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Zholshybek N, Khamitova Z, Toktarbay B, Jumadilova D, Khissamutdinov N, Dautov T, Rakhmanov Y, Bekbossynova M, Gaipov A, Salustri A. Cardiac imaging in athlete's heart: current status and future prospects. Cardiovasc Ultrasound 2023; 21:21. [PMID: 38098064 PMCID: PMC10720202 DOI: 10.1186/s12947-023-00319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Physical activity contributes to changes in cardiac morphology, which are known as "athlete's heart". Therefore, these modifications can be characterized using different imaging modalities such as echocardiography, including Doppler (flow Doppler and Doppler myocardial imaging) and speckle-tracking, along with cardiac magnetic resonance, and cardiac computed tomography. MAIN TEXT Echocardiography is the most common method for assessing cardiac structure and function in athletes due to its availability, repeatability, versatility, and low cost. It allows the measurement of parameters like left ventricular wall thickness, cavity dimensions, and mass. Left ventricular myocardial strain can be measured by tissue Doppler (using the pulse wave Doppler principle) or speckle tracking echocardiography (using the two-dimensional grayscale B-mode images), which provide information on the deformation of the myocardium. Cardiac magnetic resonance provides a comprehensive evaluation of cardiac morphology and function with superior accuracy compared to echocardiography. With the addition of contrast agents, myocardial state can be characterized. Thus, it is particularly effective in differentiating an athlete's heart from pathological conditions, however, is less accessible and more expensive compared to other techniques. Coronary computed tomography is used to assess coronary artery anatomy and identify anomalies or diseases, but its use is limited due to radiation exposure and cost, making it less suitable for young athletes. A novel approach, hemodynamic forces analysis, uses feature tracking to quantify intraventricular pressure gradients responsible for blood flow. Hemodynamic forces analysis has the potential for studying blood flow within the heart and assessing cardiac function. CONCLUSIONS In conclusion, each diagnostic technique has its own advantages and limitations for assessing cardiac adaptations in athletes. Examining and comparing the cardiac adaptations resulting from physical activity with the structural cardiac changes identified through different diagnostic modalities is a pivotal focus in the field of sports medicine.
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Affiliation(s)
- Nurmakhan Zholshybek
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Zaukiya Khamitova
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Bauyrzhan Toktarbay
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Dinara Jumadilova
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
- National Research Cardiac Surgery Center, Radiology Unit, Astana, 01000, Kazakhstan
| | - Nail Khissamutdinov
- National Research Cardiac Surgery Center, Cardiology Unit #2, Astana, 01000, Kazakhstan
| | - Tairkhan Dautov
- Clinical and Academic Department of Radiology and Nuclear Medicine, CF "University Medical Center", Astana, 01000, Kazakhstan
| | - Yeltay Rakhmanov
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | | | - Abduzhappar Gaipov
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Alessandro Salustri
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan.
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2
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Falcioni L, Gallotta MC, Baldari C, Cardinali L, Campanella M, Ferrari D, Guidetti L, Meucci M. Influence of training status on cardiac and vascular functioning in young recreational and competitive male rowers. Front Pediatr 2023; 11:1162594. [PMID: 37090920 PMCID: PMC10118033 DOI: 10.3389/fped.2023.1162594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/10/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction The aim of the study was to investigate the influence of training status on cardiovascular function in young male recreational and competitive rowers. Methods Ejection duration in percentage to the heart rate period (ED%), subendocardial viability ratio (SEVR), augmentation index at 75 bpm (AIx75) and carotid to femoral pulse wave velocity (cf-PWV) of competitive rowers (CR) (age 17.6 ± 4.1 years), recreational rowers (RR) (age 16.7 ± 2.70 years) and athletes practicing other recreational sports (ORS) (age 15.3 ± 1.4 years) were assessed. Results ED% was lower in CR compared to ORS (31.9 ± 3.9% vs. 38.4 ± 4.8%; p = 0.026) and cf-PWV was higher in CR compared to ORS (5.5 ± 1.0 m/s vs. 4.7 ± 0.5 m/s; p = 0.032). SEVR was higher in CR compared to RR and ORS (165.8 ± 33.7% vs. 127.4 ± 30.4% and 128.3 ± 27.8%; p = 0.022) and AIx75 was lower in CR compared to RR and ORS (-15.7 ± 8.6% vs. 1.2 ± 9.9% and 1.5 ± 9.1; p = 0.001). Discussion Healthy, young competitive male rowers reported higher myocardial performance and better cardiovascular health than recreational athletes. Interpretations of cf-PWV in competitive rowers should be performed alongside other cardiovascular indicators.
