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La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, Macisaac AI, Heidbüchel H, Prior DL. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 2011; 33:998-1006. [PMID: 22160404 DOI: 10.1093/eurheartj/ehr397] [Citation(s) in RCA: 513] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIMS Endurance training may be associated with arrhythmogenic cardiac remodelling of the right ventricle (RV). We examined whether myocardial dysfunction following intense endurance exercise affects the RV more than the left ventricle (LV) and whether cumulative exposure to endurance competition influences cardiac remodelling (including fibrosis) in well-trained athletes. METHODS AND RESULTS Forty athletes were studied at baseline, immediately following an endurance race (3-11 h duration) and 1-week post-race. Evaluation included cardiac troponin (cTnI), B-type natriuretic peptide, and echocardiography [including three-dimensional volumes, ejection fraction (EF), and systolic strain rate]. Delayed gadolinium enhancement (DGE) on cardiac magnetic resonance imaging (CMR) was assessed as a marker of myocardial fibrosis. Relative to baseline, RV volumes increased and all functional measures decreased post-race, whereas LV volumes reduced and function was preserved. B-type natriuretic peptide (13.1 ± 14.0 vs. 25.4 ± 21.4 ng/L, P = 0.003) and cTnI (0.01 ± .03 vs. 0.14 ± .17 μg/L, P < 0.0001) increased post-race and correlated with reductions in RVEF (r = 0.52, P = 0.001 and r = 0.49, P = 0.002, respectively), but not LVEF. Right ventricular ejection fraction decreased with increasing race duration (r = -0.501, P < 0.0001) and VO(2)max (r = -0.359, P = 0.011). Right ventricular function mostly recovered by 1 week. On CMR, DGE localized to the interventricular septum was identified in 5 of 39 athletes who had greater cumulative exercise exposure and lower RVEF (47.1 ± 5.9 vs. 51.1 ± 3.7%, P = 0.042) than those with normal CMR. CONCLUSION Intense endurance exercise causes acute dysfunction of the RV, but not the LV. Although short-term recovery appears complete, chronic structural changes and reduced RV function are evident in some of the most practiced athletes, the long-term clinical significance of which warrants further study.
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Affiliation(s)
- André La Gerche
- Department of Medicine, University of Melbourne, St Vincent's Hospital, 29 Regent Street, Fitzroy, VIC 3065, Australia.
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33
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Progression of changes in left ventricular function during four days of simulated multi-stage cycling. Eur J Appl Physiol 2011; 112:2243-55. [DOI: 10.1007/s00421-011-2201-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 09/29/2011] [Indexed: 10/16/2022]
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34
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Abstract
The cardiovascular benefits of regular physical activity are well established (J. Sci. Med. Sport,7, 2004, 6). James Fixx wrote the best-selling book on running entitled The Complete Book of Running (1977), which led to an increase in popularity. However, when Fixx collapsed and died suddenly while running in 1984, people began to consider the adverse effects of sport on cardiac conditions. Going back in time, in 490 bc Phidippides, a young Greek messenger, ran 26.2 miles from Marathon to Athens delivering the news of the Greek victory over the Persians, and immediately collapsed and died. This is probably the first recorded incident of sudden death of an athlete running a marathon. According to Noakes (Med. Sci. Sports Exerc.,19, 1987, 187), one of the earliest reports on the association between running and cardiac risk was published in 1909, which claimed that school cross-country races over one mile for boys below the age of 19 years were totally inappropriate, and that the associated stress will cause damage in the heart and other organs. Death in athletes is highly publicized and has a substantial emotional impact on the community at large, given that athletes are perceived as the healthiest segment of society.
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Affiliation(s)
- Mary N Sheppard
- CRY Centre for Cardiac Pathology, Imperial College London, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
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35
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Kim JH, Noseworthy PA, McCarty D, Yared K, Weiner R, Wang F, Wood MJ, Hutter AM, Picard MH, Baggish AL. Significance of electrocardiographic right bundle branch block in trained athletes. Am J Cardiol 2011; 107:1083-9. [PMID: 21296331 DOI: 10.1016/j.amjcard.2010.11.037] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 11/12/2010] [Accepted: 11/12/2010] [Indexed: 01/02/2023]
Abstract
We sought to determine the clinical and physiologic significance of electrocardiographic complete right bundle branch block (CRBBB) and incomplete right bundle branch block (IRBBB) in trained athletes. The 12-lead electrocardiographic and echocardiographic data from 510 competitive athletes were analyzed. Compared to the 51 age-, sport type-, and gender-matched athletes with normal 12-lead electrocardiographic QRS complex duration, the 44 athletes with IRBBB (9%) and 13 with CRBBB (3%) had larger right ventricular (RV) dimensions, as measured by the basal RV end-diastolic diameter (CRBBB 43 ± 3 mm, IRBBB 38 ± 6 mm, normal QRS complex 35 ± 4 mm, p <0.001) and RV end-diastolic area (CRBBB 33 ± 5, IRBBB 27 ± 7, and normal QRS complex 23 ± 3 cm(2); p <0.001). Athletes with CRBBB also had a relative reduction in the RV systolic function at rest as assessed by the RV fractional area change and peak systolic tissue velocity. Finally, QRS prolongation was associated with parallel increases in interventricular dyssynchrony (basal RV to basal lateral left ventricular peak systolic tissue velocity time difference: CRBBB 112 ± 15, IRBBB 73 ± 33, normal QRS complex 43 ± 39 ms, p <0.001). Despite these findings, no athlete with CRBBB or IRBBB was found to have pathologic structural cardiac disease. In conclusion, among trained athletes, CRBBB and IRBBB appear to be markers of a structural and physiological cardiac remodeling triad characterized by RV dilation, a relative reduction in the RV systolic function at rest, and interventricular dyssynchrony.
