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Pastore MC, Cavigli L, Olivoni G, Morrone F, Amati F, Imbalzano E, Rinaldi A, Liga R, Mattioli AV, Scicchitano P, Curcio A, Barillà F, Ciccarelli M, Maestrini V, Perrone Filardi P, D'Ascenzi F, Cameli M. Physical exercise in hypertensive heart disease: From the differential diagnosis to the complementary role of exercise. Int J Cardiol 2024; 410:132232. [PMID: 38844090 DOI: 10.1016/j.ijcard.2024.132232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/10/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
Arterial hypertension (AH) is one of the most common pathologic conditions and uncontrolled AH is a leading risk factor for cardiovascular disease and mortality. AH chronically causes myocardial and arterial remodelling with hemodynamic changes affecting the heart and other organs, with potentially irreversible consequences leading to poor outcomes. Therefore, a proper and early treatment of AH is crucial after the diagnosis. Beyond medical treatment, physical exercise also plays a therapeutic role in reducing blood pressure, given its potential effects on sympathetic tone, renin-angiotensin-aldosterone system, and endothelial function. International scientific societies recommend physical exercise among lifestyle modifications to treat AH in the first stages of the disease. Moreover, some studies have also shown its usefulness in addition to drugs to reduce blood pressure further. Therefore, an accurate, personalized exercise prescription is recommended to optimize the prevention and treatment of hypertension. On the other hand, uncontrolled AH in athletes requires proper risk stratification and careful evaluation to practice competitive sports safely. Moreover, the differential diagnosis between hypertensive heart disease and athlete's heart is sometimes challenging and requires a careful and comprehensive interpretation in order not to misinterpret the clinical findings. The present review aims to discuss the relationship between hypertensive heart disease and physical exercise, from diagnostic tools to prevention and treatment strategies.
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Affiliation(s)
- Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Gabriele Olivoni
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesco Morrone
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | | | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Rinaldi
- Unit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Sant'Orsola-Malpighi Hospital, IRCCS, Bologna, Italy
| | - Riccardo Liga
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | | | | | - Antonio Curcio
- Division of Cardiology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Francesco Barillà
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Michele Ciccarelli
- Cardiovascular Research Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, Italian Society of Cardiology, Federico II University of Naples, Naples, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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Di Gioia G, Crispino SP, Monosilio S, Maestrini V, Nenna A, Spinelli A, Lemme E, Squeo MR, Pelliccia A. Left Ventricular Trabeculation: Arrhythmogenic and Clinical Significance in Elite Athletes. J Am Soc Echocardiogr 2024; 37:577-586. [PMID: 38492683 DOI: 10.1016/j.echo.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Left ventricular (LV) trabeculations (LVTs) are common findings in athletes. Limited information exists regarding clinical significance, management, and outcome. OBJECTIVES The purpose of this study is to examine the prevalence and morphologic characteristics of LVTs in elite athletes, with a focus on clinical correlates and prognostic significance. METHODS We enrolled 1,492 Olympic elite athletes of different sports disciplines with electrocardiogram, echocardiogram, and exercise stress test. Individuals with a definite diagnosis of LV noncompaction (LVNC) were excluded; we focused on athletes with LVTs not meeting the criteria for LVNC. RESULTS Four hundred thirty-five (29.1%) athletes presented with LVTs, which were more frequent in male athletes (62.1% vs 53.5%, P = .002) and Black athletes compared with Caucasian (7.1% vs 2.4%, P < .0001) and endurance athletes (P = .0005). No differences were found with relation to either the site or extent of trabeculations. Endurance athletes showed a higher proportion of LVTs and larger LV volumes (end-diastolic and end-systolic, respectively, 91.5 ± 19.8 mL vs 79.3 ± 29.9 mL, P = .002; and 33.1 ± 10 mL vs 28.6 ± 11.7 mL, P = .007) and diastolic pattern with higher E wave (P = .01) and e' septal velocities (P = .02). Ventricular arrhythmias were found in 14% of LVTs versus 11.6% of athletes without LVTs (P = .22). Neither the location nor the LVTs' extension were correlated to ventricular arrhythmias. At 52 ± 32 months of follow-up, no differences in arrhythmic burden were observed (11.1% in LVT athletes vs 10.2%, P = .51). CONCLUSIONS Left ventricular trabeculations are quite common in athletes, mostly male, Black, and endurance, likely as the expression of adaptive remodeling. In the absence of associated clinical abnormalities, such as LV systolic and diastolic impairment, electrocardiogram repolarization abnormalities, or family evidence of cardiomyopathy, athletes with LVTs have benign clinical significance and should not require further investigation.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome, Italy.
