A long duration race induces a decrease of left ventricular strains, twisting mechanics and myocardial work in trained adolescents

BACKGROUND

We investigated the acute cardiac consequences of a long-duration (>5 h) adventure race in adolescent athletes from evaluations of left ventricular (LV) strains and myocardial work.

METHODS

Twenty trained male adolescents (i.e. 8 ± 4 hours/week of endurance sports) aged 14 to 17 years participated in a competitive long-duration adventure race. Blood samples were collected before, immediately and 24 h after the race to determine the time course of troponin I (cTnI) considered as a myocardial damage biomarker. Resting echocardiography were conducted before and after the race to assess myocardial regional strains, LV twisting mechanics and myocardial work using speckle tracking echocardiography.

RESULTS

The mean completion time of the race was 05:38 ± 00:20 h, with a mean heart rate (HR) of 83 ± 5% of maximal HR. cTnI concentration significantly increased in 16/20 participants after the race (pre: 0.001 ± 0.002 vs. post: 0.244 ± 0.203 ng·dL^-1, p < 0.001) and returned to baseline within 24 h. Stroke volume, ejection fraction and global longitudinal strains remained unchanged after the race while LV twist and global myocardial work significantly decreased (8.6 ± 3.3 vs. 6.3 ± 3.3 deg and 2080 ± 250 vs. 1781 ± 334 mmHg%, p < 0.05). Diastolic function, indexes of myocardial relaxation and LV untwisting rate (-91.0 ± 19.0 vs. -56.4 ± 29.1 deg·s^-1, p < 0.001) were affected after the race.

CONCLUSION

We demonstrated for the first time that, in trained adolescents, a high-intensity endurance exercise of several hours induced an increase of the cTnI concentration associated with an alteration of myocardial function.

Impact of long-duration adventure racing on hydration status, blood electrolytes and biomarkers of kidney function in trained adolescent athletes

INTRODUCTION

Little is known about the biochemical consequences of endurance activities in adolescents. The present study aimed to examine the impact of a long-duration adventure race (> 5 h) on hydration status, blood electrolytes and biomarkers of kidney function in adolescent athletes.

METHODS

Twenty male adolescents aged 14 to 17 y (mean±SD; body mass: 59.7±9.1 kg and maximal O2 uptake: 56.2±4.6 mL∙kg-1∙min-1) volunteered to participate in a competitive adventure race of 68.5 km. Volunteers could drink ad libitum and fluid intake was monitored throughout the race. Blood samples were collected before, within 15 min after, and 24 h after the race to monitor blood electrolytes (sodium, potassium, chloride), creatinine and blood urea nitrogen (BUN). Body mass and urine specific gravity (USG) were also measured across the same time points.

RESULTS

The race was completed on average in 05:38±00:20 h:min under cold and rainy conditions (10-15°C and 83-93% of relative humidity). Fluid intake was 1.45±0.66 L and body mass decreased by 1.2% compared to before the race (p < 0.001). Blood sodium concentrations remained stable after the race (140.4±2.1 mmol∙L-1) despite an expansion in the plasma volume of 8.9±15.6%. No significant variations in BUN or BUN-to-creatinine ratio occurred. A significant increase in creatinine (+13.5%, p = 0.003) was observed immediately after the race but remained within the reference range.

CONCLUSIONS

The long-duration race completed under cold and humid conditions seems not to have exposed adolescents to hypohydration, hyponatremia or clinically significant alterations in kidney function.

Changes in pulmonary function after long-duration adventure racing in adolescent athletes

The present study investigated the acute effects of a mixed-modality, long-duration adventure race on pulmonary function in adolescent athletes. Twenty male adolescents aged 14 to 17 years volunteered to participate in a wilderness adventure race of 68.5-km. Expiratory function was evaluated before, immediately after, and 24 h after race completion. Measurements included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF). Maximal inspiratory and expiratory mouth static pressures (MIP and MEP, respectively) were also measured using a portable hand-held mouth pressure meter across the same time points. The mean completion time of the race was 05:38 ± 00:20 hours. A significant post-race decrease in FVC was observed immediately after the race (-5.2%, p = 0.01). However, no significant changes were observed for FEV1, PEF and the FEV1/FVC and FEV1/PEF ratios. In addition, estimates of respiratory muscle strength (MIP and MEP) were unaffected by the race. The long-duration adventure race induced no marked reduction in expiratory pulmonary function and this response was associated with no apparent respiratory muscle fatigue. Therefore, the pulmonary system of trained adolescent athletes was sufficiently robust to sustain the mixed-modality, long-duration adventure race of ∽5-6 h.