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Affiliation(s)
- Jonathan H Kim
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
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36
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Legaz-Arrese A, George K, Carranza-García LE, Munguía-Izquierdo D, Moros-García T, Serrano-Ostáriz E. The impact of exercise intensity on the release of cardiac biomarkers in marathon runners. Eur J Appl Physiol 2011; 111:2961-7. [DOI: 10.1007/s00421-011-1922-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Accepted: 02/23/2011] [Indexed: 12/15/2022]
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37
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Serrano-Ostáriz E, Terreros-Blanco JL, Legaz-Arrese A, George K, Shave R, Bocos-Terraz P, Izquierdo-Álvarez S, Bancalero JL, Echavarri JM, Quilez J, Aragonés MT, Carranza-García LE. The impact of exercise duration and intensity on the release of cardiac biomarkers. Scand J Med Sci Sports 2011; 21:244-9. [DOI: 10.1111/j.1600-0838.2009.01042.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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O'Hanlon R, Wilson M, Wage R, Smith G, Alpendurada FD, Wong J, Dahl A, Oxborough D, Godfrey R, Sharma S, Roughton M, George K, Pennell DJ, Whyte G, Prasad SK. Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2010; 12:38. [PMID: 20598139 PMCID: PMC2908607 DOI: 10.1186/1532-429x-12-38] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 07/02/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. METHODS 17 recreation athletes (33.5 +/- 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. RESULTS Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 +/- 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64+/- 1% pre, 67+/- 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. CONCLUSION Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.
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Affiliation(s)
- Rory O'Hanlon
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Mat Wilson
- ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Qatar
| | - Riccardo Wage
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Gillian Smith
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Francisco D Alpendurada
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Joyce Wong
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Annette Dahl
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Richard Godfrey
- Department of Sport and Exercise Science, Brunel University, Uxbridge, London, UK
| | - Sanjay Sharma
- Department of Heart Muscle Disorders, Kings College London, London, UK
| | | | - Keith George
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, UK
| | - Dudley J Pennell
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Greg Whyte
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, UK
- Centre for Sports Cardiology, Harley Street, London, UK
| | - Sanjay K Prasad
- Department of Cardiovascular Magnetic Resonance, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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40
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Çolak T, Bamaç B, Çolak S, Duman C, Bayazit B, Öztürk S, Meriç B, Özbek A, Yildiz F. The Influence of a Single Bout of Wrestling Exercise on Serum Levels of Ischemia-modified Albumin. J Exerc Sci Fit 2010. [DOI: 10.1016/s1728-869x(10)60010-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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41
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Abstract
Over the past 13 years, Noakes and his colleagues have argued repeatedly for the existence of a 'Central Governor', a specific brain centre that provides a feed-forward regulation of the intensity of vigorous effort in order to conserve homeostasis, protecting vital organs such as the brain, heart and skeletal muscle against damage from hyperthermia, ischaemia and other manifestations of catastrophic failure. This brief article reviews evidence concerning important corollaries of the hypothesis, examining the extent of evolutionary pressures for the development of such a mechanism, the effectiveness of protection against hyperthermia and ischaemia during exhausting exercise, the absence of peripheral factors limiting peak performance (particularly a plateauing of cardiac output and oxygen consumption) and proof that electromyographic activity is limiting exhausting effort. As yet, there is a lack of convincing experimental evidence to support these corollaries of the hypothesis; furthermore, some findings, such as the rather consistent demonstration of an oxygen consumption plateau in young adults, argue strongly against the limiting role of a 'Central Governor'.
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Affiliation(s)
- Roy J Shephard
- Faculty of Physical Education and Health, University of Toronto, Toronto, Ontario, Canada.
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42
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Diastolic function in healthy humans: non-invasive assessment and the impact of acute and chronic exercise. Eur J Appl Physiol 2009; 108:1-14. [DOI: 10.1007/s00421-009-1233-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2009] [Indexed: 01/27/2023]
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43
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Gonzalez- Alonso J, Mortensen SP. Comments of point:counterpoint: maximal oxygen uptake is/is not limited by a central nervous system governor. J Appl Physiol (1985) 2009; 106:346. [PMID: 19202591 DOI: 10.1152/japplphysiol.zdg-8326.pcpcomm.2008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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44
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Giannoni A, Giovannini S, Clerico A. Measurement of circulating concentrations of cardiac troponin I and T in healthy subjects: a tool for monitoring myocardial tissue renewal? Clin Chem Lab Med 2009; 47:1167-77. [DOI: 10.1515/cclm.2009.320] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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