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Sara Monosilio
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Viviana Maestrini
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Nenna
- Department of Heart Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Alessandro Spinelli
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Erika Lemme
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
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Di Gioia G, Vespasiano F, Mango F, Maestrini V, Monosilio S, Squeo MR, Lemme E, Bernardi M, Pelliccia A. Cardiovascular Risk Profile in Master Paralympic Athletes, a High-Risk Undertreated Population: A Cross-Sectional Longitudinal Study. High Blood Press Cardiovasc Prev 2024; 31:279-288. [PMID: 38714607 DOI: 10.1007/s40292-024-00648-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/10/2024] Open
Abstract
INTRODUCTION Recently, European Society of Cardiology (ESC) validated a prediction model to estimate 10-year fatal and non-fatal cardiovascular disease risk (CVDR) in individuals (aged 40-60 years) without previous cardiovascular disease or diabetes (ESC-SCORE2) and to provide indications for treatment. At present, data describing the CVDR in Paralympic athletes (PAs) are scarce and inconsistent. Therefore, we sought to assess the prevalence of risk factors in PAs to estimate their CVDR through SCORE2. METHODS We enrolled 99 PAs aged ≥ 40 y.o., who participated at 2012-2022 Paralympic Games, competing in 22 different sport disciplines classified according to sport type (power, skills, endurance and mixed) and disabilities: spinal cord injuries (SCI) and non-SCI. CVDR factors, anthropometric measurements and blood samples were collected. RESULTS Among the 99 PAs (78% males, mean age 45.7 ± 4.7 y.o.), 52.5% had SCI; 54% were dyslipidemic and 23% were smokers. According to ESC-SCORE2, 29% had high and 1% very-high CVDR. Women (compared to men) and endurance (compared to other sport) exhibited better CV profile. SCI showed no differences when compared with non-SCI for CVDR, excepted for a lower HDL and lower exercise performance. None of the dyslipidemic athlete was on pharmacologically treatment, despite the altered lipid profile had already been detected at younger age. CONCLUSION PAs are a selected population, presenting a high CV risk profile, with 30% showing either high or very-high CVDR according to ESC-SCORE2. Dyslipidemia was the most common risk factor, underestimated and undertreated, emphasizing the need for specific preventive strategies in this special setting of athletes.
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Affiliation(s)
- Giuseppe Di Gioia
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy.
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis, 15, 00135, Rome, Italy.