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Affiliation(s)
- Lavinia Falcioni
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Maria Chiara Gallotta
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Ludovica Cardinali
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Matteo Campanella
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Dafne Ferrari
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
- Departement of Unicusano, Università Degli Studi Niccolò Cusano, Rome, Italy
| | - Laura Guidetti
- Departement of Unicusano, Università Degli Studi Niccolò Cusano, Rome, Italy
| | - Marco Meucci
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
- Correspondence: Marco Meucci
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Evaluation of Left Ventricular Outflow Gradients During Staged Exercise Stress Echocardiography Helps Differentiate Pediatric Patients With Hypertrophic Cardiomyopathy From Athletes and Normal Subjects. Pediatr Exerc Sci 2021; 33:196-202. [PMID: 34303306 DOI: 10.1123/pes.2020-0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/04/2021] [Accepted: 05/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Elevated left ventricular outflow tract (LVOT) gradients during exercise can occur in patients with hypertrophic cardiomyopathy (HCM) as well as in athletes and normal controls. The authors' staged exercise protocol calls for imaging at rest and during each stage of exercise to evaluate the mechanism of LVOT obstruction at each stage. They investigated whether this staged approach helps differentiate HCM from athletes and normal controls. METHODS They reviewed pediatric exercise stress echocardiograms completed between January 2009 and October 2017 at their center and identified those with gene-positive HCM, athlete's heart, and normal controls. Children with inducible obstruction (those with no LVOT gradient at rest who developed a LVOT peak gradient > 25 mm Hg during exercise) were included. LVOT peak gradient, velocity time integral, acceleration time, and deceleration time were measured at rest, submaximal stages, and peak exercise. RESULTS Compared with athletes, HCM patients had significantly higher LVOT peak gradients at rest (P = .019), stage 1 of exercise (P = .002), and peak exercise (P = .051), as well as a significantly higher change in LVOT peak gradient from rest to stage 1 (P = .016) and from rest to peak (P = .038). The acceleration time/deceleration time ratio of the LVOT Doppler was significantly lower in HCM patients compared with normal controls at peak exercise. CONCLUSIONS The HCM patients who develop elevated LVOT gradients at peak exercise typically manifest early obstruction in the submaximal stages of exercise, which helps to differentiate them from athletes and normal controls.
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Lander BS, Phelan DM, Martinez MW, Dineen EH. Hypertrophic Cardiomyopathy: Updates Through the Lens of Sports Cardiology. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23:53. [PMID: 34054288 PMCID: PMC8144867 DOI: 10.1007/s11936-021-00934-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
Purpose of review This review will summarize the distinction between hypertrophic cardiomyopathy (HCM) and exercise-induced cardiac remodeling (EICR), describe treatments of particular relevance to athletes with HCM, and highlight the evolution of recommendations for exercise and competitive sport participation relevant to individuals with HCM. Recent findings Whereas prior guidelines have excluded individuals with HCM from more than mild-intensity exercise, recent data show that moderate-intensity exercise improves functional capacity and indices of cardiac function and continuation of competitive sports may not be associated with worse outcomes. Moreover, recent studies of athletes with implantable cardioverter defibrillators (ICDs) demonstrated a safer profile than previously understood. In this context, the updated American Heart Association/American College of Cardiology (AHA/ACC) and European Society of Cardiology (ESC) HCM guidelines have increased focus on shared decision-making and liberalized restrictions on exercise and sport participation among individuals with HCM. Summary New data demonstrating the safety of exercise in individuals with HCM and in athletes with ICDs, in addition to a focus on shared decision-making, have led to the most updated guidelines easing restrictions on exercise and competitive athletics in this population. Further athlete-specific studies of HCM, especially in the context of emerging therapies such as mavacamten, are important to inform accurate risk stratification and eligibility recommendations.
