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Stoičkov V, Radovanović D, Deljanin-Ilić M, Perišić Z, Pavlović M, Tasić I, Stoičkov I, Golubović M, Scanlan AT, Jakovljević V, Stojanović E. Sport-related differences in QT dispersion and echocardiographic parameters in male athletes. Sci Rep 2023; 13:6770. [PMID: 37185606 PMCID: PMC10130053 DOI: 10.1038/s41598-023-33957-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Abstract
The aim of this study was to compare QT dispersion (QTd) and echocardiographic parameters in male athletes competing across different sports (long-distance running, volleyball, football, powerlifting, and bodybuilding) and a control population. Significant moderate-strong differences (p < 0.001, [Formula: see text] = 0.52-0.71) were found in corrected QTd, intraventricular septal wall thickness (ISWT), posterior wall thickness (PWT), relative wall thickness (RWT) and LV (left ventricular) index between groups. Corrected QTd, ISWT, PWT, and RWT were significantly (p < 0.001) higher in powerlifters and bodybuilders compared to other athlete groups and controls. While all athlete groups displayed a significantly higher LV index (p < 0.05) compared to controls, corrected QTd was significantly lower (p < 0.001) only in long-distance runners, volleyball athletes, and football athletes compared to controls. Normal or eccentric LV hypertrophy (LVH) was observed in most long-distance runners (58% and 33%), volleyball athletes (50% and 50%), and football athletes (56% and 41%). In contrast, concentric LVH was observed in most powerlifters (58%) and bodybuilders (54%). Advanced LVH, predominantly concentric in nature, appears to be accompanied with increased QTd in powerlifters and bodybuilders. On the other hand, runners, volleyball athletes, and football athletes experienced LVH toward the upper threshold of the normal reference range alongside reduced QTd compared to other groups.
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Affiliation(s)
- Viktor Stoičkov
- Institute for Treatment and Rehabilitation "Niska Banja", Clinic for Cardiovascular Diseases, Niš, Serbia
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
| | | | - Marina Deljanin-Ilić
- Institute for Treatment and Rehabilitation "Niska Banja", Clinic for Cardiovascular Diseases, Niš, Serbia
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
| | - Zoran Perišić
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
- Cardiovascular Diseases Clinic, Clinical Center Niš, Niš, Serbia
| | - Milan Pavlović
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
- Cardiovascular Diseases Clinic, Clinical Center Niš, Niš, Serbia
| | - Ivan Tasić
- Institute for Treatment and Rehabilitation "Niska Banja", Clinic for Cardiovascular Diseases, Niš, Serbia
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
| | | | - Mlađan Golubović
- Faculty of Medicine, Department of Internal Medicine, University of Niš, Niš, Serbia
- Cardiovascular and Transplant Surgery Clinic, Clinical Center Niš, Niš, Serbia
| | - Aaron T Scanlan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Human Pathology, Moscow State Medical University IM Sechenov, Moscow, Russia
| | - Emilija Stojanović
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
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A comprehensive electrocardiographic analysis for young athletes. Med Biol Eng Comput 2021; 59:1865-1876. [PMID: 34342819 DOI: 10.1007/s11517-021-02401-2] [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] [Received: 12/12/2020] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
ECG-based differences between athletes and sedentary adolescents are a frequently investigated subject in sports medicine. Especially, training-induced ECG variations are common in adult athletes and sustained training often leads to anatomical changes in the heart that can yield abnormalities in ECG. Therefore, ECG screening in athletes is important in diagnosis of cardiac problems of young athletes. The present work investigated the ECG characteristics of young athletes in terms of both gender and sedentary healthy young control group differences. Besides comparison between groups, analysis parameters were also investigated within the groups using correlation analysis. ECG characteristics were extracted using wavelet transform-based adaptive algorithms. Results showed that ECGs of athletes demonstrate differences related to gender and compared to young sedentary. Athletes had significantly lower heart rate; higher QTc, P, and T amplitudes; ST segment; and ST, QT, and RR intervals compared to control group (p < 0.05). Proposed new parameter, namely "scalogram" of each wave, was lower in male athletes compared to other groups (p < 0.05). Negative correlation between T wave amplitude and RR interval could be an indicator of long QT syndrome for male athletes. Furthermore, prolongation of QRS interval in athletes could be the underlying reason of changes in T wave amplitude. Findings of this study can propose indicators for understanding the possible diseases as well as help evaluate the sudden changes in athlete's heart.
