1
|
Bohm P, Barra S, Weizman O, Narayanan K, Meyer T, Schmied C, Bougouin W, Jouven X, Marijon E. Sudden Cardiac Arrest During Sports in Children and Adolescents. Circulation 2024; 149:794-796. [PMID: 38437484 DOI: 10.1161/circulationaha.123.064739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- Philipp Bohm
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., T.M.)
- Department of Cardiology, University Heart Center Zurich, Switzerland (P.B., C.S.)
- Rehabilitation Centre, Hochgebirgsklinik, Davos, Switzerland (P.B.)
| | - Sergio Barra
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
- Cardiology Department, Hospital da Luz Arrábida, V. N. Gaia, Portugal (S.B.)
| | - Orianne Weizman
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
| | - Kumar Narayanan
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
- Medicover Hospitals, Hyderabad, India (K.N.)
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., T.M.)
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, Switzerland (P.B., C.S.)
| | - Wulfran Bougouin
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
- Intensive Care Unit, Jacques Cartier Hospital, Massy, France (W.B.)
| | - Xavier Jouven
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
- Division of Cardiology, European Georges Pompidou Hospital, Paris, France (X.J., E.M.)
| | - Eloi Marijon
- Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale U970, Paris Cardiovascular Research Center, France (S.B., O.W., K.N., W.B., X.J., E.M.)
- Division of Cardiology, European Georges Pompidou Hospital, Paris, France (X.J., E.M.)
| |
Collapse
|
2
|
Fuentes Artiles R, Euler S, Auschra B, da Silva HB, Niederseer D, Schmied C, von Känel R, Jellestad L. Predictors of gain in exercise capacity through cardiac rehabilitation: Sex and age matter. Heart Lung 2023; 62:200-206. [PMID: 37562338 DOI: 10.1016/j.hrtlng.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that improves cardiovascular outcomes. However, the determinants of treatment success are poorly understood. OBJECTIVES We investigated the associations of health-related quality of life (HRQoL), sex, age, employment status and housing situation with improvement in exercise capacity throughout CR. METHODS We analyzed data from 392 CR outpatients (81% men and 19% women). Exercise capacity at baseline and upon completion of the program was measured with the 6-minute walk distance (6MWD). HRQoL at CR entry was assessed with the Short Form 36 Health Survey (SF-36). RESULTS A multivariable regression analysis revealed that both men and women showed significant improvement in exercise capacity (p < .001). Female sex (B = 18.118, 95% CI 0.341 - 36.035, p = .046) and younger age (B = -0.887, 95% CI -1.463 - -0.312, p = .003) emerged as predictors of greater improvement, while HRQoL, employment status, and housing situation were not associated with significant change in exercise capacity. The final model explained 25% of the variance in exercise capacity change (adjusted R2 = 0.25, p < .001). CONCLUSIONS Our results indicate that women and younger participants benefit from CR by improving their exercise capacity. Employment status, housing situation and HRQoL showed no effects on CR outcome.
Collapse
Affiliation(s)
- Rubén Fuentes Artiles
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Medicine, Limmattal Hospital, Schlieren, Switzerland.
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hadassa Brito da Silva
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Huwiler S, Carro-Domínguez M, Stich FM, Sala R, Aziri F, Trippel A, Ryf T, Markendorf S, Niederseer D, Bohm P, Stoll G, Laubscher L, Thevan J, Spengler CM, Gawinecka J, Osto E, Huber R, Wenderoth N, Schmied C, Lustenberger C. Auditory stimulation of sleep slow waves enhances left ventricular function in humans. Eur Heart J 2023; 44:4288-4291. [PMID: 37794725 PMCID: PMC10590124 DOI: 10.1093/eurheartj/ehad630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Manuel Carro-Domínguez
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Fabia M Stich
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Rossella Sala
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Florent Aziri
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Anna Trippel
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Tabea Ryf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Susanne Markendorf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Philipp Bohm
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Gloria Stoll
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Lily Laubscher
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Jeivicaa Thevan
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich 8057, Switzerland
| | - Joanna Gawinecka
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Elena Osto
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich 8032, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich 8032, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
| |
Collapse
|
4
|
Carrard J, Angst T, Weber N, Bienvenue J, Infanger D, Streese L, Hinrichs T, Croci I, Schmied C, Gallart-Ayala H, Höchsmann C, Koehler K, Hanssen H, Ivanisevic J, Schmidt-Trucksäss A. Investigating the circulating sphingolipidome response to a single high-intensity interval training session within healthy females and males in their twenties (SphingoHIIT): Protocol for a randomised controlled trial. F1000Res 2023; 11:1565. [PMID: 37533665 PMCID: PMC10390797 DOI: 10.12688/f1000research.128978.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction: Growing scientific evidence indicates that sphingolipids predict cardiometabolic risk, independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, it remains largely unknown if and how exercise, a simple, low-cost, and patient-empowering modality to optimise cardiometabolic health, influences sphingolipid levels. The SphingoHIIT study aims to assess the response of circulating sphingolipid species to a single session of high-intensity interval training (HIIT). Methods: This single-centre randomised controlled trial (RCT) will last 11 days per participant and aim to include 32 young and healthy individuals aged 20-29 (50% females). Participants will be randomly allocated to the HIIT (n= 16) or control groups (physical rest, n= 16). Participants will self-sample fasted dried blood spots for three consecutive days before the intervention (HIIT versus rest) to determine baseline sphingolipid levels. Dried blood spots will also be collected at five time points (2, 15, 30, 60min, and 24h) following the intervention (HIIT versus rest). To minimise the dietary influence, participants will receive a standardised diet for four days, starting 24 hours before the first dried blood sampling. For females, interventions will be timed to fall within the early follicular phase to minimise the menstrual cycle's influence on sphingolipid levels. Finally, physical activity will be monitored for the whole study duration using a wrist accelerometer. Ethics and dissemination: The Ethics Committee of Northwest and Central Switzerland approved this protocol (ID 2022-00513). Findings will be disseminated in scientific journals and meetings. Trial Registration The trial was registered on www.clinicaltrials.gov (NCT05390866, https://clinicaltrials.gov/ct2/show/NCT05390866) on May 25, 2022.
Collapse
Affiliation(s)
- Justin Carrard
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Thomas Angst
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Nadia Weber
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Joëlle Bienvenue
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Denis Infanger
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Lukas Streese
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Timo Hinrichs
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Ilaria Croci
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
- Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian Schmied
- Sports Cardiology Section, Department of Cardiology, University Heart Center Zurich,, University Hospital Zurich, Zurich, 8091, Switzerland
| | - Hector Gallart-Ayala
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Lausanne, 1005, Switzerland
| | - Christoph Höchsmann
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Karsten Koehler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Henner Hanssen
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| | - Julijana Ivanisevic
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Lausanne, 1005, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, 4052, Switzerland
| |
Collapse
|
5
|
Tessitore E, Schmid JP, Hermann M, Schmied C, Wilhelm M, Meyer P. Cardiovascular Rehabilitation Delivery and Outcomes in Switzerland in More Than a Hundred Thousand Patients Over the Last Decade. J Cardiopulm Rehabil Prev 2023; 43:305-307. [PMID: 36857104 PMCID: PMC10287049 DOI: 10.1097/hcr.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Elena Tessitore
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Jean-Paul Schmid
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Matthias Hermann
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Christian Schmied
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Matthias Wilhelm
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| | - Philippe Meyer
- Cardiology Service, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (Drs Tessitore and Meyer); Clinic Gais, Gais, Switzerland (Dr Schmid); Division of Cardiology, University Hospital Zurich, Zurich, Switzerland (Drs Hermann and Schmied); and Department of Cardiology, Cardiovascular Center, University Hospital of Bern, Switzerland (Dr Wilhelm)
| |
Collapse
|
6
|
Schmied C. Körperliche Aktivität/Sport – Auswirkung unterschiedlicher Trainingsformen und -intensitäten auf das Herz. Aktuelle Kardiologie 2023. [DOI: 10.1055/a-2018-3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Zusammenfassung„Das Sport-Paradox“ beschreibt die Ambivalenz zwischen einerseits klar evidenzbasierten gesundheitlichen Vorteilen des regelmäßigen Sporttreibens und andererseits der ebenso unumstrittenen
gesundheitlichen Nachteile, die der Sport mit sich bringen kann.Mindestens 30 Minuten moderate körperliche Belastung (bei Kindern 60 Minuten), an mindesten 5 Tagen pro Woche sind notwendig, um die gesundheitlichen Vorteile zu erreichen. Das
Herz-Kreislaufsystem unterliegt dabei, bei regelmäßigem intensiven, vor allem dynamischem Ausdauertraining physiologischen Adapationen, welche von verschiedenen weiteren Faktoren abhängen.
Während die exzentrische Hypertrophie des linken Ventrikels, in der Regel, reversibel ist, zeigt sich die „right ventricular fatigue“, bei entsprechender genetischer Belastung teilweise
progredient. Dilatation und Fibrosierung der Vorhöfe führen zu einem erhöhten Risiko für ein Vorhofflimmern und auch eine häufig klinisch asymptomatische Dilatation der Aorta oder eine durch
chronischen Stress bedingte Koronarsklerose können potenziell schwerwiegende Folgen mit sich bringen. Umso entscheidender sind individuelle und spezifische Trainingsempfehlungen.
Collapse
|
7
|
Schmied C. [Non-steroidal Anti-inflammatory Drugs and Cardiovascular Risk]. Praxis (Bern 1994) 2023; 112:16-21. [PMID: 36597690 DOI: 10.1024/1661-8157/a003948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Non-steroidal Anti-inflammatory Drugs and Cardiovascular Risk Abstract. Non-steroidal anti-inflammatory drugs (NSAIDs) are amongst the most frequently used drugs worldwide, although medically controlled prescription is missing most of the time. Beside well-known gastro-intestinal and renal side effects, the potentially increased cardiovascular risk under NSAIDs remains underestimated. Nonselective NSAIDs, but also selective COX-2 inhibitors may block and decrease prostacyclin, which itself physiologically would inhibit platelets and promote vasodilation. Furthermore, in selective COX-2 inhibitors a shift towards COX-1 activity may be observed, which further promotes platelet aggregation. Nonselective NSAIDs with a long half-life time are characterized by relatively stable plasma levels and thus a relatively stable platelet inhibition. Non-selective NSAIDs may additionally inhibit acetylsalicylic acid, which negatively affects its effect on platelet inhibition.
Collapse
Affiliation(s)
- Christian Schmied
- Kardiologische Poliklinik, Universitäres Herzzentrum Zürich, Zürich, Schweiz
| |
Collapse
|
8
|
Huwiler S, Huwyler S, Kiener L, Sala R, Schmied C, Huber R, Wenderoth N, Lustenberger C. Effects of auditory sleep modulation approaches on slow waves and autonomic recovery functions. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
9
|
Bohm P, Meyer T, Narayanan K, Schindler M, Weizman O, Beganton F, Schmied C, Bougouin W, Barra S, Dumas F, Varenne O, Cariou A, Karam N, Jouven X, Marijon E. Sports-related sudden cardiac arrest in young adults. Europace 2022; 25:627-633. [PMID: 36256586 PMCID: PMC9935050 DOI: 10.1093/europace/euac172] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/08/2022] [Indexed: 01/14/2023] Open
Abstract
AIMS Data on sports-related sudden cardiac arrest (SrSCA) among young adults in the general population are scarce. We aimed to determine the overall SrSCA incidence, characteristics, and outcomes in young adults. METHODS AND RESULTS Prospective cohort study of all cases of SrSCA between 2012 and 2019 in Germany and Paris area, France, involving subjects aged 18-35 years. Detection of SrSCA was achieved via multiple sources, including emergency medical services (EMS) reporting and web-based screening of media releases. Cases and aetiologies were centrally adjudicated. Overall, a total of 147 SrSCA (mean age 28.1 ± 4.8 years, 95.2% males) occurred, with an overall burden of 4.77 [95% confidence interval (CI) 2.85-6.68] cases per million-year, including 12 (8.2%) cases in young competitive athletes. While bystander cardiopulmonary resuscitation (CPR) was initiated in 114 (82.6%), automated external defibrillator (AED) use by bystanders occurred only in a minority (7.5%). Public AED use prior to EMS arrival (odds ratio 6.25, 95% CI 1.48-43.20, P = 0.02) was the strongest independent predictor of survival at hospital discharge (38.1%). Among cases that benefited from both immediate bystander CPR and AED use, survival rate was 90.9%. Coronary artery disease was the most frequent aetiology (25.8%), mainly through acute coronary syndrome (86.9%). CONCLUSION Sports-related sudden cardiac arrest in the young occurs mainly in recreational male sports participants. Public AED use remains disappointingly low, although survival may reach 90% among those who benefit from both bystander CPR and early defibrillation. Coronary artery disease is the most prevalent cause of SrSCA in young adults.