| | - Francesca Vespasiano
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Federica Mango
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Viviana Maestrini
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Sara Monosilio
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Maria Rosaria Squeo
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Erika Lemme
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Marco Bernardi
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Antonio Pelliccia
- Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
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Di Gioia G, Crispino SP, Maestrini V, Monosilio S, Ortolina D, Segreti A, Squeo MR, Lemme E, Nenna A, Pelliccia A. Lack of cardiac remodelling in elite endurance athletes: an unexpected and not so rare finding. Eur J Appl Physiol 2024:10.1007/s00421-024-05489-0. [PMID: 38647676 DOI: 10.1007/s00421-024-05489-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Endurance elite athletes are expected to present a cardiac remodelling, characterized by eccentric hypertrophy (EH), may be associated with higher sportive performances. However, not all can present a cardiac remodelling. The study aimed to identify endurance athletes without cardiac remodelling characterizing their physiologic and clinical features. METHODS We studied 309 endurance athletes (cycling, rowing, canoeing, triathlon, athletics, long-distance swimming, cross-country skiing, mid-long distance track, pentathlon, biathlon, long-distance skating and Nordic-combined) examined during period of training, by clinical evaluation, ECG, echocardiogram and exercise-stress test. Sport career achievements (Olympic\World championship medals or national\world records) were recorded. RESULTS EH was found in most of athletes, (n = 126, 67% of males; n = 85, 68.5% of females). A significant proportion,, exhibited normal geometry (NG) ( n = 59, 31.3% in males; n = 39, 31.4% in females). At stress test, significant differences between EH and NG athletes were found in peak power (317.1 ± 71.2W in NG vs. 342.2 ± 60.6W in EH, p = 0.014 in males and 225.1 ± 38.7W in NG vs. 247.1 ± 37W in EH, p = 0.003 in females), rest heart rate (66.1 ± 13 in NG vs. 58.6 ± 11.6 in EH, p = 0.001 in males and 68 ± 13.2 in NG vs. 59.2 ± 11.2 in EH, p = 0.001 in females) with similar ventricular extrasystoles (p = 0.363 in males and p = 0.492 in females). However, no significant differences in athletic achievements were registered. CONCLUSION Our study demonstrates a relatively high prevalence of NG in endurance athletes, in addition to the expected EH. Athletes with NG perform worse in exercise-stress test and exhibit some less advantageous functional heart characteristics. However, the type of heart geometry is not associated with negative clinical findings.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy.
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis, 15, 00135, Rome, Italy.
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Viviana Maestrini
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Rome, Italy
| | - Sara Monosilio
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Davide Ortolina
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis, 15, 00135, Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Erika Lemme
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Antonio Nenna
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy
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Di Gioia G, Crispino SP, Maestrini V, Monosilio S, Squeo MR, Lemme E, Nenna A, Luvero D, Angioli R, Pelliccia A. Cardiovascular Effects of Chronic Hormone Therapy: Study on Olympic Female Athletes. Am J Cardiol 2024; 212:6-12. [PMID: 37984634 DOI: 10.1016/j.amjcard.2023.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/01/2023] [Accepted: 11/11/2023] [Indexed: 11/22/2023]
Abstract
Female physiology is regulated after puberty by the menstrual cycle, whose hormonal fluctuations create a multitude of effects on several systems, including the cardiovascular one. The use of hormone therapy (HT) is quite common in female athletes, and data on cardiovascular effects in this population are lacking. We sought to investigate the effects of HT in highly trained athletes to assess any difference associated with HT on cardiac remodeling, exercise capacity, and clinical correlates. We studied 380 female elite athletes (mean age 25.5 ± 4.8) competing in endurance and mixed sports; 67 athletes (18%) were in chronic HT therapy. All athletes underwent baseline electrocardiography, exercise electrocardiography stress test, transthoracic echocardiogram, and complete blood tests, including lipid profile and inflammation indexes. The echocardiographic study showed a characteristic left ventricular (LV) remodeling, defined by lower LV mass index (86.2 vs 92.5 g/m2, p <0.006), end-diastolic LV diameter (28.3 vs 29.4 mm/m2, p <0.004), and end-diastolic LV volume (61.82 vs 67.09 ml/m2, p <0.010) compared with controls, without changes in systolic function and diastolic relaxation/filling indexes. A lower burden of ventricular arrhythmias on exercise was observed in HT athletes (1.5% vs 8.6% in those without therapy, p = 0.040). Linear regression analysis showed that HT had an independent effect on LV end-diastolic diameter indexed (p = 0.014), LV end-diastolic volume indexed (p = 0.030), and LV mass indexed (p = 0.020). In conclusion, chronic treatment with HT in female athletes is associated with less cardiac remodeling, including a lower LV cavity, volume, and mass, with preserved systolic and diastolic function, and decreased burden of exercise-induced ventricular arrhythmias. HT, therefore, appears to be responsible for a more economic but equally efficient cardiac adaptation to intensive athletic conditioning.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, Italy.