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Christou GA, O'Driscoll JM. The impact of demographic, anthropometric and athletic characteristics on left atrial size in athletes. Clin Cardiol 2020; 43:834-842. [PMID: 32271473 PMCID: PMC7403671 DOI: 10.1002/clc.23368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/24/2020] [Indexed: 01/01/2023] Open
Abstract
The structural adaptations of the “athlete's heart” include left atrial (LA) enlargement. A literature search was performed based on PubMed listings up to November 2, 2019 using “athletes AND left atrium,” “athletes AND LA,” “sports AND left atrium,” “sports AND LA,” “exercise AND left atrium,” and “exercise AND LA” as the search terms. Eligible studies included those reporting the influence of demographic, anthropometric and athletic characteristics on LA size in athletes. A total of 58 studies were included in this review article. Although LA volume has been reported to be greater in males compared to females when indexed for body surface area (BSA), there was no difference between sexes. The positive association between LA size and age in athletes may reflect the increase in body size with maturation in nonadult athletes and the training age of endurance athletic activity in adult athletes. Caucasian and black athletes have been demonstrated to exhibit similar LA enlargement. The positive association of LA size with lean body mass (LBM) possibly accounts for the relationship of LA size with BSA. LA enlargement has been reported only in endurance‐trained, but not in strength‐trained athletes. LA size appears to increase with an increase in both the volume and intensity of endurance training. LA size correlates independently with the training age of endurance athletes. The athlete's characteristics that independently determine LA size include LBM, endurance training, and training age.
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Affiliation(s)
- Georgios A Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece.,MSc Sports Cardiology, St George's University of London, London, UK
| | - Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK.,Department of Cardiology, St George's Healthcare NHS Trust, London, UK
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Echocardiographic assessment of children participating in regular sports training. North Clin Istanb 2019; 6:236-241. [PMID: 31650109 PMCID: PMC6790927 DOI: 10.14744/nci.2018.40360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/29/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE: The aim of the present study was to determine the effects of a well-controlled endurance training program on cardiac functions and structures in healthy children and to define whether training hours per week and type of sports affect the training-induced cardiovascular response. METHODS: Echocardiographic recordings were obtained in 126 children who systematically participated in sports training for at least 1 year (study group), and the results were compared with the values obtained in 62 normal children who did not actively engage in any sports activity (control group). The two groups were comparable for age, sex, and body mass index. Study group participants were divided into two groups according to the duration of physical activity (training hours per week, <8 h and >8 h) and five groups according to the cardiovascular demand of sports type. Clinical examination, resting electrocardiogram, two-dimensional, M-mode, and Doppler echocardiography were obtained in all participants. RESULTS: Left ventricle wall dimensions, left atrial diameters, and aortic measurements were significantly higher in the study group. The mean mitral E/A ratio was also significantly higher in the training group than in untrained subjects (p<0.001). Echocardiographic measurements were similar between different sports type participants in the study group. However, aortic root diameter, left atrial diameter, and left ventricle posterior wall diastolic thickness were higher in children training >8 h/week than in children training <8 h/week in the study group. CONCLUSION: The present study showed that the echocardiographic parameters of children participating in regular sports training activities statistically significantly exceeded the parameters of untrained controls. These parameters were mostly dependent on the duration of training hours per week.
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Malhotra VK, Singh N, Bishnoi RS, Chadha DS, Bhardwaj P, Madan H, Dutta R, Ghosh AK, Sengupta S, Perumal P. The prevalence of abnormal ECG in trained sportsmen. Med J Armed Forces India 2015; 71:324-9. [PMID: 26663958 DOI: 10.1016/j.mjafi.2015.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 06/08/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Competitive sports training causes structural and conductive system changes manifesting by various electrocardiographic alterations. We undertook this study to assess the prevalence of abnormal ECG in trained Indian athletes and correlate it with the nature of sports training, that is endurance or strength training. METHODS We evaluated a standard resting, lying 12 lead Electrocardiogram (ECG) in 66 actively training Indian athletes. Standard diagnostic criteria were used to define various morphological ECG abnormalities. RESULTS 33/66 (50%) of the athletes were undertaking endurance training while the other 33 (50%) were involved in a strength-training regimen. Overall 54/66 (81%) sportsmen had significant ECG changes. 68% of these changes were considered as normal training related features, while the remaining 32% were considered abnormal. There were seven common training related ECG changes-Sinus Bradycardia (21%), Sinus Arrhythmia (16%), 1st degree Atrioventricular Heart Block (6%), Type 1 2nd-degree Atrioventicular Heart Block (3%), Incomplete Right bundle branch block (RBBB) (24%), Early Repolarization (42%), Left Ventricular Hypertrophy (LVH) (14%); while three abnormal ECG changes--T-wave inversion (13%), RBBB(4%), Right ventricular hypertrophy (RVH) with strain (29%) were noted. Early repolarization (commonest change), sinus bradycardia, and incomplete RBBB were the commoner features noticed, with a significantly higher presence in the endurance trained athletes. CONCLUSION A high proportion of athletes undergoing competitive level sports training are likely to have abnormal ECG recordings. Majority of these are benign, and related to the physiological adaptation to the extreme levels of exertion. These changes are commoner during endurance training (running) than strength training (weightlifting).