Collapse
Affiliation(s)
- Philipp Bohm
- Institute of Sports and Preventive Medicine, Saarland University, 66123 Saarbrücken, Germany,Department of Cardiology, University Heart Center Zurich, HerzZentrum Hirslanden Zurich Witellikerstrasse 36, CH-8008 Zurich, Switzerland
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, 66123 Saarbrücken, Germany
| | - Kumar Narayanan
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Cardiology Department, Medicover Hospitals, Madhapur, Hyderabad, Telangana 500081, India
| | - Matthias Schindler
- Department of Cardiology, University Heart Center Zurich, HerzZentrum Hirslanden Zurich Witellikerstrasse 36, CH-8008 Zurich, Switzerland
| | - Orianne Weizman
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Frankie Beganton
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, HerzZentrum Hirslanden Zurich Witellikerstrasse 36, CH-8008 Zurich, Switzerland
| | - Wulfran Bougouin
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Intensive Care Unit, Jacques cartier Hospital, 6 Av. du Noyer Lambert, 91300 Massy, France
| | - Sergio Barra
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Cardiology Department, Hospital da Luz Arrábida, V. N. PCT de Henrique Moreira 150, 4400-346 Vila Nova de Gaia, Portugal
| | - Florence Dumas
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Intensive Care Unit, Jacques cartier Hospital, 6 Av. du Noyer Lambert, 91300 Massy, France,Emergency Department, Cochin Hospital, 25 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Olivier Varenne
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Intensive Care Unit, Jacques cartier Hospital, 6 Av. du Noyer Lambert, 91300 Massy, France,Cardiology Department, Cochin Hospital, 25 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Alain Cariou
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,Intensive Care Unit, Jacques cartier Hospital, 6 Av. du Noyer Lambert, 91300 Massy, France,Intensive Care Unit, Cochin Hospital, 25 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Nicole Karam
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,University of Paris, 103, Boulevard Saint-Michel, Paris, France,Cardiology Department, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Xavier Jouven
- Paris-Sudden Death Expertise Center, INSERM U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France,University of Paris, 103, Boulevard Saint-Michel, Paris, France,Cardiology Department, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Eloi Marijon
- Corresponding author. Tel: +33 6 6283 3848; fax: +33 1 5609 3047. E-mail address:
| |
Collapse
|
10
|
Tessitore E, Schmid JP, Hermann M, Capoferri M, Kiencke S, Schmied C, Tschanz H, Wilhelm M, Meyer P. Cardiovascular rehabilitation delivery and outcomes in Switzerland: data from a national database over the last decade. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac rehabilitation (CR) is a multidisciplinary, comprehensive, exercise-based intervention strongly recommended by current guidelines to improve symptoms and quality of life and to reduce cardiovascular adverse outcomes, mainly in patients with coronary artery disease and heart failure. CR activities have not been reported on a Swiss national base so far.
Purpose
To report CR outcome variables from a Swiss national base.
Methods
As part of the Swiss working group for cardiovascular prevention, rehabilitation, and sports cardiology (SCPRS) quality standards, all Swiss CR centres provide yearly a quality indicator report on an online questionnaire. Annual data from 2010 to 2019 were transferred as medians or means of all individual patients' data from each centre. We used the t-Student test to compare changes of outcome variables between entry and exit of the programme.
Results
A total of 133,060 CR patients were included (68,690 inpatients and 64,370 outpatients) with a progressive increase reaching its climax with 14'909 patients/year in 2018. Mean age ± standard deviation (SD) in outpatient and inpatient programmes was 60±1 and 68±1 years, and women percentage 21% and 32%, respectively. The most common CR indication was acute coronary syndrome (51%) in outpatient, whereas cardiovascular surgery of various types (60%) was the main indication in inpatient programmes. Mean improvement ± SD of functional capacity was 38% ±3.6 using the six-minute walk test in inpatient (p<0.001) and 21% ±2 using cycle-ergometer maximal exercise testing in outpatient programmes (p<0.001). Quality of life mainly assessed with the 12-item Short Form Survey (SF-12) in outpatient CR improved by 13% ±4.5. MacNew Heart questionnaire systematically performed in inpatient programmes showed significant improvement at emotional level by 12% ±0.4, at physical level by 30% ±0.9, and at social level by 18% ±0.6.
Conclusion
Even if still underutilised in certain groups of patients such as women or heart failure, CR has gained growing importance in Switzerland during the last decade. Functional capacity, as well as quality of life, was significantly improved. Individual CR patient data should be collected in the future to improve assessment of outcome parameters and benchmarking of centres.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- E Tessitore
- University Hospital of Geneva, Department of Cardiology , Geneva , Switzerland
| | - J P Schmid
- Clinic Gais, Department of Cardiology , Gais , Switzerland
| | - M Hermann
- University of Zurich, Department of Cardiology , Zurich , Switzerland
| | - M Capoferri
- Cardiocentro Ticino, Department of Cardiology , Lugano , Switzerland
| | - S Kiencke
- Kardiologische Gemeinschaftspraxis , Bern , Switzerland
| | - C Schmied
- University of Zurich, Department of Cardiology , Zurich , Switzerland
| | - H Tschanz
- Berner Reha Zentrum , Heiligenschwendi , Switzerland
| | - M Wilhelm
- University of Bern, Department of Cardiology , Bern , Switzerland
| | - P Meyer
- University Hospital of Geneva, Department of Cardiology , Geneva , Switzerland
| |
Collapse
|
11
|
Huwiler S, Carro Dominguez M, Huwyler S, Kiener L, Stich FM, Sala R, Aziri F, Trippel A, Schmied C, Huber R, Wenderoth N, Lustenberger C. Effects of auditory sleep modulation approaches on brain oscillatory and cardiovascular dynamics. Sleep 2022; 45:6632997. [PMID: 35793672 PMCID: PMC9453626 DOI: 10.1093/sleep/zsac155] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Slow waves, the hallmark feature of deep nonrapid eye movement sleep, do potentially drive restorative effects of sleep on brain and body functions. Sleep modulation techniques to elucidate the functional role of slow waves thus have gained large interest. Auditory slow wave stimulation is a promising tool; however, directly comparing auditory stimulation approaches within a night and analyzing induced dynamic brain and cardiovascular effects are yet missing. Here, we tested various auditory stimulation approaches in a windowed, 10 s ON (stimulations) followed by 10 s OFF (no stimulations), within-night stimulation design and compared them to a SHAM control condition. We report the results of three studies and a total of 51 included nights and found a large and global increase in slow-wave activity (SWA) in the stimulation window compared to SHAM. Furthermore, slow-wave dynamics were most pronouncedly increased at the start of the stimulation and declined across the stimulation window. Beyond the changes in brain oscillations, we observed, for some conditions, a significant increase in the mean interval between two heartbeats within a stimulation window, indicating a slowing of the heart rate, and increased heart rate variability derived parasympathetic activity. Those cardiovascular changes were positively correlated with the change in SWA, and thus, our findings provide insight into the potential of auditory slow wave enhancement to modulate cardiovascular restorative conditions during sleep. However, future studies need to investigate whether the potentially increased restorative capacity through slow-wave enhancements translates into a more rested cardiovascular system on a subsequent day.
Collapse
Affiliation(s)
- Stephanie Huwiler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuel Carro Dominguez
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Silja Huwyler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Luca Kiener
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Fabia M Stich
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Rossella Sala
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Florent Aziri
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Anna Trippel
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicole Wenderoth
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Caroline Lustenberger
- Corresponding author. Caroline Lustenberger, Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Zurich, 8092, Switzerland.
| |
Collapse
|
12
|
Kirchhoff E, Schneider V, Pichler G, Reif P, Haas J, Joksch M, Mager C, Schmied C, Schöll W, Pichler-Stachl E, Gold D. Hexoprenaline Compared with Atosiban as Tocolytic Treatment for Preterm Labor. Geburtshilfe Frauenheilkd 2022; 82:852-858. [PMID: 35967742 PMCID: PMC9365465 DOI: 10.1055/a-1823-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/10/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction
Preterm birth is defined as a live birth before 37 weeks of gestation and is associated with increased neonatal morbidity and mortality. The aim of this study is to
compare the efficacy of hexoprenaline and atosiban for short- and long-term tocolysis and their effects on neonatal and maternal outcomes.
Methods
This retrospective cohort study included women with threatened preterm labor between 24 + 0 and 34 + 0 weeks of gestation without premature rupture of membranes. The
tocolytic efficacy of hexoprenaline and atosiban was compared in women receiving one of the two medications for short- and long-term tocolysis. Continuous variables were compared using
t-test or Mann–Whitney U test, as appropriate. Comparison of categorical variables between the two groups was done with χ
2
test after Pearsonʼs and Fisherʼs exact test.
Results
761 women were enrolled in this study; 387 women received atosiban and 374 women received hexoprenaline as their primary tocolytic agent. Atosiban showed a higher efficacy as
a primary tocolytic agent (p = 0.000) within 48 hours. As regards long-term tocolysis, there were no differences between the treatment groups (p = 0.466). Maternal side effects such as
tachycardia (p = 0.018) or palpitations (p = 0.000) occurred more frequently after the administration of hexoprenaline, while there were no differences between the two drugs administered
with regard to any other maternal or neonatal outcome parameter.
Conclusion
Our retrospective study shows a significantly higher efficacy of atosiban in the first 48 hours, especially when administered at an early gestational age. There were no
significant differences in terms of neonatal outcome but significantly more maternal adverse effects during the administration of hexoprenaline.
Collapse
Affiliation(s)
- Ebba Kirchhoff
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Verena Schneider
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Gerhard Pichler
- 2 Klinische Abteilung für Neonatologie der Med. Universität Graz, Graz, Austria
| | - Philipp Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Josef Haas
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Maike Joksch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Corinna Mager
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Christian Schmied
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Wolfgang Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Elisabeth Pichler-Stachl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Daniela Gold
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| |
Collapse
|
13
|
Dal-Bianco A, Schranzer R, Grabner G, Lanzinger M, Kolbrink S, Pusswald G, Altmann P, Ponleitner M, Weber M, Kornek B, Zebenholzer K, Schmied C, Berger T, Lassmann H, Trattnig S, Hametner S, Leutmezer F, Rommer P. Iron Rims in Patients With Multiple Sclerosis as Neurodegenerative Marker? A 7-Tesla Magnetic Resonance Study. Front Neurol 2022; 12:632749. [PMID: 34992573 PMCID: PMC8724313 DOI: 10.3389/fneur.2021.632749] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system, characterized by inflammatory-driven demyelination. Symptoms in MS manifest as both physical and neuropsychological deficits. With time, inflammation is accompanied by neurodegeneration, indicated by brain volume loss on an MRI. Here, we combined clinical, imaging, and serum biomarkers in patients with iron rim lesions (IRLs), which lead to severe tissue destruction and thus contribute to the accumulation of clinical disability. Objectives: Subcortical atrophy and ventricular enlargement using an automatic segmentation pipeline for 7 Tesla (T) MRI, serum neurofilament light chain (sNfL) levels, and neuropsychological performance in patients with MS with IRLs and non-IRLs were assessed. Methods: In total 29 patients with MS [15 women, 24 relapsing-remitting multiple sclerosis (RRMS), and five secondary-progressive multiple sclerosis (SPMS)] aged 38 (22–69) years with an Expanded Disability Status Score of 2 (0–8) and a disease duration of 11 (5–40) years underwent neurological and neuropsychological examinations. Volumes of lesions, subcortical structures, and lateral ventricles on 7-T MRI (SWI, FLAIR, and MP2RAGE, 3D Segmentation Software) and sNfL concentrations using the Simoa SR-X Analyzer in IRL and non-IRL patients were assessed. Results: (1) Iron rim lesions patients had a higher FLAIR lesion count (p = 0.047). Patients with higher MP2Rage lesion volume exhibited more IRLs (p <0.014) and showed poorer performance in the information processing speed tested within 1 year using the Symbol Digit Modalities Test (SDMT) (p <0.047). (2) Within 3 years, patients showed atrophy of the thalamus (p = 0.021) and putamen (p = 0.043) and enlargement of the lateral ventricles (p = 0.012). At baseline and after 3 years, thalamic volumes were lower in IRLs than in non-IRL patients (p = 0.045). (3) At baseline, IRL patients had higher sNfL concentrations (p = 0.028). Higher sNfL concentrations were associated with poorer SDMT (p = 0.004), regardless of IRL presence. (4) IRL and non-IRL patients showed no significant difference in the neuropsychological performance within 1 year. Conclusions: Compared with non-IRL patients, IRL patients had higher FLAIR lesion counts, smaller thalamic volumes, and higher sNfL concentrations. Our pilot study combines IRL and sNfL, two biomarkers considered indicative for neurodegenerative processes. Our preliminary data underscore the reported destructive nature of IRLs.