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Italy
| | - Viviana Maestrini
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, Italy
| | - Sara Monosilio
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, Italy
| | - Maria Rosaria Squeo
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy
| | - Erika Lemme
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy
| | - Antonio Nenna
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Italy
| | - Daniela Luvero
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Roberto Angioli
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, Italy
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Di Gioia G, Crispino SP, Maestrini V, Monosilio S, Squeo MR, Lemme E, Segreti A, Serdoz A, Fiore R, Zampaglione D, Pelliccia A. Prevalence of Hyperuricemia and Associated Cardiovascular Risk Factors in Elite Athletes Practicing Different Sporting Disciplines: A Cross-Sectional Study. J Clin Med 2024; 13:560. [PMID: 38256692 PMCID: PMC10816906 DOI: 10.3390/jcm13020560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/29/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
Uricemia has been identified as an independent risk factor for cardiovascular disease. In the general population, hyperuricemia is associated with hypertension, endothelial dysfunction, and other cardiovascular risk (CVR) factors. Our aim was to explore the prevalence of hyperuricemia among Olympic athletes, evaluating the influence of sporting discipline and its correlation with CVR factors. We enrolled 1173 Olympic athletes classified into four disciplines: power, skill, endurance, and mixed. Clinical, anthropometric data, and complete blood test results were collected. Hyperuricemia was present in 4.4% of athletes, 0.3% were hypertensive, 11.7% had high-normal blood pressure values, 0.2% were diabetic, 1.2%. glucose intolerance, 8.2% active smokers, and 3% were obese. Males had a higher prevalence of hyperuricemia (5.3%) than females (3.4%) with no significant differences between different sporting disciplines (male, p = 0.412; female p = 0.561). Males with fat mass >22% presented higher uricemia (5.8 ± 1 vs. 5.3 ± 1 mg/dL, p = 0.010) like hypertensive athletes (6.5 ± 0.3 vs. 5.3 ± 1 mg/dL, p = 0.031), those with high-normal blood pressure (5.13 ± 1 vs. 4.76 ± 1.1 mg/dL, p = 0.0004) and those with glucose intolerance (6 ± 0.8 vs. 5.3 ± 1 mg/dL, p = 0.066). The study provides a comprehensive evaluation of hyperuricemia among Olympic athletes, revealing a modest prevalence, lower than in the general population. However, aggregation of multiple CVR factors could synergistically elevate the risk profile, even in a population assumed to be at low risk. Therefore, uric acid levels should be monitored as part of the CVR assessment in athletes.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
| | - Viviana Maestrini
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Sara Monosilio
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Erika Lemme
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy; (S.P.C.); (A.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Andrea Serdoz
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Roberto Fiore
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Domenico Zampaglione
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli 1, 00197 Rome, Italy; (V.M.); (S.M.); (M.R.S.); (E.L.); (A.S.); (R.F.); (D.Z.); (A.P.)
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Rozado J, Avanzas P. Paralympic Athletes: A Heterogeneous Population Not Exempt from Cardiovascular Disease Risk. Am J Cardiol 2024; 210:311-312. [PMID: 37918472 DOI: 10.1016/j.amjcard.2023.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Jose Rozado
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain; Health Research Institute of Asturias, ISPA, Oviedo, Spain
| | - Pablo Avanzas
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain; Health Research Institute of Asturias, ISPA, Oviedo, Spain; University of Oviedo, Oviedo, Spain; Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
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Di Gioia G, Coletti F, Buzzelli L, Maestrini V, Monosilio S, Segreti A, Squeo MR, Lemme E, Nenna A, Pelliccia A. Influence of the Type of Disability and Sporting Discipline on Lipid Profile in a Cohort of Italian Paralympic Athletes. Am J Cardiol 2024; 210:107-112. [PMID: 38682709 DOI: 10.1016/j.amjcard.2023.09.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 05/01/2024]
Abstract