Effect of Long-Duration Adventure Races on Cardiac Damage Biomarker Release and Muscular Function in Young Athletes

The aim of the present study was to examine the effect of 1- and 2-day adventure races on cardiac muscle damage and skeletal muscle soreness and function in young athletes. Twelve male trained adolescents (14-15 years) completed both 1-day (48.2 km) and 2-day (66.0 km) races that included trail running, mountain biking, kayaking, and in-line skating separated by 10 weeks. Myocardial damage biomarker concentrations (cTnI and CK-MB), maximal voluntary isometric contraction (MVIC) torque, perceived knee extensor (KE) muscle soreness (PMS), and drop and squat jump heights were measured before and after each race. Heart rate was also monitored throughout. Mean heart rate (% cardiac reserve) was higher during the 1-day (66.6 ± 6.4%) than 2-day (62.6 ± 7.8%, p = 0.038) race. The amplitude of cardiac damage biomarker release was also higher following the 1-day than the 2-day race (peak cTnI: 0.14 vs. 0.03 ng/mL, p = 0.045; peak CK-MB: 20.30 vs. 11.98 ng/mL, p = 0.020). However, cardiac biomarker concentrations returned to baseline at 24-48 h post-exercise, except for CK-MB after the 2-day race (p = 0.017). Eight and three participants exceeded the cTnI cut-off for myocardial injury in 1- and 2-day races, respectively, but none exceeded the cut-off for acute myocardial infarction. While there was a significant decrease in drop jump height (-5.9%, p = 0.003), MVIC torque and squat jump height remained unchanged after both races. PMS was increased at 24 h after both races (p < 0.001) but returned to baseline levels by 72 h post-race. In conclusion, the shorter, more intense race produced more cardiac damage, although this probably represents a standard exercise intensity-dependent response rather than pathological response. Skeletal muscle functional and soreness responses were moderate and similar between races.

Aortic compliance variation in long male distance triathletes: A new insight into the athlete's artery?

OBJECTIVES

To assess cardiac and vascular adaptations in long-distance male triathletes and the influence of an increased training volume on these parameters.

DESIGN

Case-control study using long-distance male triathletes (Tri) (n=12) and an age-matched cohort of sedentary volunteers (Ctrl).

METHODS

All participants gave an informed consent and underwent a Cardiovascular Magnetic Resonance imaging (CMR) exam to measure left and right ventricle functional parameters, and aortic parameters (surface, strain, compliance, pulse wave velocity). This exam was repeated in the triathletes' group after an increased training volume of at least 2h/week for six weeks.

RESULTS

Compared to control volunteers, triathletes presented at baseline a typical pattern of athlete's heart (higher end-diastolic, end-systolic and stroke volumes index, p≤0.009, and lower cardiac rate, p=0.015) but similar vascular characteristics except a trend towards an enlarged ascending aorta (surface 942±106 vs 812±127mm², p=0.058). Between the two visits, the triathletes increased their weekly training time from 9.67±2.43 (Tri1) to 12.15±3.01h (Tri2): no modifications were found regarding cardiac parameters, but compliance and distensibility of the ascending aorta increased, from 2.60 to 3.34mm²/mmHg (p=0.028) and from 3.36 to 4.40×10^-3mmHg^-1 (p=0.048) respectively.

CONCLUSIONS

Using CMR, we showed that vascular characteristics of the ascending aorta may vary along the sport season in endurance athletes. This remodelling could be considered as a physiological adaptation, but could eventually lead to an adverse vascular remodelling.

Real-time sonography to estimate muscle thickness: comparison with MRI and CT

PURPOSE

We investigated the feasibility of using real-time sonography to measure muscle thickness. Clinically, this technique would be used to measure the thickness of human muscles in which intramuscular microstimulators have been implanted to treat or prevent disuse atrophy.

METHODS

Porcine muscles were implanted with microstimulators and imaged with sonography, MRI, and CT to assess image artifacts created by the microstimulators and to design protocols for image alignment between methods. Sonography and MRI were then used to image the deltoid and supraspinatus muscles of 6 healthy human subjects.

RESULTS

Microstimulators could be imaged with all 3 methods, producing only small imaging artifacts. Muscle-thickness measurements agreed well between methods, particularly when external markers were used to precisely align the imaging planes. The correlation coefficients for sonographic and MRI measurements were 0.96 for the supraspinatus and 0.97 for the deltoid muscle. Repeated sonographic measurements had a low coefficient of variation: 2.3% for the supraspinatus and 3.1% for the deltoid muscle.

CONCLUSIONS

Real-time sonography is a relatively simple and inexpensive method of accurately measuring muscle thickness as long as the operator adheres to a strict imaging protocol and avoids excessive pressure with the transducer.