Collapse
Affiliation(s)
| | - R Schranzer
- Department of Neurology, Vienna, Austria.,Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria
| | - G Grabner
- Department of Neurology, Vienna, Austria.,Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria
| | | | - S Kolbrink
- Department of Neurology, Vienna, Austria
| | - G Pusswald
- Department of Neurology, Vienna, Austria
| | - P Altmann
- Department of Neurology, Vienna, Austria
| | | | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy, High Field Magnetic Resonance Centre, Vienna, Austria
| | - B Kornek
- Department of Neurology, Vienna, Austria
| | | | - C Schmied
- Department of Neurology, Vienna, Austria
| | - T Berger
- Department of Neurology, Vienna, Austria
| | - H Lassmann
- Department of Neuroimmunology, Center for Brain Research, Vienna, Austria
| | - S Trattnig
- Department of Biomedical Imaging and Image-Guided Therapy, High Field Magnetic Resonance Centre, Vienna, Austria
| | - S Hametner
- Department of Neurology, Vienna, Austria.,Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - P Rommer
- Department of Neurology, Vienna, Austria
| |
Collapse
|
14
|
Albiński M, Saubade M, Menafoglio A, Meyer P, Capelli B, Perrin T, Trachsel L, Hagemeyer D, Casagrande D, Wilhelm M, Benaim C, Pirrello T, Albrecht S, Schmied C, Mivelaz Y, Tercier S, Baggish A, Gabus V. Diagnostic yield and cost analysis of electrocardiographic screening in Swiss paediatric athletes. J Sci Med Sport 2021; 25:281-286. [PMID: 34895837 DOI: 10.1016/j.jsams.2021.11.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Athletes performing sports on high level are at increased risk for sudden cardiac death. This includes paediatric athletes, even though data on screening strategies in this age group remain scarce. This study aimed to assess electrocardiogram interpretation criteria in paediatric athletes and to evaluate the cost of screening. METHODS National, multicentre, retrospective, observational study on 891 athletes of paediatric age (<18 years) evaluated by history, physical examination and 12-lead electrocardiogram. The primary outcome measure was abnormal electrocardiogram findings according to the International Recommendations for Electrographic Interpretation in Athletes. The secondary outcome measure was cost of screening. RESULTS 19 athletes (2.1%) presented abnormal electrocardiogram findings requiring further investigations, mainly abnormal T-wave inversion. These 19 athletes were predominantly males, performing endurance sports with a mean volume of 10 weekly hours for a mean duration of 6 years of training. Further investigations did not identify any relevant pathology. All athletes were cleared for competition with regular follow-up. Total costs of the screening were 108,860 USD (122 USD per athlete). CONCLUSIONS Our study using the International Recommendations for Electrographic Interpretation in Athletes identified a low count of abnormal findings in paediatric athletes, yet raising substantially the cost of screening. Hence, the utility of electrocardiogram-inclusive screening of paediatric athletes remains to be elucidated by longitudinal data.
Collapse
Affiliation(s)
- M Albiński
- Division of Paediatrics, Lausanne University Hospital, Switzerland.
| | - M Saubade
- Centre of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Switzerland; Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland; SportAdo Centre, Department of Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - A Menafoglio
- Department of Cardiology, San Giovanni Hospital Bellinzona, Switzerland
| | - P Meyer
- Service of Cardiology, University Hospital Geneva, Switzerland
| | - B Capelli
- Department of Cardiology, Cardiocentro Ticino, Switzerland
| | - T Perrin
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - L Trachsel
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - D Hagemeyer
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - D Casagrande
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - M Wilhelm
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - C Benaim
- Centre of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Switzerland
| | - T Pirrello
- Swiss Federal Institute of Sports, Switzerland
| | - S Albrecht
- Swiss Federal Institute of Sports, Switzerland
| | - C Schmied
- Department of Cardiology, University Heart Centre Zurich, University of Zurich, Switzerland
| | - Y Mivelaz
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Switzerland
| | - S Tercier
- SportAdo Centre, Department of Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - A Baggish
- Division of Cardiology, Massachusetts General Hospital, United States of America
| | - V Gabus
- Department of Cardiology, Lausanne University Hospital, Switzerland
| |
Collapse
|
15
|
Niederseer D, Walser R, Schmied C, Dela F, Gräni C, Bohm P, Müller E, Niebauer J. Effects of a 12-Week Recreational Skiing Program on Cardio-Pulmonary Fitness in the Elderly: Results from the Salzburg Skiing in the Elderly Study (SASES). Int J Environ Res Public Health 2021; 18:ijerph182111378. [PMID: 34769896 PMCID: PMC8583387 DOI: 10.3390/ijerph182111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate whether recreational alpine skiing in the elderly can improve cardio-pulmonary fitness. DESIGN Randomized controlled study with pre-post repeated measurements. METHODS A total of 48 elderly participants (60-76 years) were randomly assigned to either participate in a 12-week guided recreational skiing program (intervention group, IG, average of 28.5 ± 2.6 skiing days) or to continue a sedentary ski-free lifestyle (control group, CG). Cardio-pulmonary exercise testing (CPET) and pulmonary function testing were performed in both groups before (PRE) and after (POST) the intervention/control period to compare parameters PRE vs. POST CPET. RESULTS At baseline, IG and CG did not differ significantly with respect to CPET and pulmonary function parameters. At POST, several measures of maximal exercise capacity and breathing economy were significantly improved in IG as compared to CG: maximal oxygen capacity (IG: 33.8 ± 7.9; CG: 28.7 ± 5.9 mL/min/kg; p = 0.030), maximal carbon dioxide production (IG: 36.2 ± 7.7; CG: 31.8 ± 6.5 mL/min/kg; p = 0.05), maximal oxygen pulse (IG: 16.8 ± 4.2; CG: 13.2 ± 4 mL/heart beat; p = 0.010), maximal minute ventilation (IG: 96.8 ± 17.8; CG: 81.3 ± 21.9 l/min; p = 0.025), and maximal metabolic equivalent of task (METs, IG: 9.65 ± 2.26; CG: 8.19 ± 1.68 METs; p = 0.029). Except for oxygen pulse, these significant changes could also be observed at the anaerobic threshold. Maximal heart rate and pulmonary function parameters remained essentially unchanged. CONCLUSION Regular recreational skiing improves cardio-pulmonary fitness along with breathing economy and thus can contribute to a heart-healthy lifestyle for the elderly.
Collapse
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.W.); (C.S.); (P.B.)
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;
- Correspondence: ; Tel.: +41-(0)44-253-94-71; Fax: +41-(0)44-255-44-01
| | - Roman Walser
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.W.); (C.S.); (P.B.)
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.W.); (C.S.); (P.B.)
| | - Flemming Dela
- Department of Geriatrics, Bispebjerg-Frederiksberg University Hospital, DK-2400NV Copenhagen, Denmark;
- Xlab, Department of Biomedicine, University of Copenhagen, DK-2200N Copenhagen, Denmark
| | - Christoph Gräni
- Department of Cardiology, Bern University Hospital, 3010 Bern, Switzerland;
| | - Philipp Bohm
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.W.); (C.S.); (P.B.)
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, 5020 Salzburg, Austria;
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;
| |
Collapse
|
16
|
Abstract
Purpose of Review We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. Recent Findings An estimated quarter of the world’s population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual’s eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual’s risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Summary Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.
Collapse
Affiliation(s)
- Victor Schweiger
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christine Attenhofer-Jost
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.,Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| |
Collapse
|
17
|
Carrard J, Gallart-Ayala H, Weber N, Colledge F, Streese L, Hanssen H, Schmied C, Ivanisevic J, Schmidt-Trucksäss A. How Ceramides Orchestrate Cardiometabolic Health-An Ode to Physically Active Living. Metabolites 2021; 11:metabo11100675. [PMID: 34677390 PMCID: PMC8538837 DOI: 10.3390/metabo11100675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 01/02/2023] Open
Abstract
Cardiometabolic diseases (CMD) represent a growing socioeconomic burden and concern for healthcare systems worldwide. Improving patients’ metabolic phenotyping in clinical practice will enable clinicians to better tailor prevention and treatment strategy to individual needs. Recently, elevated levels of specific lipid species, known as ceramides, were shown to predict cardiometabolic outcomes beyond traditional biomarkers such as cholesterol. Preliminary data showed that physical activity, a potent, low-cost, and patient-empowering means to reduce CMD-related burden, influences ceramide levels. While a single bout of physical exercise increases circulating and muscular ceramide levels, regular exercise reduces ceramide content. Additionally, several ceramide species have been reported to be negatively associated with cardiorespiratory fitness, which is a potent health marker reflecting training level. Thus, regular exercise could optimize cardiometabolic health, partly by reversing altered ceramide profiles. This short review provides an overview of ceramide metabolism and its role in cardiometabolic health and diseases, before presenting the effects of exercise on ceramides in humans.
Collapse
Affiliation(s)
- Justin Carrard
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland; (L.S.); (H.H.); (A.S.-T.)
- Correspondence:
| | - Hector Gallart-Ayala
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Quartier UNIL-CHUV, Rue du Bugnon 19, 1005 Lausanne, Switzerland; (H.G.-A.); (J.I.)
| | - Nadia Weber
- Medical School, Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Universitätstrasse 2, 8092 Zurich, Switzerland;
| | - Flora Colledge
- Division of Sports Science, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland;
| | - Lukas Streese
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland; (L.S.); (H.H.); (A.S.-T.)
| | - Henner Hanssen
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland; (L.S.); (H.H.); (A.S.-T.)
| | - Christian Schmied
- Sports Cardiology Section, Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Julijana Ivanisevic
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Quartier UNIL-CHUV, Rue du Bugnon 19, 1005 Lausanne, Switzerland; (H.G.-A.); (J.I.)