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Affiliation(s)
- Bradley S Lander
- Division of Cardiology, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Dermot M Phelan
- Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC 28203 USA
| | - Matthew W Martinez
- Department of Cardiovascular Medicine, Atlantic Health, Morristown Medical Center, Morristown, NJ 07960 USA.,Sports Cardiology and Hypertrophic Cardiomyopathy, 111 S Madison Ave, Suite 300, Morristown, NJ 07960 USA
| | - Elizabeth H Dineen
- Division of Cardiology, University of California Irvine, 333 City Blvd W, Suite 400, Orange, CA 92868 USA
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5
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Christopoulos G, Barrett-O'Keefe Z, Chandrasekaran K. The Significance of "Contractile Reserve" in the Echocardiographic Assessment of Athletic Heart Syndrome. J Cardiovasc Echogr 2020; 30:33-34. [PMID: 32766104 PMCID: PMC7307621 DOI: 10.4103/jcecho.jcecho_48_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/11/2019] [Accepted: 02/23/2020] [Indexed: 11/23/2022] Open
Abstract
The clinical distinction between athlete's heart and structural heart disease in the echocardiography laboratory is often challenging. We present a case where athletic heart syndrome was promptly differentiated from pathology with a simple maneuver during echocardiography.
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6
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Lewicka-Potocka Z, Dąbrowska-Kugacka A, Lewicka E, Kaleta AM, Dorniak K, Daniłowicz-Szymanowicz L, Fijałkowski M, Nabiałek-Trojanowska I, Ratkowski W, Potocki W, Raczak G. The "athlete's heart" features in amateur male marathon runners. Cardiol J 2020; 28:707-715. [PMID: 31909474 DOI: 10.5603/cj.a2019.0110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/30/2019] [Accepted: 11/05/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Training on a professional level can lead to cardiac structural adaptations called the "athlete's heart". As marathon participation requires intense physical preparation, the question arises whether the features of "athlete's heart" can also develop in recreational runners. METHODS The study included 34 males (mean age 40 ± 8 years) who underwent physical examination, a cardiopulmonary exercise test and echocardiographic examination (ECHO) before a marathon. ECHO results were compared with the sedentary control group, reference values for an adult male population and those for highly-trained athletes. Runners with abnormalities revealed by ECHO were referred for cardiac magnetic resonance imaging (CMR). RESULTS The mean training distance was 56.5 ± 19.7 km/week, peak oxygen uptake was 53.7 ± 6.9 mL/kg/min and the marathon finishing time was 3.7 ± 0.4 h. Compared to sedentary controls, amateur athletes presented larger atria, increased left ventricular (LV) wall thickness, larger LV mass and basal right ventricular (RV) inflow diameter (p < 0.05). When compared with ranges for the general adult population, 56% of participants showed increased left atrial volume, indexed to body surface area (LAVI), 56% right atrial area and interventricular septum thickness, while 47% had enlarged RV proximal outflow tract diameter. In 50% of cases, LAVI exceeded values reported for highly-trained athletes. Due to ECHO abnormalities, CMR was performed in 6 participants, which revealed hypertrophic cardiomyopathy in 1 runner. CONCLUSIONS "Athlete's heart" features occur in amateur marathon runners. In this group, ECHO reference values for highly-trained elite athletes should be considered, rather than those for the general population and even then LAVI can exceed the upper normal value.