Dyslipidemia is the most frequent cardiovascular (CV) risk factor in able-bodied athletes and is frequently undertreated, resulting in an underestimated risk of atherosclerosis-related diseases. Data on lipid profile in Paralympic athletes are lacking. Our study aimed to identify the prevalence of dyslipidemia and the influence of disability type and sporting discipline in Paralympic athletes. We evaluated 289 athletes who participated in the Paralympic Games from London 2012 to Beijing 2022. All athletes underwent clinical/physical evaluation, blood tests, and body composition analysis. They were divided into different groups based on sports disciplines and disability type (spinal cord injuries [SCIs] and non-SCIs [NSCIs]). Among the Paralympic athletes, 34.6% had a low-density lipoprotein (LDL) level ≥115 mg/100 ml. They were older (38.1 ± 9.2 vs 30.6 ± 9.6, p = 0.001) and had a higher CV risk. Athletes with SCI showed similar total cholesterol and triglycerides, higher LDL (110.9 ± 35.2 vs 102.7 ± 30.6 mg/100 ml, p = 0.03) and lower high-density lipoprotein (HDL) (53.6 ± 13.6 vs 60.5 ± 15.4 mg/100 ml, p = 0.001) than those with NSCI. Endurance athletes had lower LDL, the highest HDL, and the lowest triglycerides and LDL/HDL ratio compared with other sports disciplines. A mean follow-up of 61.5 ± 30.5 months was available in 47% athletes, and 72.7% of the athletes with dyslipidemia continued to present altered LDL values at follow-up. In conclusion, dyslipidemia is the most common CV risk factor in the Paralympics, affecting 35% of athletes, with only mild lipid changes over a medium-term time. The type of disability and sporting discipline has an impact on lipids, improving HDL and reducing LDL, with a better profile observed in NSCI and endurance athletes.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Piazza Lauro de Bosis, Rome, Italy.
| | - Federica Coletti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Lorenzo Buzzelli
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Viviana Maestrini
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, Rome, Italy
| | - Sara Monosilio
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Piazza Lauro de Bosis, Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Erika Lemme
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Antonio Nenna
- Heart Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
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Di Gioia G, Polito D, Crispino SP, Maestrini V, Nenna A, Segreti A, Squeo MR, Lemme E, Pelliccia A. Influence of isometric versus isotonic exercise training on right ventricular morpho-functional parameters in Olympic athletes. Echocardiography 2024; 41:e15731. [PMID: 38113308 DOI: 10.1111/echo.15731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Cardiovascular adaptations in elite athletes involve both ventricular and atrial changes. Nowadays, limited research exists on right ventricular (RV) remodeling, particularly in female athletes and across different types of exercise training. METHODS Our study evaluated 370 athletes (61% males) participated at 2020 Tokyo and 2022 Beijing Olympic Games. Athletes were categorized according to main type of exercise into isometric and isotonic. Comprehensive echocardiographic assessments were conducted to analyze RV morpho-functional parameters, comparing genders and different sporting exercise. RESULTS Significant differences in RV parameters were observed based on exercise type and gender. Isotonic athletes showed greater RV remodeling with larger RV outflow tract (15.1 ± 2.1 vs. 14.5 ± 1.7 mm, p < .0001) end-diastolic and end-systolic area (respectively, 24.6 ± 5.5 vs. 21.7 ± 5 mm, p < .000 and 11.7 ± 3.2 vs. 10.1 ± 2.8 mm, p < .0001) and right atrium size (11.7 ± 3.2 vs. 10.2 ± 2.3 mm2 , p = .0001). Functional parameters, such as TDI velocities, were similar between groups. Males showed larger RV area and right atrium size (p < .0001) and lower RV TDI velocities with reduced E' (15.4 ± 2.9 vs. 16.1 ± 3.2 m/s in females, p = .031), resulting in lower E'/A' ratio (1.69 ± .6 vs. 1.84 ± .6 m/s, p = .021), while S' was lower females (14.6 ± 2.3 vs. 14.1 ± 2.4 m/s, p = .041). RV TDI velocities were similar in isotonic and isometric both in male and females. CONCLUSIONS In elite athletes, RV morphological changes are influenced by exercise modality but do not translate into functional differences. Female athletes present distinct RV functional profiles, with lower S' velocities and a higher E'/A' ratio. Functional RV TDI parameters are not affected by the typology of exercise practiced.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Dajana Polito