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Affiliation(s)
- V K Malhotra
- Sports Physiologist, Army Sports Institute, Pune 411036, India
| | - Navreet Singh
- Classified Specialist (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi, 110011, India
| | - R S Bishnoi
- Commanding Officer, Army Sports Institute, Pune 411036, India
| | - D S Chadha
- Senior Adviser (Medicine) and Cardiology, Military Hospital (Cardiothoracic Center), Pune 411040, India
| | - P Bhardwaj
- Consultant (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India
| | - H Madan
- Senior Adviser (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India
| | - R Dutta
- Consultant (Medicine) and Cardiologist, & Commandant, Armed Forces Clinic, Dalhousie Road, New Delhi 110001, India
| | - A K Ghosh
- Senior Adviser (Medicine) and Cardiology, Command Hospital (Southern Command), Pune 411040, India
| | - S Sengupta
- Classified Specialist (Medicine) and Cardiologist, Military Hospital Jalandhar, Punjab, India
| | - P Perumal
- Nursing Assistant (Cardiology), Command Hospital (Southern Command), Pune 411040, India
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da Silva VP, de Oliveira NA, Silveira H, Mello RGT, Deslandes AC. Heart rate variability indexes as a marker of chronic adaptation in athletes: a systematic review. Ann Noninvasive Electrocardiol 2015; 20:108-18. [PMID: 25424360 PMCID: PMC6931675 DOI: 10.1111/anec.12237] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Regular exercise promotes functional and structural changes in the central and peripheral mechanisms of the cardiovascular system. Heart rate variability (HRV) measurement provides a sensitive indicator of the autonomic balance. However, because of the diversity of methods and variables used, the results are difficult to compare in the sports sciences. Since the protocol (supine, sitting, or standing position) and measure (time or frequency domain) are not well defined, the aim of this study is to investigate the HRV measures that better indicates the chronic adaptations of physical exercise in athletes. METHOD PubMed (MEDLINE), Web of Science, SciELO (Scientific Electronic Library), and Scopus databases were consulted. Original complete articles in English with short-term signals evaluating young and adult athletes, between 17 and 40 years old, with a control group, published up to 2013 were included. RESULTS Selected 19 of 1369 studies, for a total sample pool of 333 male and female athletes who practice different sports. The main protocols observed were the supine or standing positions in free or controlled breathing conditions. The main statistical results found in this study were the higher mean RR, standard deviation of RR intervals, and high frequency in athletes group. In addition, the analyses of Cohen's effect size showed that factors as modality of sport, protocol used and unit of measure selected could influence this expected results. CONCLUSION Our findings indicate that time domain measures are more consistent than frequency domain to describe the chronic cardiovascular autonomic adaptations in athletes.
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Affiliation(s)
- Vanessa Pereira da Silva
- Psychiatric InstituteFederal University of Rio de Janeiro (IPUB/UFRJ)Brazil
- Department of Physical Education and Sports, Centro de Instrução Almirante Alexandrino—Brazilian NavyRio de JaneiroBrazil
- Exercise Neuroscience Laboratory—LaNExRio de JaneiroBrazil
| | - Natacha Alves de Oliveira
- Psychiatric InstituteFederal University of Rio de Janeiro (IPUB/UFRJ)Brazil
- Exercise Neuroscience Laboratory—LaNExRio de JaneiroBrazil
| | - Heitor Silveira
- Psychiatric InstituteFederal University of Rio de Janeiro (IPUB/UFRJ)Brazil
- Exercise Neuroscience Laboratory—LaNExRio de JaneiroBrazil
| | - Roger Gomes Tavares Mello
- Biomedical Engineering ProgramFederal University of Rio de JaneiroBrazil
- Biomechanics and Exercise Physiology Laboratory—LaFEB, Department of Physical Education and Sports, Naval Academy—Brazilian NavyRio de JaneiroBrazil
| | - Andrea Camaz Deslandes
- Psychiatric InstituteFederal University of Rio de Janeiro (IPUB/UFRJ)Brazil
- Exercise Neuroscience Laboratory—LaNExRio de JaneiroBrazil