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland; (L.S.); (H.H.); (A.S.-T.)
| |
Collapse
|
18
|
Kruzik M, Padrutt M, Stehli J, Brunckhorst C, Schmied C, Niederseer D. Flecainide induced ST segment changes can mimic pathological ECG changes in patients undergoing exercise testing: A case report. Cardiovasc Med 2021. [DOI: 10.4414/cvm.2021.02178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Matthias Kruzik
- Fellow
- Kardiologie
- Rämistrasse 100
- Zürich
- 8006
- SWITZERLAND
- 0796815987
| | | | - Julia Stehli
- Oberärztin für Interventionelle und Strukturelle Kardiologie, Leiterin Interv. F, Interventionelle Kardiologie, Rämistrasse 100, Zürich, 8091, SWITZERLAND
| | | | - Christian Schmied
- Cardiology University Hospital Zurich, Raemistrasse 100, Zürich, 8093, CH
| | - David Niederseer
- University Clinic Zurich, Resident, Clinic of Cardiology, Raemistr. 100, Zurich, 8031, SWITZERLAND
| |
Collapse
|
19
|
Niederseer D, Schmied C. Socioeconomic status matters: How can we individualize cardiac rehabilitation according to different socioeconomic needs? Eur J Prev Cardiol 2021; 28:510-512. [PMID: 32484046 DOI: 10.1177/2047487320931309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, University Hospital Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, University Hospital Zurich, Switzerland
| |
Collapse
|
20
|
Corrado D, van Tintelen PJ, McKenna WJ, Hauer RNW, Anastastakis A, Asimaki A, Basso C, Bauce B, Brunckhorst C, Bucciarelli-Ducci C, Duru F, Elliott P, Hamilton RM, Haugaa KH, James CA, Judge D, Link MS, Marchlinski FE, Mazzanti A, Mestroni L, Pantazis A, Pelliccia A, Marra MP, Pilichou K, Platonov PGA, Protonotarios A, Rampazzo A, Saffitz JE, Saguner AM, Schmied C, Sharma S, Tandri H, Te Riele ASJM, Thiene G, Tsatsopoulou A, Zareba W, Zorzi A, Wichter T, Marcus FI, Calkins H. Arrhythmogenic right ventricular cardiomyopathy: evaluation of the current diagnostic criteria and differential diagnosis. Eur Heart J 2021; 41:1414-1429. [PMID: 31637441 PMCID: PMC7138528 DOI: 10.1093/eurheartj/ehz669] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/04/2019] [Accepted: 09/05/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Peter J van Tintelen
- Department of Clinical Genetics, Academic Medical Center, University of Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.,Department of Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - William J McKenna
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, 7GR5+RW Doha, Qatar.,Institute of Cardiovascular Science, University College London, 62 Huntley St, Fitzrovia, London WC1E 6DD, UK
| | - Richard N W Hauer
- Department of Cardiology, Netherlands Heart Institute, University Medical Center Utrecht, Moreelsepark 1, 3511 EP Utrecht, Netherlands
| | - Aris Anastastakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Leof. Andrea Siggrou 356, Kallithea 176 74, Greece
| | - Angeliki Asimaki
- Molecular and Clinical Sciences Research Institute, St. George's University of London NHS Trust, Cranmer Terrace, London SW17 0RE, UK
| | - Cristina Basso
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Barbara Bauce
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Corinna Brunckhorst
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Chiara Bucciarelli-Ducci
- Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHS Foundation, Trust Headquarters, Marlborough St, Bristol BS1 3NU, UK
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Perry Elliott
- Institute of Cardiovascular Science, University College London, 62 Huntley St, Fitzrovia, London WC1E 6DD, UK
| | - Robert M Hamilton
- The Labatt Family Heart Centre and Division of Cardiology, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, Canada
| | - Kristina H Haugaa
- Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
| | - Cynthia A James
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Daniel Judge
- Department of Medicine, Medical University of South Carolina (MUSC), 30 Courtenay Drive Room 326 Gazes, Charleston, MSC 592, USA
| | - Mark S Link
- Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Francis E Marchlinski
- Cardiac Electrophysiology Program, Cardiovascular Division Hospital of the University of Pennsylvania, 9 Founders Pavilion - Cardiology, 3400 Spruce St., Philadelphia, PA, 19104, USA
| | - Andrea Mazzanti
- Department of Molecular Medicine, University of Pavia, Corso Str. Nuova 25, Pavia, Italy
| | - Luisa Mestroni
- Molecular Genetics, Cardiovascular Institute, University of Colorado, Denver Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Antonis Pantazis
- Inherited Cardiovascular Conditions services, The Royal Brompton and Harefield Hospitals, Sydney St, Chelsea, London SW3 6NP, UK
| | - Antonio Pelliccia
- Department of Cardiology, Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Roma, Italy
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Kalliopi Pilichou
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Pyotr G A Platonov
- Department of Cardiology, Lund University Arrhythmia Clinic, Skåne University Hospital, Entrégatan 7, 222 42 Lund, Sweden
| | - Alexandros Protonotarios
- Inherited Cardiovascular Disease Unit, Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - Alessandra Rampazzo
- Department of Biology, University of Padua, Viale Giuseppe Colombo, 3, 35131 Padova PD, Italy
| | - Jeffry E Saffitz
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Sanjay Sharma
- Cardiology Clinical Academic Group, St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
| | - Hari Tandri
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Anneline S J M Te Riele
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.,Netherlands Heart Institute, Utrecht, Moreelsepark 1, 3511 EP Utrecht, Netherlands
| | - Gaetano Thiene
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | | | - Wojciech Zareba
- Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 150 Lucius Gordon Dr, West Henrietta, NY 14586, USA
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Thomas Wichter
- Heart Center Osnabrück, Bad Rothenfelde Niels-Stensen-Kliniken Marienhospital Osnabrück, Ulmenallee 5 - 11, 49214 Bad Rothenfelde, Germany
| | - Frank I Marcus
- Sarver Heart Center, The University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | | |
Collapse
|
21
|
van Buuren F, Gati S, Sharma S, Papadakis M, Adami PE, Niebauer J, Pelliccia A, Rudolph V, Börjesson M, Carre F, Solberg E, Heidbuchel H, Caselli S, Corrado D, Serratosa L, Biffi A, Pressler A, Schmied C, Panhuyzen-Goedkoop NM, Rasmussen HK, La Gerche A, Faber L, Bogunovic N, D'Ascenzi F, Mellwig KP. Athletes with valvular heart disease and competitive sports: a position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2021; 28:1569-1578. [PMID: 33846742 DOI: 10.1093/eurjpc/zwab058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 12/18/2022]
Abstract
This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precaution to ensure a high level of safety for all affected individuals. Valvular heart disease is usually an age-related degenerative process, predominantly affecting individuals in their fifth decade and onwards. However, there is an increasing group of younger individuals with valvular defects. The diagnosis of cardiac disorders during routine cardiac examination often raises questions about on-going participation in competitive sport with a high dynamic or static component and the level of permissible physical effort during recreational exercise. Although the natural history of several valvular diseases has been reported in the general population, little is known about the potential influence of chronic intensive physical activity on valve function, left ventricular remodelling pulmonary artery pressure, and risk of arrhythmia. Due to the sparsity of data on the effects of exercise on VHD, the present document is largely based on clinical experience and expert opinion.
Collapse
Affiliation(s)
- Frank van Buuren
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.,Catholic Hospital Southwestfalia, St. Martinus Hospital Olpe, Germany
| | - Sabiha Gati
- National Heart and Lung Institute, Imperial College, London, UK.,Department of Cardiology, Royal Brompton Hospital, London, SW3 6NP, UK
| | - Sanjay Sharma
- Cardiovascular Clinical Academic Group, St. George's, University of London, UK
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St. George's, University of London, UK
| | - Paolo Emilio Adami
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Antonio Pelliccia
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Volker Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Mats Börjesson
- Department of Molecular and Clinical Medicine, Institute of Medicine; Center for Health and Performance, Gothenburg University.,Department of Medicine, Sahlgrenzska University Hospital/Östra, Gothenburg, Sweden
| | - Francois Carre
- Sport Medicine Department, Rennes University Hospital, LTSI INSERM UMR 1099, France
| | - Erik Solberg
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Hein Heidbuchel
- Antwerp University and University Hospital, Cardiology, Antwerp, Belgium
| | - Stefano Caselli
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland.,Ospedale San Pietro Fatebenefratelli, Rome, Italy
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padova, Italy
| | - Luis Serratosa
- Hospital Universitario Quironsalud Madrid, Spain.,Ripoll y De Prado Sport Clinic, FIFA Medical Centre of Excellence, Madrid, Spain
| | - Alessandro Biffi
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Axel Pressler
- Centre for General, Sports and Preventive Cardiology, Munich, Germany.,Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Germany
| | - Christian Schmied
- Kardiologisches Ambulatorium, Sportmedizin/Sportkardiologie, University Heart Center, Zurich, Switzerland
| | | | | | | | - Lothar Faber
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Nikola Bogunovic
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Klaus Peter Mellwig
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| |
Collapse
|
22
|
Albiński M, Saubade M, Benaim C, Menafoglio A, Meyer P, Capelli B, Perrin T, Trachsel L, Hagemeyer D, Casagrande D, Wilhelm M, Pirrello T, Albrecht S, Schmied C, Mivelaz Y, Tercier S, Baggish A, Gabus V. Impact of early sports specialisation on paediatric ECG. Scand J Med Sci Sports 2021; 31:1335-1341. [PMID: 33619756 DOI: 10.1111/sms.13942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Abstract
Athletes of pediatric age are growing in number. They are subject to a number of risks, among them sudden cardiac death (SCD). This study aimed to characterize the pediatric athlete population in Switzerland, to evaluate electrocardiographic findings based on the International Criteria for electrocardiography (ECG) Interpretation in Athletes, and to analyze the association between demographic data, sport type, and ECG changes. Retrospective, observational study of pediatric athletes (less than 18 years old) including medical history, physical examination, and a 12-lead resting ECG. The primary focus was on identification of normal, borderline, and abnormal ECG findings. The secondary observation was the relation between ECG and demographic, anthropometric, sport-related, and clinical data. The 891 athletes (mean 14.8 years, 35% girls) practiced 45 different sports on three different levels, representing all types of static and dynamic composition of the Classification of Sports by Mitchell. There were 75.4% of normal ECG findings, among them most commonly early repolarization, sinus bradycardia, and left ventricular hypertrophy; 4.3% had a borderline finding; 2.1% were abnormal and required further investigations, without SCD-related diagnosis. While the normal ECG findings were related to sex, age, and endurance sports, no such observation was found for borderline or abnormal criteria. Our results in an entirely pediatric population of athletes demonstrate that sex, age, and type of sports correlate with normal ECG findings. Abnormal ECG findings in pediatric athletes are rare. The International Criteria for ECG Interpretation in Athletes are appropriate for this age group.
Collapse
Affiliation(s)
- Maciej Albiński
- Department of Woman-Mother-Child, Division of Paediatrics, Lausanne University Hospital, Lausanne, Switzerland
| | - Mathieu Saubade
- Center of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Lausanne, Switzerland.,Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Department of Woman-Mother-Child, Interdisciplinary Division for Adolescent Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Charles Benaim
- Center of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrea Menafoglio
- Department of Cardiology, San Giovanni Hospital Bellinzona, Bellinzona, Switzerland
| | - Philippe Meyer
- Service of Cardiology, University Hospital Geneva, Geneva, Switzerland
| | - Bruno Capelli
- Department of Cardiology, Cardiocentro Ticino, Lugano, Switzerland
| | - Tilman Perrin
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland
| | - Lukas Trachsel
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland
| | - Daniel Hagemeyer
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland
| | - Damien Casagrande
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland
| | - Tony Pirrello
- Swiss Federal Institute of Sports, Magglingen, Switzerland
| | | | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | - Yvan Mivelaz
- Department of Woman-Mother-Child, Paediatric Cardiology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Stéphane Tercier
- Department of Woman-Mother-Child, Interdisciplinary Division for Adolescent Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Aaron Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA
| | - Vincent Gabus
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
23
|
Churchill TW, Petek BJ, Wasfy MM, Guseh JS, Weiner RB, Singh TK, Schmied C, O'Malley H, Chiampas G, Baggish AL. Cardiac Structure and Function in Elite Female and Male Soccer Players. JAMA Cardiol 2021; 6:316-325. [PMID: 33263734 DOI: 10.1001/jamacardio.2020.6088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance Population-specific normative data are essential for the evaluation of competitive athletes. At present, there are limited data defining normal electrocardiographic (ECG) and echocardiographic values among elite US soccer players. Objective To describe ECG and echocardiographic findings in healthy elite US soccer players. Design, Setting, and Participants This cross-sectional study analyzed Fédération Internationale de Football Association-mandated screening sessions performed at US Soccer National Team training locations from January 2015 to December 2019. US women's and men's national team soccer players undergoing mandated cardiovascular screening were included. Main Outcomes and Measures Normal training-related and abnormal ECG findings were reported using the International Recommendations for Electrocardiographic Interpretation in Athletes. Echocardiographic measurements of structural and functional parameters relevant to cardiovascular remodeling were assessed relative to American Society of Echocardiography guideline-defined normal ranges. Results A total of 238 athletes (122 [51%] female; mean [SD] age, 20 [4] years; age range, 15-40 years) were included. Male athletes demonstrated a higher prevalence of normal training-related ECG findings, while female athletes were more likely to have abnormal ECG patterns (14 [11%] vs 0 in male cohort), largely accounted for by abnormal T-wave inversions. Echocardiography revealed no pathologic findings meeting criteria for sport restriction, but athletes frequently exceeded normal ranges for structural cardiac parameters responsive to exercise-induced remodeling including body surface area-indexed left ventricular (LV) mass (58 of 113 female athletes [51%] and 67 of 114 male athletes [59%]), indexed LV volume (89 of 115 female athletes [77%] and 76 of 111 male athletes [68%]), and LV wall thickness (37 of 122 female athletes [30%] and 47 of 116 male athletes [41%]). Age-stratified analysis revealed age-dependent increases in LV wall thickness, mass, and volumes among female athletes and LV wall thickness and mass among male athletes. Conclusions and Relevance These data represent the first set of comprehensive normative values for elite US soccer players and one of the largest sport-specific echocardiographic remodeling studies in female athletes. Abnormal ECG findings were more common in female athletes, while both female and male athletes frequently exceeded clinical normality cut points for remodeling-associated echocardiographic parameters.