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Affiliation(s)
- Zuzanna Lewicka-Potocka
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland. .,First Department of Cardiology, Medical University of Gdansk, Poland.
| | | | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
| | - Anna Maria Kaleta
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
| | - Karolina Dorniak
- Noninvasive Cardiac Diagnostics Department, Medical University of Gdansk, Poland
| | | | | | - Izabela Nabiałek-Trojanowska
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland.,First Department of Cardiology, Medical University of Gdansk, Poland
| | - Wojciech Ratkowski
- Department of Management Tourism and Recreation, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Wojciech Potocki
- Department of Molecular Bacteriology, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, Poland
| | - Grzegorz Raczak
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
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7
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Advances in heart regeneration based on cardiomyocyte proliferation and regenerative potential of binucleated cardiomyocytes and polyploidization. Clin Sci (Lond) 2019; 133:1229-1253. [PMID: 31175264 DOI: 10.1042/cs20180560] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022]
Abstract
One great achievement in medical practice is the reduction in acute mortality of myocardial infarction due to identifying risk factors, antiplatelet therapy, optimized hospitalization and acute percutaneous coronary intervention. Yet, the prevalence of heart failure is increasing presenting a major socio-economic burden. Thus, there is a great need for novel therapies that can reverse damage inflicted to the heart. In recent years, data have accumulated suggesting that induction of cardiomyocyte proliferation might be a future option for cardiac regeneration. Here, we review the relevant literature since September 2015 concluding that it remains a challenge to verify that a therapy induces indeed cardiomyocyte proliferation. Most importantly, it is unclear that the detected increase in cardiomyocyte cell cycle activity is required for an associated improved function. In addition, we review the literature regarding the evidence that binucleated and polyploid mononucleated cardiomyocytes can divide, and put this in context to other cell types. Our analysis shows that there is significant evidence that binucleated cardiomyocytes can divide. Yet, it remains elusive whether also polyploid mononucleated cardiomyocytes can divide, how efficient proliferation of binucleated cardiomyocytes can be induced, what mechanism regulates cell cycle progression in these cells, and what fate and physiological properties the daughter cells have. In summary, we propose to standardize and independently validate cardiac regeneration studies, encourage the field to study the proliferative potential of binucleated and polyploid mononucleated cardiomyocytes, and to determine whether induction of polyploidization can enhance cardiac function post-injury.
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8
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Boban M, Pesa V, Antic Kauzlaric H, Brusich S, Rotim A, Madzar T, Zulj M, Vcev A. Ventricular diastolic dimension over maximal myocardial thickness is robust landmark of systolic impairment in patients with hypertrophic cardiomyopathy. Med Sci Monit 2018; 24:1880-1886. [PMID: 29602944 PMCID: PMC5892461 DOI: 10.12659/msm.906111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background The effects of focal hypertrophy on geometry of the left ventricle and systolic function have not been studied in patients with hypertrophic cardiomyopathy (HCM), despite the fact that the former is the most prominent disease characteristic. The aim of our study was to analyze systolic function over ventricle geometry, generating a functional index made from left ventricle end diastolic dimension (LVEDD) divided by end diastolic thickness of the region with maximal extent of hypertrophy and interventricular septum. Material/Methods Our hospital database of cardiac magnetic resonance was screened for HCM. Geometric functional index (GFI) was calculated for LVEDD over maximal end diastolic thickness (MaxEDT) giving GFI-M, while LVEDD over interventricular septum was expressed as GFI-I. There were 55 consecutive patients with HCM. Results There were 43 males (78.2%) and 12 females (21.8%). The mean age was 52.3±16.7 years (range: 15.5–76.4 years). A significant difference of GFI was found for preserved versus impaired systolic function of the left ventricle (preserved systolic function); GFI-M 2.28±0.60 versus 3.66±0.50 (p<0.001), and GFI-I 2.75±0.88 versus 3.81±0.87 (p<0.001), respectively. Diagnostic value was tested using receiver operating curve (ROC) analyzes, with GFI-M area under curve (AUC)=0.959 (95% CI: 0.868–0.994); (p<0.001) and GFI-I-AUC=0.847 (0.724–0.930); (p<0.001). GFI-M was superior to GFI-I for appraisal of left ventricle systolic dysfunction in HCM; ΔAUC=0.112 (0.018–0.207); (p=0.020). Conclusions GFI is a simple tool, with high sensitivity and specificity for detecting impairment of systolic function in patients with HCM. Further studies would be necessary to investigate its clinical and prognostic impacts, as well as reproducibility with prospective validation.