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Aparci M, Erdal M, Isilak Z, Yalcin M, Uz O, Arslan Z, Kardesoglu E. Enlargement of the aorta: An occupational disease? Exp Clin Cardiol 2013; 18:93-7. [PMID: 23940428 PMCID: PMC3718583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Aortic dilation may critically precede progression to thoracic aortic aneurysm (TAA). Prolonged or repetitive isometric-type heavier strenuous activities resulting from the nature of some professions may be an important causative factor for TAA. METHOD The echocardiographic measurement data of middle-age subjects who were isometric-type daily strenuous activity trainers or ordinary activity trainers were retrospectively analyzed. Clinical features and echocardiographic parameters of the left ventricle and left atrium (LA), aortic root (AR) and ascending aorta (AA) were compared between the groups. RESULTS AR (35.6±3.0 mm versus 33.5±1.9 mm), AA (36.8±3.0 mm versus 34.4±1.9 mm) and LA (37.4±2.2 mm versus 36.2±2.2 mm) diameters were significantly enlarged in the strenuous activity trainer group versus the ordinary activity group. Diastolic blood pressure was significantly lower (73.8±5.9 mmHg versus 78.3±6.0 mmHg) in this group. AR diameter was correlated with height (β=0.460; P=0.004) and LA diameter (β=0.280; P=0.008) while AA diameter was correlated with type of profession (β=0.309; P=0.003), left ventricular systolic diameter (β=0.500; P=0.001) and LA diameter (β=0.272; P=0.005) in regression analysis. CONCLUSION Aortic dilation and, subsequently, TAA may be an occupational disease due to nature of some professions (eg, the military, security, weight lifters, athletes, heavy workers, etc). Echocardiography is a convenient method of imaging that could be easily applied either during preparticipation screening or during periodical examination of these subjects. Earlier detection of TAA and limitation of such strenuous activities in these individuals may be initial lifesaving measures for the prevention of future cases of aortic aneurysm and dissection.
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Affiliation(s)
- Mustafa Aparci
- Etimesgut Military Hospital, Department of Cardiology and Aviation Medicine Center, Ankara
| | - Muhammed Erdal
- Etimesgut Military Hospital, Department of Family Physician, Ankara
| | - Zafer Isilak
- Haydarpasa Training Hospital, Department of Cardiology, Istanbul, Turkey
| | - Murat Yalcin
- Haydarpasa Training Hospital, Department of Cardiology, Istanbul, Turkey
| | - Omer Uz
- Haydarpasa Training Hospital, Department of Cardiology, Istanbul, Turkey
| | - Zekeriya Arslan
- Etimesgut Military Hospital, Department of Cardiology and Aviation Medicine Center, Ankara
| | - Ejder Kardesoglu
- Haydarpasa Training Hospital, Department of Cardiology, Istanbul, Turkey
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Toufan M, Javadrashid R, Paak N, Gojazadeh M, Khalili M. Relationship between incidentally detected calcification of the mitral valve on 64-row multidetector computed tomography and mitral valve disease on echocardiography. Int J Gen Med 2012; 5:839-43. [PMID: 23077412 PMCID: PMC3474172 DOI: 10.2147/ijgm.s33665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Mitral valve calcification is often incidentally detected on chest computed tomography (CT) scans obtained for a variety of noncardiac indications. In this study, we evaluated the association between mitral valve calcification incidentally detected on chest CT and the presence and severity of mitral valve disease on echocardiography. Methods Of 760 patients undergoing 64-row multidetector CT of the chest, 50 with mitral valve calcification and 100 controls were referred on for echocardiography. Calcifications of the mitral valve leaflet and annulus were assessed for length, Agatston score, and site, and were compared with echocardiographic findings. Results Mitral valve calcification was noted in 59 (7.7%) patients on multidetector CT. Fifty of these patients were assessed by echocardiography, and 32 (64%) were found to have mitral annular calcification. Nine patients (18%) had posterior mitral valve leaflet calcification, and both mitral valve leaflet and annular calcification were detected in nine (18%) cases. Nine (18%) patients had mild, three (6%) had moderate, and one (2%) had severe mitral stenosis. None of the patients with isolated mitral annular calcification had mitral stenosis; however, all the patients with mitral stenosis showed mitral valve leaflet calcification with or without mitral annular calcification (P < 0.001). Moreover, patients with mitral stenosis had a larger mitral calcification length and greater Agatston scores in comparison with those without mitral stenosis (P = 0.001). While 31 patients (62%) with mitral calcification had mitral regurgitation on echocardiography, 21 (21%) in the control group showed mitral regurgitation (P = 0.001). Conclusion Mitral valve leaflet calcification, with or without annular calcification, may be an indicator of mitral stenosis. Mitral calcification can also be considered as an indicator for mitral regurgitation in general. Therefore, patients with mitral valve calcification detected incidentally on chest CT scan may benefit from functional assessment of the valve using echocardiography.
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Affiliation(s)
- Mehrnoush Toufan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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