Collapse
Affiliation(s)
- Timothy W Churchill
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | - Bradley J Petek
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Meagan M Wasfy
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | - James S Guseh
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Rory B Weiner
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | | | | | | | - George Chiampas
- United States Soccer Federation, Chicago, Illinois.,Feinberg School of Medicine, Department of Emergency Medicine, Northwestern University, Evanston, Illinois
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston.,United States Soccer Federation, Chicago, Illinois
| |
Collapse
|
24
|
Schäfer C, Mayr B, Fernandez La Puente de Battre MD, Reich B, Schmied C, Loidl M, Niederseer D, Niebauer J. Health effects of active commuting to work: The available evidence before GISMO. Scand J Med Sci Sports 2021; 30 Suppl 1:8-14. [PMID: 32297362 PMCID: PMC7540011 DOI: 10.1111/sms.13685] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/27/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
Sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Global guidelines recommend for maintaining health in adults, at least 150 minutes of moderate intensity of physical activity throughout the week, but compliance is insufficient and health problems arise. One obvious way to overcome this is to integrate physical activity into the daily routine for example by active commuting to work. Scientific evidence, however, is scarce and therefore we set out to perform this systematic review of the available literature to improve understanding of the efficiency of active commuting initiatives on health. Literature searches were performed in PubMed and Cochrane database. Altogether, 37 studies were screened. Thereof, eight publications were reviewed, which included 555 participants. The mean study duration of the reviewed research was 36 ± 26 (8-72) weeks. Overall, active commuting in previously untrained subjects of both sexes significantly improved exercise capacity, maximal power, blood pressure, lipid parameters including cholesterol, high-density lipoprotein, and waist circumference. Improvement was independent of the type of active commuting. Despite relatively few studies that were previously performed, this review revealed that active commuting has health beneficial effects comparable to those of moderate exercise training.
Collapse
Affiliation(s)
- Christine Schäfer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Barbara Mayr
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
25
|
Niederseer D, Schmied C. It is not all about mortality. Heart 2021; 107:heartjnl-2020-318918. [PMID: 33436488 DOI: 10.1136/heartjnl-2020-318918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
26
|
Churchill TW, Groezinger E, Kim JH, Loomer G, Guseh JS, Wasfy MM, Isselbacher EM, Lewis GD, Weiner RB, Schmied C, Baggish AL. Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes. JAMA Cardiol 2021; 5:522-531. [PMID: 32101252 DOI: 10.1001/jamacardio.2020.0054] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Aortic dilatation is frequently encountered in clinical practice among aging endurance athletes, but the distribution of aortic sizes in this population is unknown. It is additionally uncertain whether this may represent aortic adaptation to long-term exercise, similar to the well-established process of ventricular remodeling. Objective To assess the prevalence of aortic dilatation among long-term masters-level male and female athletes with about 2 decades of exercise exposure. Design, Setting, and Participants This cross-sectional study evaluated aortic size in veteran endurance athletes. Masters-level rowers and runners aged 50 to 75 years were enrolled from competitive athletic events across the United States from February to October 2018. Analysis began January 2019. Exposures Long-term endurance exercise. Main Outcomes and Measures The primary outcome was aortic size at the sinuses of Valsalva and the ascending aorta, measured using transthoracic echocardiography in accordance with contemporary guidelines. Aortic dimensions were compared with age, sex, and body size-adjusted predictions from published nomograms, and z scores were calculated where applicable. Results Among 442 athletes (mean [SD] age, 61 [6] years; 267 men [60%]; 228 rowers [52%]; 214 runners [48%]), clinically relevant aortic dilatation, defined by a diameter at sinuses of Valsalva or ascending aorta of 40 mm or larger, was found in 21% (n = 94) of all participants (83 men [31%] and 11 women [6%]). When compared with published nomograms, the distribution of measured aortic size displayed a rightward shift with a rightward tail (all P < .001). Overall, 105 individuals (24%) had at least 1 z score of 2 or more, indicating an aortic measurement greater than 2 SDs above the population mean. In multivariate models adjusting for age, sex, body size, hypertension, and statin use, both elite competitor status (rowing participation in world championships or Olympics or marathon time under 2 hours and 45 minutes) and sport type (rowing) were independently associated with aortic size. Conclusions and Relevance Clinically relevant aortic dilatation is common among aging endurance athletes, raising the possibility of vascular remodeling in response to long-term exercise. Longitudinal follow-up is warranted to establish corollary clinical outcomes in this population.
Collapse
Affiliation(s)
- Timothy W Churchill
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | - Erich Groezinger
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Jonathan H Kim
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia
| | - Garrett Loomer
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - J Sawalla Guseh
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Meagan M Wasfy
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | - Eric M Isselbacher
- Echocardiography Laboratory, Massachusetts General Hospital, Boston.,Thoracic Aortic Center, Massachusetts General Hospital, Boston
| | - Gregory D Lewis
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Rory B Weiner
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| | | | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston.,Echocardiography Laboratory, Massachusetts General Hospital, Boston
| |
Collapse
|
27
|
Niederseer D, Rossi VA, Kissel C, Scherr J, Caselli S, Tanner FC, Bohm P, Schmied C. Role of echocardiography in screening and evaluation of athletes. Heart 2020; 107:heartjnl-2020-317996. [PMID: 33203709 DOI: 10.1136/heartjnl-2020-317996] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022] Open
Abstract
The term athlete's heart describes structural, functional and electrical adaptations of the cardiovascular system due to repetitive intense exercise. Physiological cardiac adaptations in athletes, however, may mimic features of cardiac diseases and therefore make it difficult to distinguish physiological adaptions from disease. Furthermore, regular exercise may also lead to pathological adaptions that can promote or worsen cardiac disease (eg, atrial dilation/atrial fibrillation, aortic dilation/aortic dissection and rhythm disorders). Sudden cardiac death (SCD) is a major concern in sports cardiology, and preparticipation screening (PPS) has demonstrated to be effective in identifying athletes at risk for SCD. In Europe, PPS is advocated to include personal and family history, physical examination and ECG, with further workup including echocardiography only if the initial screening investigations show abnormal findings. We review the current available evidence for echocardiography as a screening tool for conditions associated with SCD in recreational and professional athletes and advocate to include screening echocardiography to be performed at least twice in an athlete's career. We recommend that the first echocardiography is performed during adolescence to rule out structural heart conditions associated with SCD that cannot be detected by ECG, especially mitral valve prolapse, coronary artery anomalies, bicuspid aortic valve and dilatation of the aorta. A second echocardiography could be performed from the age of 30-35 years, when athletes age and become master athletes, to especially evaluate pathological cardiac remodelling to exercise (eg, atrial and/or right ventricular dilation), late onset cardiomyopathies and wall motion abnormalities due to myocarditis or coronary artery disease.
Collapse
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Valentina Alice Rossi
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christine Kissel
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Johannes Scherr
- University Center for Prevention and Sports Medicine, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden, Klinik im Park, Zurich, Switzerland
| | - Felix C Tanner
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp Bohm
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
28
|
Corrado D, Perazzolo Marra M, Zorzi A, Beffagna G, Cipriani A, Lazzari MD, Migliore F, Pilichou K, Rampazzo A, Rigato I, Rizzo S, Thiene G, Anastasakis A, Asimaki A, Bucciarelli-Ducci C, Haugaa KH, Marchlinski FE, Mazzanti A, McKenna WJ, Pantazis A, Pelliccia A, Schmied C, Sharma S, Wichter T, Bauce B, Basso C. Diagnosis of arrhythmogenic cardiomyopathy: The Padua criteria. Int J Cardiol 2020; 319:106-114. [DOI: 10.1016/j.ijcard.2020.06.005] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
|
29
|
Bhatia RT, Marwaha S, Malhotra A, Iqbal Z, Hughes C, Börjesson M, Niebauer J, Pelliccia A, Schmied C, Serratosa L, Papadakis M, Sharma S. Exercise in the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) era: A Question and Answer session with the experts Endorsed by the section of Sports Cardiology & Exercise of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol 2020; 27:1242-1251. [PMID: 32475157 PMCID: PMC7717284 DOI: 10.1177/2047487320930596] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Abstract
Regular exercise has multiple benefits for physical and mental health, including the body's ability to combat infections. The current COVID-19 pandemic and the social distancing measures employed to curtail the impact of the infection are likely to reduce the amount of usual physical activity being performed by most individuals, including habitual exercisers. The uncertainties relating to the impact of the SARS-CoV-2 virus on the heart may cause increased anxiety, particularly in athletes who need to sustain a vigorous exercise regime in order to maintain their skills and fitness in preparation for return to competition after a short re-training period. The aim of this document is to provide practical answers to pertinent questions being posed by the sporting community, in an attempt to offer reassurance, promote safe participation in exercise during as well as after the COVID-19 pandemic and provide a framework of management for physicians caring for athletes.
Collapse
Affiliation(s)
- Raghav T Bhatia
- />Cardiology Clinical Academic Group, St George’s, University of London, UK
| | - Sarandeep Marwaha
- />Cardiology Clinical Academic Group, St George’s, University of London, UK
| | - Aneil Malhotra
- />Division of Cardiovascular Science, University of Manchester, Manchester University NHS Foundation Trust, UK
| | - Zafar Iqbal
- />Department of Sports Medicine, Crystal Palace FC, London, UK
| | | | - Mats Börjesson
- />Department of Molecular and Clinical Medicine Institute of Medicine, Centre for Health and Performance, Gothenburg University and Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden
| | - Josef Niebauer
- />Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | | | | | - Luis Serratosa
- />Hospital Universitario Quironsalud Madrid, Spain *These authors contributed jointly as senior authors
| | - Michael Papadakis
- />Cardiology Clinical Academic Group, St George’s, University of London, UK
| | - Sanjay Sharma
- />Cardiology Clinical Academic Group, St George’s, University of London, UK
| |
Collapse
|
30
|
D'Ascenzi F, Anselmi F, Mondillo S, Finocchiaro G, Caselli S, Garza MSDL, Schmied C, Adami PE, Galderisi M, Adler Y, Pantazis A, Niebauer J, Heidbuchel H, Papadakis M, Dendale P. The use of cardiac imaging in the evaluation of athletes in the clinical practice: A survey by the Sports Cardiology and Exercise Section of the European Association of Preventive Cardiology and University of Siena, in collaboration with the European Association of Cardiovascular Imaging, the European Heart Rhythm Association and the ESC Working Group on Myocardial and Pericardial Diseases. Eur J Prev Cardiol 2020; 28:1071-1077. [PMID: 32529943 DOI: 10.1177/2047487320932018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022]
Abstract
AIMS Pre-participation evaluation (PPE) is recommended to prevent sudden cardiac death in athletes. Although imaging is not advocated as a first-line screening tool, there is a growing interest in the use of echocardiography in PPE of athletes. This survey aimed to map the use of imaging in the setting of PPE and explore physician beliefs and potential barriers that may influence individual practices. METHODS An international survey of healthcare professionals was performed across ESC Member Countries. Percentages were reported based on the number of respondents per question. RESULTS In total, 603 individuals from 97 countries participated in the survey. Two-thirds (65%) of respondents use echocardiography always or often as part of PPE of competitive athletes and this practice is not influenced by the professional or amateur status of the athlete. The majority (81%) of respondents who use echocardiography as a first-line screening tool perform the first echocardiogram during adolescence or at the first clinical evaluation, and 72% repeat it at least once in the athletes' career, at 1-5 yearly intervals. In contrast, cardiac magnetic resonance is reserved as a second-line investigation of symptomatic athletes. The majority of the respondents did not report any barriers to echocardiography, while several barriers were identified for cardiac magnetic resonance. CONCLUSIONS Echocardiography is frequently used as a first-line screening tool of athletes. In the absence of scientific evidence, before such practice is recommended, large studies using echocardiography in the PPE setting are necessary.