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Affiliation(s)
- Marko Boban
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Rijeka, Croatia.,Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
| | - Vladimir Pesa
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Helena Antic Kauzlaric
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Sandro Brusich
- Department of Cardiology, University Hospital Centre Rijeka, Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Ante Rotim
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Rijeka, Croatia
| | - Tomislav Madzar
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
| | - Marinko Zulj
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijekk, Osijek, Croatia
| | - Aleksandar Vcev
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Osijek, Croatia
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9
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Sympatho-adrenergic activation by endurance exercise: Effect on metanephrines spillover and its role in predicting athlete's performance. Oncotarget 2018; 9:15650-15657. [PMID: 29643999 PMCID: PMC5884654 DOI: 10.18632/oncotarget.24584] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background The sympatho-adrenergic activation during exercise is implicated in many cardiovascular respiratory and metabolic adaptations which have been thought to partially explain the different levels of performance observed between trained and untrained subjects. To date, no evidence exists about the association between competition performance and markers of “acute stress response”. We designed this study to investigate; (i) the acute sympatho-adrenergic activation during endurance exercise in recreational runners by measuring plasma levels of free metanephrine (MN) and normethanephrine (NMN) before and after a half-marathon run; (ii) the association between the metanephrines levels and the running time. Methods 26 amateur runners (15 males, 11 females) aged 30 to 63 years were enrolled. The quantification of MN and NMN was performed by LC-MS/MS. Anthropometric ergonomic and routine laboratory data were recorded. Statistical analyses included paired T-test, univariate and multivariate regressions. Results The post-run values of MN and NMN displayed a nearly 3.5 and 7 fold increase respectively compared to the baseline values (p < 0.0001 for both). NMN pre-run values and pre/post run delta values showed a significant direct and inverse association (p = 0.021 and p = 0.033, respectively) with running performance. No correlations were found for MN values. Conclusion NMN is a reliable marker of sympatho-adrenergic activation by exercise and can predict endurance performance in the individual athlete. Adaptation phenomenon occurring not only in the adrenal medulla might represent the biological mechanism underlying this association. Further studies on sympatho-adrenergic activation, competition performance and training status should contemplate the measurement of these metabolites instead of their unstable precursors.