Synthesis and antimuscarinic properties of some N-substituted 5-(aminomethyl)-3,3-diphenyl-2(3H)-furanones

In a study aimed toward developing new, selective antimuscarinic drugs with potential utility in the treatment of urinary incontinence associated with bladder muscle instability, a series of N-substituted 5-(aminomethyl)-3,3-diphenyl-2(3H)-furanones, conformationally-constrained lactone relatives of benactyzine, was prepared. The compounds were examined in several paradigms that measure muscarinic (M1, M2, and M3) receptor antagonist activity. Selected members of the series that displayed potency and/or selectivity in these tests were studied for their effects on urinary bladder contraction, mydriasis, and salivation in guinea pigs. These studies revealed that incorporation of the amino functionality into an imidazole or pyrazole ring resulted in some novel, potent, and selective antimuscarinic agents. Appropriate alkyl substitution of position 2 of the imidazole strikingly affected muscarinic, particularly M3, receptor activity and may reflect a complementary site of interaction. Some of the compounds selectively reduced bladder pressure in a cystometrogram (CMG) model without producing concomitant mydriatic and salivary effects. The separate and distinct action of several compounds of this series in these in vivo protocols suggests the possibility of subtypes of muscarinic receptors that may correspond to previously characterized molecular cloned subpopulations. In this article, structure-activity relationships for the series of substituted lactones are discussed. These studies led to the identification of (R)-[(2-isopropyl-1H-imidazol-1-yl)methyl]-4,5-dihydro-3,3-diphenyl-2(3H )- furanone (23) as a clinical candidate for treating urinary bladder dysfunction.

Analogues of oxybutynin. Synthesis and antimuscarinic and bladder activity of some substituted 7-amino-1-hydroxy-5-heptyn-2-ones and related compounds

Oxybutynin chloride [4-(diethylamino)-2-butynyl alpha-cyclohexyl-alpha-hydroxybenzeneacetate hydrochloride, Ditropan] is widely used for the relief of symptoms in neurogenic bladder. This is a result of its combined anticholinergic, antispasmodic, and local anesthetic activities. In a study directed toward development of agents possessing the beneficial properties of oxybutynin, but having a longer duration of action, a series of metabolically more stable keto analogues of the parent ester, i.e. substituted 7-amino-1-hydroxy-5-heptyn-2-ones along with some analogues and derivatives, was prepared and evaluated for in vitro and in vivo antimuscarinic action in guinea pig preparations. Several members of the series were potent antimuscarinics having a longer duration of activity than that of oxybutynin in a guinea pig cystometrogram model. On the basis of its in vitro and in vivo antimuscarinic activity, coupled with a 5-fold greater duration of action than that of oxybutynin, 1-cyclobutyl-7-(dimethylamino)-1-hydroxy-1-phenyl-5-heptyn-2-one (14b) was selected for clinical evaluation.

Aminoalkynyldithianes. A new class of calcium channel blockers

Several dithiane derivatives, prepared as intermediates for compounds structurally related to the therapeutically useful antimuscarinic agent oxybutynin, were effective inhibitors of calcium ion induced contraction of guinea pig ileal strips and of KCl-induced calcium entry into neuronal cells. Although the first member of this series, 2-[5-(diethylamino)-3-pentynyl]-1,3-dithiane (2a), was only marginally effective, its condensation product with diphenyl ketone, i.e. 2-[5-(diethylamino)-3-pentynyl]-2-(a,a-diphenyl-a- hydroxymethyl)-1,3-dithiane (3a), demonstrated weak, but significant, calcium channel antagonist activity. As part of a structure-activity relationship (SAR) study, various structural analogues of 2a and 3a were prepared and examined for calcium antagonist properties. In addition to these structural types, ring bridged (tricyclic) congeners of 3, i.e. 4, related bicyclic compounds 5, dehydroxylated derivatives 6, some homologous 2-[[[(N,N-disubstituted-amino)methyl]2- phenyl-1,3-dithianes (7), and a series of 2-[6-[N,N-disubstituted-amino)methyl]-1-hydroxy-1-phenyl- 4-hexynyl]-1,3-dithianes (8) were prepared and studied for calcium channel blocking activity. In general, greatest potency was noted in the tricyclic series 4; however, a definitive SAR could not be established. A structural similarity between several potent calcium antagonists having the structures 7c, 8b, and 8d and the well-known calcium channel blockers verapamil and tiapamil suggests these compounds may act at the same site. Compounds in the other classes (2-6) failed to show clearly defined SAR and their potency differed markedly in two tests for calcium channel antagonist activity. These results may indicate that the dithiane derivatives 2-6 produce their effects in a manner differing from that of the calcium channel antagonists diltiazem, verapamil, and nitrendepine.