Collapse
Affiliation(s)
- Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Francesca Anselmi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | | | - Stefano Caselli
- Cardiovascular Centre Zürich, Hirslanden Klinik im Park, Zürich, Switzerland
| | | | - Christian Schmied
- Department of Cardiology, University Heart Centre Zurich, University of Zurich, Switzerland
| | - Paolo Emilio Adami
- Health and Science Department, International Association of Athletics Federation - IAAF, Monaco, France
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Yehuda Adler
- College of Law and Business, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel.,Mayanei Hayeshua Medical Center, Bnei Brak, Israel
| | | | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp, and Antwerp University, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Michael Papadakis
- Cardiology Clinical Academic Group, St George's University of London, UK
| | - Paul Dendale
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
31
|
Patriki D, Baltensperger N, Berg J, Cooper LT, Kissel CK, Kottwitz J, Lovrinovic M, Manka R, Scherff F, Schmied C, Tanner FC, Luescher TF, Heidecker B. A Prospective Pilot Study to Identify a Myocarditis Cohort who may Safely Resume Sports Activities 3 Months after Diagnosis. J Cardiovasc Transl Res 2020; 14:670-673. [PMID: 32367345 PMCID: PMC8397673 DOI: 10.1007/s12265-020-09983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
International cardiovascular society recommendations to return to sports activities following acute myocarditis are based on expert consensus in the absence of prospective studies. We prospectively enrolled 30 patients with newly diagnosed myocarditis based on clinical parameters, laboratory measurements and cardiac magnetic resonance imaging with mildly reduced or preserved left ventricular ejection fraction (LVEF) with a follow-up of 12 months. Cessation of physical activity was recommended for 3 months. The average age was 35 (19-80) years with 73% male patients. One case of non-sustained ventricular tachycardia was recorded during 48-h-Holter electrocardiogram. Except for this case, all patients were allowed to resume physical exercise after 3 months. At 6- (n = 26) and 12-month (n = 19) follow-up neither cardiac events nor worsening LVEF were recorded. The risk of cardiac events at 1 year after diagnosis of myocarditis appears to be low after resumption of exercise after 3 months among patients who recover from acute myocarditis.
Collapse
Affiliation(s)
- D Patriki
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - J Berg
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - C K Kissel
- Cardiology, University Heart Center, Zurich, Switzerland
| | - J Kottwitz
- Cardiology, University Heart Center, Zurich, Switzerland
| | - M Lovrinovic
- Cardiology, University Heart Center, Zurich, Switzerland
| | - R Manka
- Cardiology, University Heart Center, Zurich, Switzerland
| | - F Scherff
- Cardiology, University Heart Center, Zurich, Switzerland
| | - C Schmied
- Cardiology, University Heart Center, Zurich, Switzerland
| | - F C Tanner
- Cardiology, University Heart Center, Zurich, Switzerland
| | - T F Luescher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,Imperial College and Royal Brompton & Harefield Hospital, London, UK
| | - Bettina Heidecker
- Cardiology, University Heart Center, Zurich, Switzerland. .,Charite Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany, Hindenburgdamm 30, 12203, Berlin, Germany.
| |
Collapse
|
32
|
Reich B, Niederseer D, Loidl M, Fernandez La Puente de Battre MD, Rossi VA, Zagel B, Caselli S, Schmied C, Niebauer J. Effects of active commuting on cardiovascular risk factors: GISMO-a randomized controlled feasibility study. Scand J Med Sci Sports 2020; 30 Suppl 1:15-23. [PMID: 32335963 PMCID: PMC7496369 DOI: 10.1111/sms.13697] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
A sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Lifestyle modification in order to increase exercise capacity is key in the prevention and rehabilitation of chronic diseases. This could be achieved by active commute. The aim of this study was to assess the effects of daily active commuting on physical activity (PA) and exercise capacity. Seventy‐three healthy hospital employees (age: 46 ± 9 years, 38% male), with a predominantly passive way of commuting, were randomly assigned to two parallel groups, a control group (CG, N = 22) or an intervention group (IG, N = 51), which was further split into public transportation/active commuting (IG‐PT, N = 25) and cycling (IG‐C, N = 26). Both intervention groups were asked to reach 150 min/wk of moderate‐ to vigorous‐intensity exercise during their commute for 1 year. CG maintained a passive commuting mode. All participants underwent assessment of anthropometry, risk factor stratification, and exercise capacity by a medical doctor at the Institute of Sports Medicine, Prevention and Rehabilitation. Weekly physical activity, using the International Physical Activity Questionnaire and commuting behavior, using an online diary, were used to assess physical activity. At the end of the study, the change in exercise capacity did significantly differ between IG and CG (P = .003, ES = 0.82). Actively covered distances through commuting significantly differed between groups (walking P = .026; cycling P < .001). Therefore, active commuting improves exercise capacity and can be recommended to the working population to increase exercise capacity.
Collapse
Affiliation(s)
- Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Valentina Alice Rossi
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Bernhard Zagel
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Stefano Caselli
- Cardiovascular Center Zürich, Hirslanden Klinik im Park, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
33
|
Sareban M, Fernandez La Puente de Battre MD, Reich B, Schmied C, Loidl M, Niederseer D, Niebauer J. Effects of active commuting to work for 12 months on cardiovascular risk factors and body composition. Scand J Med Sci Sports 2020; 30 Suppl 1:24-30. [PMID: 32333707 PMCID: PMC7496505 DOI: 10.1111/sms.13695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
Active commuting has the potential to decrease cardiovascular risk by increasing physical activity. We aimed to investigate the effects of active commuting to work for 12 months on body composition and cardiovascular risk factors. Therefore, 73 hospital employees (age: 46 ± 9 years, 36% males), with a predominantly passive way of commuting, were randomly assigned to an intervention group (IG) and a control group (CG) in a 2:1 fashion. The IG was further divided into a public transportation plus active commuting group (IG‐PT) and a cycling group (IG‐C). Both IGs were prompted to reach 150 min/wk of moderate intensity exercise. Daily self‐reported commuting details were verified by GPS tracking. All subjects underwent assessment of body composition, resting blood pressure, glycemic control, and lipid profile at the beginning and end of the study. Data for final analyses were available in 62 subjects. Commuting details indicated that the subjects randomized to IG changed their commuting habits. HbA1c decreased by 0.2% [95%CI: −0.3, −0.2] in IG‐PT but was not statistically different between groups (P = .06). LDL cholesterol decreased in IG‐C by 0.8 mmol/L [−1.1, −0.4] and by 0.6 mmol/L [−1.2, 0.1] in IG‐PT which can be considered biologically relevant but did not yield statistical significance. Body composition and blood pressure did not differ between groups. Active commuting to work for 12 months did not change body composition but yielded relevant changes in lipid profile and glycemic control. Health benefits of active commuting should be addressed by healthcare professionals when counseling individuals that seek to improve their cardiovascular risk profile.
Collapse
Affiliation(s)
- Mahdi Sareban
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zürich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zürich, Zürich, Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
34
|
Fernandez La Puente de Battre MD, Neumeier LM, Ensslin C, Loidl M, Gräni C, Schmied C, Reich B, Niebauer J, Niederseer D. What it takes to recruit 77 subjects for a one-year study on active commuting. Scand J Med Sci Sports 2020; 30:1090-1095. [PMID: 32285530 DOI: 10.1111/sms.13682] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Luis Moritz Neumeier
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Caroline Ensslin
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Bernhard Reich
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| |
Collapse
|
35
|
Neumeier LM, Loidl M, Reich B, Fernandez La Puente de Battre MD, Kissel CK, Templin C, Schmied C, Niebauer J, Niederseer D. Effects of active commuting on health-related quality of life and sickness-related absence. Scand J Med Sci Sports 2020; 30 Suppl 1:31-40. [PMID: 32246792 DOI: 10.1111/sms.13667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/19/2020] [Accepted: 03/24/2020] [Indexed: 01/19/2023]
Abstract
Increased physical activity is associated with numerous health benefits. This study investigated the effect of active commuting (walking and cycling to work) on health-related quality of life (HRQoL) and absence days from work due to sickness in healthy working adults. In total, 73 participants (age: 46 ± 9 years), all working at a tertiary university hospital in Salzburg, Austria, were randomized into an intervention group (IG, n = 51) and a control group (CG, n = 22). The IG was asked to commute actively for twelve months, whereas the CG did not have to change their usual commuting behavior. IG was divided into two subgroups: IG-C (cycling, n = 26) was asked to commute by bicycle and IG-PT (public transport, n = 25) partially using public transportation and walked the remaining distance to work. Significant positive changes in IG were observed in four subcomponents of the SF-36 (physical functioning (95 [10] to 100 [8.8], P = .023), mental health (82 [15] to 86 [15], P = .036), vitality (65 [20] to 70 [14], P = .005), and general health (70 [19] to 80 [24], P = .004)) as well as the physical component summary score (56.5 [9] to 59.2 [6.3], P = .002). IG-C showed greater and more statistically significant changes regarding HRQoL compared to IG-PT. Associations between active commuting and sick-leave days were only observed in IG-PT (7.5 [14.8] to 4.0 [11.3] days, P = .038). In conclusion, active commuting improves various components of HRQoL and might therefore be a possible strategy to increase quality of life in the workforce.
Collapse
Affiliation(s)
- Luis M Neumeier
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics-Z_GIS, University of Salzburg, Salzburg, Austria
| | - Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christine K Kissel
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Christian Templin
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| |
Collapse
|
36
|
Loidl M, Stutz P, Fernandez Lapuente de Battre MD, Schmied C, Reich B, Bohm P, Sedlacek N, Niebauer J, Niederseer D. Merging self-reported with technically sensed data for tracking mobility behavior in a naturalistic intervention study. Insights from the GISMO study. Scand J Med Sci Sports 2020; 30 Suppl 1:41-49. [PMID: 32034943 PMCID: PMC7496425 DOI: 10.1111/sms.13636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 11/27/2022]
Abstract
Sound exposure data are central for any intervention study. In the case of utilitarian mobility, where studies cannot be conducted in controlled environments, exposure data are commonly self‐reported. For short‐term intervention studies, wearable devices with location sensors are increasingly employed. We aimed to combine self‐reported and technically sensed mobility data, in order to provide more accurate and reliable exposure data for GISMO, a long‐term intervention study. Through spatio‐temporal data matching procedures, we are able to determine the amount of mobility for all modes at the best possible accuracy level. Self‐reported data deviate ±10% from the corrected reference. Derived modal split statistics prove high compliance to the respective recommendations for the control group (CG) and the two intervention groups (IG‐PT, IG‐C). About 73.7% of total mileage was travelled by car in CG. This share was 10.3% (IG‐PT) and 9.7% (IG‐C), respectively, in the intervention groups. Commuting distances were comparable in CG and IG, but annual mean travel times differ between
x¯
= 8,458 min (σ = 6,427 min) for IG‐PT,
x¯
= 8,444 min (σ = 5,961 min) for IG‐C, and
x¯
= 5,223 min (σ = 5,463 min) for CG. Seasonal variabilities of modal split statistics were observable. However, in IG‐PT and IG‐C no shift toward the car occurred during winter months. Although no perfect single‐method solution for acquiring exposure data in mobility‐related, naturalistic intervention studies exists, we achieved substantially improved results by combining two data sources, based on spatio‐temporal matching procedures.
Collapse
Affiliation(s)
- Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Petra Stutz
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Maria Dolores Fernandez Lapuente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Philipp Bohm
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | | | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
37
|
Schmied C, Loidl M, Rossi V, Fernandez La Puente de Battre MD, Reich B, Niebauer J, Niederseer D. Dose-response relationship of active commuting to work: Results of the GISMO study. Scand J Med Sci Sports 2020; 30 Suppl 1:50-58. [PMID: 32003063 DOI: 10.1111/sms.13631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 12/24/2022]
Abstract
The positive health benefits of regular exercise, particularly regarding cardiovascular risk and diseases, are well recognized and scientifically evident. However, a sedentary lifestyle is one of the most important cardiovascular risk factors that are still insufficiently addressed. Leisure-time active commuting like walking and biking is an ideal way to improve exercise behavior in the general population. The purpose of this substudy of the GISMO study was to assess dose-response relations in all commuters and the three subgroups of commuters (physically active by bicycle and/or walking, physically active by using public transportation (PT), and the controls using their own vehicles). As such, a positive dose-response relationship could be confirmed in all physically active commuters compared to the control group. Whether the commuters cycled, walked, or traveled by PT -the more the physical exercise they performed (measured in metabolic equivalent [MET]-hours), the larger their gain in physical fitness (measured in gained or "Delta" Watt during a maximal exercise test), and their physical fitness at the end of the study was P = .016 and P = .003, respectively. Health-related quality of life correlated in two out of eight subdomains of the SF-36 questionnaire with MET-hours achieved during the study period (General Health and Physical Functioning). No clearly significant dose-response could be observed regarding HDL(high-density lipoprotein)-cholesterol or body composition. Our results indicate a dose-response pattern of healthy commuting in exercise capacity and health-related quality of life to increase doses of physically active commuting.