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10
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Chronic exercise induces pathological left ventricular hypertrophy in adrenaline-deficient mice. Int J Cardiol 2018; 253:113-119. [DOI: 10.1016/j.ijcard.2017.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 08/28/2017] [Accepted: 10/02/2017] [Indexed: 11/20/2022]
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11
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Tower-Rader A, Betancor J, Lever HM, Desai MY. A Comprehensive Review of Stress Testing in Hypertrophic Cardiomyopathy: Assessment of Functional Capacity, Identification of Prognostic Indicators, and Detection of Coronary Artery Disease. J Am Soc Echocardiogr 2017; 30:829-844. [DOI: 10.1016/j.echo.2017.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Indexed: 01/17/2023]
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12
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Dickson D, Shave R, Rishniw M, Patteson M. Echocardiographic assessments of longitudinal left ventricular function in healthy English Springer spaniels. J Vet Cardiol 2017; 19:339-350. [DOI: 10.1016/j.jvc.2017.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/15/2017] [Accepted: 04/10/2017] [Indexed: 11/27/2022]
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13
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Ceccarelli G, Benedetti L, Arcari ML, Carubbi C, Galli D. Muscle Stem Cell and Physical Activity: What Point is the Debate at? Open Med (Wars) 2017; 12:144-156. [PMID: 28765836 PMCID: PMC5529938 DOI: 10.1515/med-2017-0022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 04/21/2017] [Indexed: 12/11/2022] Open
Abstract
In the last 15 years, it emerged that the practice of regular physical activity reduces the risks of many diseases (cardiovascular diseases, diabetes, etc.) and it is fundamental in weight control and energy consuming to contrast obesity. Different groups proposed many molecular mechanisms as responsible for the positive effects of physical activity in healthy life. However, many points remain to be clarified. In this mini-review we reported the latest observations on the effects of physical exercise on healthy skeletal and cardiac muscle focusing on muscle stem cells. The last ones represent the fundamental elements for muscle regeneration post injury, but also for healthy muscle homeostasis. Interestingly, in both muscle tissues the morphological consequence of physical activity is a physiological hypertrophy that depends on different phenomena both in differentiated cells and stem cells. The signaling pathways for physical exercise effects present common elements in skeletal and cardiac muscle, like activation of specific transcription factors, proliferative pathways, and cytokines. More recently, post translational (miRNAs) or epigenetic (DNA methylation) modifications have been demonstrated. However, several points remain unresolved thus requiring new research on the effect of exercise on muscle stem cells.
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Affiliation(s)
- Gabriele Ceccarelli
- Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy.,Center of Health Technologies (CHT), University of Pavia, Pavia, Italy
| | - Laura Benedetti
- Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy.,Center of Health Technologies (CHT), University of Pavia, Pavia, Italy
| | - Maria Luisa Arcari
- Department of Medicine and Surgery, S.Bi.Bi.T. Unit, University of Parma, Parma, Italy
| | - Cecilia Carubbi
- Department of Medicine and Surgery, S.Bi.Bi.T. Unit, University of Parma, Parma, Italy
| | - Daniela Galli
- Department of Medicine and Surgery, S.Bi.Bi.T. Unit and Sport and Exercise Medicine Center (SEM)., University of Parma c/o Ospedale Maggiore, Via Gramsci, 14, 43126, Tel: +39-0521-036306, , Parma, Italy.,Department of Medicine and Surgery, S.Bi.Bi.T. Unit, University of Parma, Parma, Italy
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14
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von Lueder TG, Hodt A, Gjerdalen GF, Steine K. Left ventricular biomechanics in professional football players. Scand J Med Sci Sports 2017; 28:187-195. [PMID: 28378431 DOI: 10.1111/sms.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
Abstract
Chronic exercise induces adaptive changes of left ventricular (LV) ejection and filling capacities which may be detected by novel speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. A total of 103 consecutive male elite Norwegian soccer players and 46 age-matched healthy controls underwent echocardiography at rest. STE was used to assess LV torsional mechanics and LV systolic longitudinal strain (LS). Diastolic function was evaluated by trans-mitral blood flow, mitral annular velocities by TDI, and LV inflow propagation velocity by color M-mode. Despite similar global LS, players displayed lower basal wall and higher apical wall LS values vs controls, resulting in an incremental base-to-apex gradient of LS. Color M-mode and TDI-derived data were similar in both groups. Peak systolic twist rate (TWR) was significantly lower in players (86.4±2.8 vs controls 101.9±5.2 deg/s, P<.01). Diastolic untwisting rate (UTWR) was higher in players (-124.5±4.2 vs -106.9±6.7 deg/s) and peaked earlier during the cardiac cycle (112.7±0.8 vs 117.4±2.4% of systole duration, both P<.05). Untwisting/twisting ratio (-1.48±0.05 vs -1.11±0.08; P<.001) and untwisting performance (=UTR/TW; -9.25±0.34 vs -7.38±0.40 s-1 , P<.01) were increased in players. Augmented diastolic wall strain (DWS), a novel measure of LV compliance in players, was associated with improved myocardial mechanical efficiency. The described myocardial biomechanics may underlie augmented exertional cardiac function in athletes and may have a potential role to characterize athlete's heart by itself or to distinguish it from hypertensive or hypertrophic cardiomyopathy.
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Affiliation(s)
- T G von Lueder
- Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.,Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - A Hodt
- Center for Heart Failure Research, University of Oslo, Oslo, Norway.,Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway
| | - G F Gjerdalen
- Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway
| | - K Steine
- Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.,Center for Heart Failure Research, University of Oslo, Oslo, Norway
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15
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Choudhury L, Rigolin VH, Bonow RO. Integrated Imaging in Hypertrophic Cardiomyopathy. Am J Cardiol 2017; 119:328-339. [PMID: 27816114 DOI: 10.1016/j.amjcard.2016.09.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/27/2022]
Abstract
Hypertrophic cardiomyopathy (HC) has a very heterogeneous clinical spectrum and lends itself to multimodality imaging for evaluation and management. This review addresses clinical applications of cardiac imaging in patients with HC. Integrating various techniques of echocardiography and cardiac magnetic resonance (CMR) is discussed in the clinical context such as diagnosis, evaluation, management, risk stratification, and family screening of patients with HC. The utility of periprocedural imaging techniques is highlighted for guiding surgical and transcatheter septal reduction procedures. More limited roles of invasive or computed tomography coronary angiography are discussed for patients with HC with chest pain and risk factors for coronary artery disease. Nuclear techniques although available for decades play a more limited role in contemporary routine management but may assist in risk assessment. Newer CMR and echo imaging techniques are discussed in their emerging roles for further characterization of patients with HC and family members with prospects of preclinical diagnosis. The strengths of the different imaging modalities are presented as well as a flow diagram summarizing integrated imaging in this disease. In conclusion, integrated imaging using the various imaging techniques predominantly echocardiography and CMR based on the clinical picture plays an essential role in the management of patients with HC.
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Arrieta A, Blackwood EA, Glembotski CC. ER Protein Quality Control and the Unfolded Protein Response in the Heart. Curr Top Microbiol Immunol 2017; 414:193-213. [PMID: 29026925 DOI: 10.1007/82_2017_54] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiac myocytes are the cells responsible for the robust ability of the heart to pump blood throughout the circulatory system. Cardiac myocytes grow in response to a variety of physiological and pathological conditions; this growth challenges endoplasmic reticulum-protein quality control (ER-PQC), a major feature of which includes the unfolded protein response (UPR). ER-PQC and the UPR in cardiac myocytes growing under physiological conditions, including normal development, exercise, and pregnancy, are sufficient to support hypertrophic growth of each cardiac myocyte. However, the ER-PQC and UPR are insufficient to respond to the challenge of cardiac myocyte growth under pathological conditions, including myocardial infarction and heart failure. In part, this insufficiency is due to a continual decline in the expression levels of important adaptive UPR components as a function of age and during myocardial pathology. This chapter will discuss the physiological and pathological conditions unique to the heart that involves ER-PQC, and whether the UPR is adaptive or maladaptive under these circumstances.
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Affiliation(s)
- A Arrieta
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA
| | - E A Blackwood
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA
| | - C C Glembotski
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA.
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17
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Abstract
Chronic physical training has been shown to produce multiple changes in the heart, resulting in the athlete's heart phenotype. Some of the changes can make it difficult to discern athlete's heart from true cardiac disease, most notably hypertrophic cardiomyopathy. Other diseases such as dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy may be difficult to rule in or out. In this article, the physiological cardiac changes of chronic athletic training are reviewed. A methodological approach using electrocardiography and echocardiography to differentiate between athlete's heart and cardiac disease is proposed.
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