Collapse
Affiliation(s)
- Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Valentina Rossi
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| |
Collapse
|
38
|
Pelliccia A, Caselli S, Sharma S, Basso C, Bax JJ, Corrado D, D'Andrea A, D'Ascenzi F, Di Paolo FM, Edvardsen T, Gati S, Galderisi M, Heidbuchel H, Nchimi A, Nieman K, Papadakis M, Pisicchio C, Schmied C, Popescu BA, Habib G, Grobbee D, Lancellotti P. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur Heart J 2019; 39:1949-1969. [PMID: 29029207 DOI: 10.1093/eurheartj/ehx532] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/23/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Antonio Pelliccia
- Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Rome, Italy
| | - Stefano Caselli
- Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Rome, Italy
| | | | - Cristina Basso
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Jeroen J Bax
- Departmentt of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Antonello D'Andrea
- Department of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Fernando M Di Paolo
- Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Rome, Italy
| | - Thor Edvardsen
- Department of Cardiology, Center of Cardiologic Innovation, Oslo University Hospital, University of Oslo, Oslo, Norway
| | | | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Hein Heidbuchel
- Jessa Hospital, Hasselt University and Heart Center Hasselt, Hasselt, Belgium
| | | | - Koen Nieman
- Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Cataldo Pisicchio
- Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Rome, Italy
| | | | - Bogdan A Popescu
- Institute of Cardiovascular Diseases, University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania
| | - Gilbert Habib
- Department of Cardiology, Hôpital La Timone, Marseille, France
| | - Diederick Grobbee
- Department of Epidemiology, University Medical Center, Utrecht, The Netherlands
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Valvular Disease Clinic, Belgium
| | | |
Collapse
|
39
|
Ulrich D, Schneider V, Pichler G, Haas J, Culea V, Joksch M, Mager C, Schmied C, Lakovschek IC, Lang U, Reif P. Neonatal Outcome After Hexoprenaline Compared with Atosiban After Preterm Premature Rupture of Membranes. J Fetal Med 2019. [DOI: 10.1007/s40556-019-00225-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractPreterm premature rupture of membranes (PPROM) occurs in up to 3% of all pregnancies. Only few comparative studies have investigated potential risks and benefits between different tocolytic substances in women with PPROM. The aim of this study was to compare the neonatal short term outcome after tocolysis with Atosiban or Hexoprenaline in women with PPROM. This is a retrospective observational cohort study of women with PPROM between 24 and 32 weeks of gestation comparing neonatal and maternal outcome after tocolysis with atosiban or hexoprenaline. Outcome parameters were short term neonatal outcome, maternal tocolytic efficacy, effectiveness and tolerability and neonatal neurodevelopmental long-term outcome. Continuous variables were compared using t-Test or Mann–Whitney U test, as appropriate. For categorical variables Chi-square after Pearson and Fisher exact-test were used to compare the two groups. 93 women were included into this study with 42 women receiving hexoprenaline and 51 women receiving atosiban as primary tocolytic treatment. Mean gestational age was 29 weeks in both groups at the time PPROM. No differences were found for any short term neonatal outcome parameters, tocolytic efficacy, effectiveness and tolerability and neonatal neurodevelopmental long-term outcome. Both hexoprenaline and atosiban do not affect the short and long term neonatal outcome in women with PPROM for the time of lung maturation.
Collapse
|
40
|
Patriki D, Baltensperger N, Cooper LT, Kissel CK, Kottwitz J, Lovrinovic M, Manka R, Scherff F, Schmied C, Tanner FC, Luescher TF, Heidecker B. P5276A prospective pilot study to identify a myocarditis cohort who may safely resume sports activities 3 months after diagnosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sports activities may promote arrhythmias in the setting of acute myocarditis. International cardiovascular society recommendations to return to sports activities following acute myocarditis are based on expert consensus in the absence of prospective studies.
Purpose
We sought to identify patients who may safely resume sports activities 3 months after acute myocarditis.
Methods
We prospectively enrolled 27 patients with newly diagnosed myocarditis based on clinical parameters, elevated high sensitive troponin (TnT-hs) and cardiac magnetic resonance imaging (CMR) with mildly reduced or preserved LVEF. Follow-up examination included laboratory findings, electrocardiogram (ECG), 48-hour-Holter ECG, echocardiography, exercise stress testing and CMR. Cessation of physical activity was recommended for 3 months. All patients were followed for cardiac events for 12 months.
Results
Average age was 35 (19–80) years with 73% male patients. All patients performed 3- and 6-month follow-up with above mentioned diagnostic tests. Eight patients did not present for 12-month follow-up, but were contacted by phone. No cardiac events occurred within the interval of 12 months.
After 3 months, participants achieved an average of 92% of predicted maximum power on stress test. One case of non-sustained ventricular tachycardia was recorded during 48-hour-Holter ECG. Except for this case, all patients were allowed to resume physical exercise after 3 months. At 6- (n=26) and 12-month (n=19) follow-up no arrhythmias, recurrent myocarditis, worsening left ventricular ejection fraction (LVEF) or physical performance were recorded. TnT-hs, creatine kinase (CK), myoglobin (Mb), and C-reactive protein (CRP) normalized.
Conclusion
The risk of cardiac events and decreasing LVEF appears to be low after early resumption of exercise in asymptomatic patients who recover from acute myocarditis.
Acknowledgement/Funding
Forschungskredit of the University of Zurich,the Holcim Foundation, the Hartmann Müller Foundation, and the Walter and Gertrud Siegenthaler Foundation
Collapse
Affiliation(s)
- D Patriki
- University Hospital Zurich, Zurich, Switzerland
| | | | - L T Cooper
- Mayo Clinic, Jacksonville, United States of America
| | - C K Kissel
- University Hospital Zurich, Zurich, Switzerland
| | - J Kottwitz
- University Hospital Zurich, Zurich, Switzerland
| | | | - R Manka
- University Hospital Zurich, Zurich, Switzerland
| | - F Scherff
- University Hospital Zurich, Zurich, Switzerland
| | - C Schmied
- University Hospital Zurich, Zurich, Switzerland
| | - F C Tanner
- University Hospital Zurich, Zurich, Switzerland
| | | | - B Heidecker
- Charite - Campus Benjamin Franklin, Berlin, Germany
| |
Collapse
|
41
|
Schmied C, Nietlispach V, Zerguini Y, Niederseer D, Di Paolo F, Pelliccia A. P306Echocardiographic criteria of left ventricular non-compaction cardiomyopathy in black athletes from homogenous ethnic descent. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
To prevent sudden cardiac death in sports, pre-competition medical assessment aims to detect underlying cardiac diseases as electrical disorders or cardiomyopathies. Due to a large diagnostic grey-zone, Left Ventricular Non-Compaction Cardiomyopathy (LVNC) is an entity quite challenging to diagnose, particularly in athletes from Afro-Caribbean descent.
Purpose
The aim of the study was to assess the currently established echocardiographic diagnostic criteria for LVNC in a cohort of adolescent African football players of relatively homogenous ethnic descent.
Methods
The study took place in the West-African sub-Saharan country of Gabon were the ethnic background of its population is relatively homogenous. The competitive football players underwent cardiac screening, including personal and family history, physical examination, 12-lead resting ECG and transthoracic echocardiography, that particularly assessed the three currently established diagnostic echocardiographic criteria to diagnose LVNC (Jenni-, Chin- and Stöllberger-Criteria).
Results
The mean age of the 210 male athletes was 18.6 years (range 18–22). Family history revealed sudden or unexplained death in 17%. Most of the cases concerned athletes without an echocardiographic LVNC pattern. Clearly suspicious ECG findings were unexpectedly rare, with T-wave inversions in 7 athletes (3.3%) and ST-segment depression in 1 athlete (0.5%). All ECG changes but two were seen in athletes with positive echocardiographic criteria for LVNC. The number of athletes exhibiting at least one of the established echocardiographic criteria for LVNC was very high (n=83, 39.5%). All of these 83 athletes were positive for the Chin criteria (100%), while 41 athletes showed positive criteria for Stöllberger (49.3%, 19.5% overall) and 21 for Jenni (25.3%, 4.8% overall) criteria. In not less than 17 athletes all three currently established diagnostic criteria were positive (20.5%, 8.1% overall). The LV systolic function was normal in all athletes.
Conclusions
In adolescent African football players from relatively homogenous ethnic background, the prevalence of positive echocardiographic diagnostic criteria for LVNC is unexpectedly high. Almost 40% of the athletes fulfill at least one of the established diagnostic criteria. Thus, these established criteria should not be used routinely for a population of black athletes. The estimation, which of the three diagnostic sets may be the most accurate is not conclusive, however, it is remarkable that the “Chin” criteria were positive in all players with LVNC pattern, while the “Jenni” criteria were positive in only 25%. In 8.1% of the overall cohort all three diagnostic criteria were positive, making these athletes most likely to have the definite diagnosis. At a nine year follow-up there were no adverse or fatal events reported. More studies, which should integrate cardiac MRI, are needed to improve diagnostic accuracy of these morphologic findings.
Collapse
Affiliation(s)
- C Schmied
- University Heart Center, Cardiology, Zurich, Switzerland
| | - V Nietlispach
- University Heart Center, Cardiology, Zurich, Switzerland
| | - Y Zerguini
- Clinique Chahrazed, Cheraga, Algiers, Algeria
| | - D Niederseer
- University Heart Center, Cardiology, Zurich, Switzerland
| | - F Di Paolo
- Institute of Sports Medicine and Science (CONI), Rome, Italy
| | - A Pelliccia
- Institute of Sports Medicine and Science (CONI), Rome, Italy
| |
Collapse
|
42
|
Monney P, Namdar M, Schmied C, Gruner C, Dormond O, Krayenbuhl PA, Barbey F, Nowak A. P899Long-term evolution of Fabry cardiomyopathy under enzyme replacement therapy in the Swiss Fabry cohort. An echocardiographic study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Fabry cardiomyopathy may present with left ventricular hypertrophy (LVH) and enzyme replacement therapy (ERT) aims to slow its progression in affected patients. LVH progression may be observed despite ERT and the aim of this study was to identify predictors of adverse LV remodeling under treatment.
Methods
This multicentric study included consecutive Fabry patients receiving ERT and for whom a clinical follow-up (FU) with echocardiography (TTE) of at least 5 years was available. The first TTE was performed at the time of ERT start and disease progression was defined as an increase in LV mass index between the first and the last available FU TTE.
Results
Sixty-one patients (median age 35 years [23–48] and 40 (66%) men) were included with a median FU of 10.5 years [7.2–12.2]. Progression was seen in 33 (54%) patients with an annual increase in LV mass index of 1.8 g/m2/year [0.7–3.2] (vs −0.8 g/m2/year [−1.6 to 0.4] in the non-progression group). Presence of LVH (>95 g/m2 in women or >115 g/m2 in men) at the start of ERT was the only morphological baseline parameter significantly associated with progression after adjustment for age, gender and baseline arterial hypertension (OR 22.5, 95% CI 2.7–188.3, p=0.004). Over the FU duration, patients with baseline LVH (n=22) had higher increase in LV diastolic diameter (2.3±4.9 mm vs 0.9±4.1, p=0.009), a lower increase in relative wall thickness (−1.7±14.1% vs 4.6±9.8%, p=0.04), and a higher increase in LV mass index (22±22 g/m2 vs 0±17 g/m2, p=0.001), as compared with patients with no baseline LVH. While no difference was seen in the evolution of the LV ejection fraction, a faster decline in diastolic function was observed in patients with baseline LVH, with a higher increase in E/e' ratio (5.9±7.4 vs 1.1±2.8, p=0.001) and in left atrial diameter (4.7±5.4 mm vs 1.8±5.2 mm).
Baseline characteristics All (n=61) No LVH (n=39) LVH (n=22) p Age (years) 35 [23–48] 17 [21–36] 50 [44–54] <0.001 Male gender 40 (66%) 22 (56%) 18 (82%) 0.79 Arterial hypertension 10 (17%) 3 (8%) 7 (31%) 0.03 LV mass index (g/m2) 105±43 79±18 150±38 <0.001 Mitral E/e' ratio 7.8±5.0 6.7±2.0 9.9±7.8 0.02
Conclusion
Over a median FU of over 10 years, LV wall thickness, LV mass and LV diastolic function remained stable under ERT, providing the treatment was started, early, i.e. before development of LVH. If LVH is already present at baseline, ERT appears to be less effective, with significant progression in LV mass and significantly faster decrease in diastolic function.
Collapse
Affiliation(s)
- P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - M Namdar
- Geneva University Hospitals, Geneva, Switzerland
| | - C Schmied
- University Hospital Zurich, Zurich, Switzerland
| | - C Gruner
- University Hospital Zurich, Zurich, Switzerland
| | - O Dormond
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | | | - F Barbey
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - A Nowak
- University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
43
|
Borjesson M, Dellborg M, Niebauer J, LaGerche A, Schmied C, Solberg EE, Halle M, Adami PE, Biffi A, Carré F, Caselli S, Papadakis M, Pressler A, Rasmusen H, Serratosa L, Sharma S, van Buuren F, Pelliccia A. Brief recommendations for participation in leisure time or competitive sports in athletes-patients with coronary artery disease: Summary of a Position Statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol 2019; 27:770-776. [PMID: 31514519 DOI: 10.1177/2047487319876186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This paper presents a brief summary of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology (EAPC) on sports-participation in patients with coronary artery disease, coronary artery anomalies or spontaneous dissection of the coronary arteries, all entities being associated with myocardial ischaemia.1 Given the wealth of evidence supporting the benefits of exercise for primary and secondary prevention of coronary artery disease, individuals should be restricted from competitive sport only when a substantial risk of adverse event or disease progression is present. These recommendations aim to encourage regular physical activity including participation in sports and, with reasonable precaution, ensure a high level of safety for all individuals with coronary artery disease. The present document is based on available current evidence, but in most instances because of lack of evidence, also on clinical experience and expert opinion.
Collapse
Affiliation(s)
- Mats Borjesson
- Centre for Health and Performance (CHP), Department of Food, Nutrition and Sport Sciences, Gothenburg University, Sweden.,Department of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Mikael Dellborg
- Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Andre LaGerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Christian Schmied
- Kardiologisches Ambulatorium, Sportmedizin/Sportkardiologie, Universitäres Herzzentrum Zürich, Switzerland
| | - Erik E Solberg
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital' Klinikum rechts der Isar, Technical University of Munich, ESC/EAPC Certified Centre for Sports Cardiology, German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany
| | - Paolo Emilio Adami
- Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy
| | - Alessandro Biffi
- Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy
| | - Francois Carré
- Sport Medicine Department-Rennes University Hospital, LTSI INSERM UMR 1099, France
| | - Stefano Caselli
- Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy.,Ospedale San Pietro Fatebenefratelli, Rome, Italy
| | - Michael Papadakis
- Cardiology Clinical Academic Group, St George's, University of London, UK
| | - Axel Pressler
- Centre for General, Sports and Preventive Cardiology, Munich, Germany.,Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Germany
| | - Hanne Rasmusen
- Department of Cardiology, Bisbebjerg University Hospital, Copenhagen, Denmark
| | - Luis Serratosa
- Hospital Universitario Quironsalud Madrid, Spain.,Ripoll y De Prado Sport Clinic, FIFA Medical Centre of Excellence, Madrid, Spain
| | - Sanjay Sharma
- Cardiology Clinical Academic Group, St George's, University of London, UK
| | - Frank van Buuren
- Catholic Hospital Southwestfalia, St. Martinus-Hospital Olpe, Germany
| | - Antonio Pelliccia
- Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy
| |
Collapse
|
44
|
Niederseer D, Schmied C, Niebauer J, Loidl M. Geographical Information Support for Health Mobility-Promoting active commuting as a novel option to counteract sedentary lifestyle. Scand J Med Sci Sports 2019; 30 Suppl 1:5-7. [PMID: 31389090 DOI: 10.1111/sms.13533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/25/2019] [Indexed: 12/23/2022]
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| |
Collapse
|
45
|
Eichhorn C, Bière L, Schnell F, Schmied C, Wilhelm M, Kwong RY, Gräni C. Myocarditis in Athletes Is a Challenge: Diagnosis, Risk Stratification, and Uncertainties. JACC Cardiovasc Imaging 2019; 13:494-507. [PMID: 31202742 DOI: 10.1016/j.jcmg.2019.01.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/10/2018] [Accepted: 01/05/2019] [Indexed: 12/12/2022]
Abstract
Presentation of myocarditis in athletes is heterogeneous and establishing the diagnosis is challenging with no current uniform clinical gold standard. The combined information from symptoms, electrocardiography, laboratory testing, echocardiography, cardiac magnetic resonance imaging, and in certain cases endomyocardial biopsy helps to establish the diagnosis. Most patients with myocarditis recover spontaneously; however, athletes may be at higher risk of adverse cardiac events. Based on scarce evidence and mainly autopsy studies and expert's opinions, current recommendations generally advise abstinence from competitive sports ranging from a minimum of 3 to 6 months. However, the dilemma poses that (un)necessary prolonged disqualification of athletes to avoid adverse cardiac events can cause considerable disruption to training schedules and tournament preparation and lead to a decline in performance and ability to compete. Therefore, better risk stratification tools are imperatively needed. Using latest available data, this review contrasts existing recommendations and presents a new proposed diagnostic flowchart putting a greater focus on the use of cardiac magnetic resonance imaging in athletes with suspected myocarditis. This may enable cardiac caregivers to counsel athletes with suspected myocarditis more systematically and furthermore allow for pooling of more unified data. To modify recommendations regarding sports behavior in athletes with myocarditis, evidence, based on large multicenter registries including cardiac magnetic resonance imaging and endomyocardial biopsy, is needed. In the future, physicians might rely on combined novel risk stratification methods, by implementing both noninvasive and invasive tissue characterization methods.
Collapse
Affiliation(s)
- Christian Eichhorn
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts
| | - Loïc Bière
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts; Institut MitoVasc, Laboratoire Cardioprotection, Remodelage et Thrombose, University of Angers, Angers, France; Department of Cardiology, University Hospital of Angers, Angers, France
| | - Frédéric Schnell
- Rennes University Health Centre, Sports Medicine Division, Physiology Laboratories, Rennes-1 University, Rennes, France
| | - Christian Schmied
- Department of Cardiology, University Heart Center, Zurich, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland
| | - Raymond Y Kwong
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christoph Gräni
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts; Department of Cardiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
| |
Collapse
|
46
|
Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Rasmusen HK, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg EE, Halle M, Gerche AL, Papadakis M, Sharma S, Pelliccia A. Brief recommendations for participation in competitive sports of athletes with arterial hypertension: Summary of a Position Statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol 2019; 26:1549-1555. [DOI: 10.1177/2047487319852807] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Owing to its undisputed multitude of beneficial effects, European Society of Cardiology guidelines advocate regular physical activity as a class IA recommendation for the prevention and treatment of cardiovascular disease. Nonetheless, competitive athletes with arterial hypertension may be exposed to an increased risk of cardiovascular events. Guidance to physicians will be given in this summary of our recently published recommendations for participation in competitive sports of athletes with arterial hypertension.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Martin Halle
- Paracelsus Medical University, Salzburg, Austria
| | | | | | | | | |
Collapse
|
47
|
Berg J, Lovrinovic M, Baltensperger N, Kissel CK, Kottwitz J, Manka R, Patriki D, Scherff F, Schmied C, Landmesser U, Lüscher TF, Heidecker B. Non-steroidal anti-inflammatory drug use in acute myopericarditis: 12-month clinical follow-up. Open Heart 2019; 6:e000990. [PMID: 31168382 PMCID: PMC6519432 DOI: 10.1136/openhrt-2018-000990] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 12/30/2022] Open
Abstract
Objective Clinical data on the effect of non-steroidal anti-inflammatory drugs (NSAIDs) in myopericarditis are limited. Since NSAIDs are standard therapy in pericarditis, we retrospectively investigated their safety in myopericarditis. Methods In a retrospective case-control study, we identified 60 patients with myopericarditis from September 2010 to August 2017. Diagnosis was based on clinical criteria, elevated high-sensitivity troponin T and cardiac magnetic resonance imaging (CMR). All patients received standard heart failure therapy if indicated. Twenty-nine patients (62%) received NSAIDs (acetylsalicylic acid: n=7, average daily dose =1300 mg or ibuprofen: n=22, average daily dose =1500 mg) for an average duration of 4 weeks. To create two cohorts with similar baseline conditions, 15 patients were excluded. Three months after diagnosis, 29 patients were re-evaluated by CMR to measure late gadolinium enhancement (LGE). Results Baseline characteristics of those treated with or without NSAIDs were similar. Mean age was 34 (±13) years, 6 (13%) were women. Mean left ventricular ejection fraction (LVEF) was 56% (±5). 82 % of the patients (14 of 17) treated with NSAIDs experienced a decrease in LGE at 3 months, while it was only 58 % (7 of 12) of those without NSAIDs (p=0.15). At 12-month follow-up, one of the patients treated without NSAIDs experienced polymorphic ventricular tachycardia (VT) with cardiac arrest, while one of the patients with NSAIDs experienced non-sustained VT. Conclusions This is the first case-control study demonstrating that NSAIDs are safe in patients with myopericarditis and preserved LVEF. Our data suggest that this drug class should be tested prospectively in a large randomised clinical trial.
Collapse
Affiliation(s)
- Jan Berg
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | | | | | - Jan Kottwitz
- Cardiology, University Heart Center, Zurich, Switzerland
| | - Robert Manka
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - Frank Scherff
- Cardiology, University Heart Center, Zurich, Switzerland
| | | | - Ulf Landmesser
- Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,Royal Brompton and Harefield Hospitals and Imperial College, London, UK
| | - Bettina Heidecker
- Cardiology, University Heart Center, Zurich, Switzerland.,Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| |
Collapse
|
48
|
Affiliation(s)
- Christian Schmied
- Department of Cardiology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland
| |
Collapse
|
49
|
Rossi VA, Schmied C, Niebauer J, Niederseer D. Cardiovascular effects and risks of recreational alpine skiing in the elderly. J Sci Med Sport 2019; 22 Suppl 1:S27-S33. [PMID: 30772188 DOI: 10.1016/j.jsams.2019.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/14/2018] [Accepted: 01/22/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Alpine skiing is one of the most popular recreational winter sports and attracts millions of tourists every year alone in the Alpine region. Several studies highlight the positive effects of alpine skiing as aerobic physical training and isometric muscle activity that is able to increase exercise capacity and reduce cardiovascular risk factors. However, a certain cardiovascular risk mainly related to an abrupt increase of myocardial oxygen consumption during skiing especially in otherwise sedentary subjects and effects of hypoxia in untrained patients have to be acknowledged. DESIGN In this article, we provide an up-to-date evaluation of risks and benefits of alpine skiing in relation of cardiovascular disease and elderly persons. METHODS Narrative Review. RESULTS In the first section, the current recommendations of physical activity and effects of alpine skiing - with particular attention to the elderly population - are described. In the second section, the present knowledge regarding cardiovascular risk and alpine skiing is summarized and possible pathophysiological mechanisms are highlighted. Finally, a summary regarding actual clinical recommendations is provided. CONCLUSIONS Alpine skiing may safely be recommended also to the elderly if certain precautions are applied, as the benefits outbalance the potential risks in most subjects.
Collapse
Affiliation(s)
- Valentina Alice Rossi
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland.
| |
Collapse
|
50
|
Caselli S, Serdoz A, Mango F, Lemme E, Vaquer Seguì A, Milan A, Attenhofer Jost C, Schmied C, Spataro A, Pelliccia A. High blood pressure response to exercise predicts future development of hypertension in young athletes. Eur Heart J 2018; 40:62-68. [DOI: 10.1093/eurheartj/ehy810] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/12/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stefano Caselli
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
- Cardiovascular Center Zürich, Hirslanden Klinik im Park, Seestrasse 220, Zürich, Switzerland
| | - Andrea Serdoz
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| | - Federica Mango
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| | - Erika Lemme
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| | - Antonia Vaquer Seguì
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| | - Alberto Milan
- Department of Medical Sciences, Hospital ‘Città della Salute e della Scienza di Torino’, University of Torino, Corso Bramante, 88, Torino, Italy
| | | | | | - Antonio Spataro
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, Rome, Largo Piero Gabrielli, Roma, Italy
| |
Collapse
|