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Viviana Maestrini
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Nenna
- Department of Heart Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Erika Lemme
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy
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10
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Di Gioia G, Crispino SP, Monosilio S, Maestrini V, Nenna A, Segreti A, Squeo MR, Lemme E, Ussia GP, Grigioni F, Pelliccia A. Cardiovascular and metabolic effects of hyperbilirubinemia in a cohort of Italian Olympic athletes. Scand J Med Sci Sports 2023; 33:2534-2547. [PMID: 37650311 DOI: 10.1111/sms.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/09/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Bilirubin was supposed to have cardio-metabolic protective role by signaling functions. Indeed, mild hyperbilirubinemia has immunosuppressive and endocrine activities and may offer protection against oxidative stress-mediated diseases. Gilbert syndrome (GS) has been hypothesized to provide cardio-metabolic benefits. OBJECTIVE To investigate the prevalence of hyperbilirubinemia and its cardio-metabolic effects in a cohort of elite Italian athletes engaged in different sports disciplines. METHODS We enrolled 1492 elite athletes (age 25.8 ± 5.1) practising different disciplines (power, skills, endurance, and mixed) underwent blood, echocardiographic, and exercise tests. GS was diagnosed per exclusionem in athletes with isolated asymptomatic unconjugated hyperbilirubinemia. RESULTS GS was highlighted in 91 athletes (6%; globally 9% male and 2.4% female); 82% were males (p < 0.0001) showing higher indirect bilirubin (0.53 ± 0.4 vs. 0.36 ± 0.24 mg/dL in females, p < 0.0001). GS athletes had fewer platelets (201 ± 35 vs. 214 ± 41, p = 0.01), higher iron (male: 124 ± 44 vs. 100.9 ± 34 mcg/dL, p < 0.0001; female: 143.3 ± 35 vs. 99.9 ± 42 mcg/dL, p < 0.0001), and lower erythrocyte sedimentation rate, (1.93 ± 0.9 vs. 2.80 ± 2.7 mm/H, p = 0.03). At multivariate analysis, male (OR 3.89, p = 0.001) and iron (OR 3.47, p = 0.001) were independently associated with GS. No significant differences were found in cardiac remodeling, heart rate, blood pressure, arrhythmias, or power capacity at stress test. Endurance athletes (313) presented higher total (p = 0.003) and indirect bilirubin (p = 0.001). CONCLUSION Bilirubin has several metabolic effects (including immunosuppressive and endocrine) and plays a role in regulating antioxidant pathways exercise-related with hematological consequences but seems not to affect significantly cardiovascular remodeling. Endurance athletes present higher bilirubin concentrations, likely as an adaptive mechanism to counteract increased oxidative stress.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Simone Pasquale Crispino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Sara Monosilio
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Viviana Maestrini
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Nenna
- Department of Heart Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Erika Lemme
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Gian Paolo Ussia
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Francesco Grigioni
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
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McHugh C, Hind K, Kelly A, Fearon U, Wasfy M, Floudas A, Barad Z, Dane K, Farrell G, Wilson F. Cardiovascular risk and systemic inflammation in male professional rugby: a cross-sectional study. BMJ Open Sport Exerc Med 2023; 9:e001636. [PMID: 37937309 PMCID: PMC10626771 DOI: 10.1136/bmjsem-2023-001636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To investigate cardiovascular risk factors' prevalence and association with systemic inflammation in professional male rugby players (RP). Methods A cross-sectional investigation of 46 professional male RP (26.1±4.1 years) cardiovascular risk factors were compared by position. Inflammatory markers were compared with healthy controls (n=13) and patients with rheumatoid arthritis (RA) (n=10). Results Twenty-six per cent of RP had no risk factors, 49% had 1-2 cardiovascular risk factors and 25% had 3-4 risk factors. Forwards had greater body fat (p<0.001), visceral fat (p<0.001), glucose (p=0.025), and C reactive protein (CRP) (p=0.023) compared with backs. RP demonstrated more favourable lipid and glucose profiles than reference values for the general population. Most RP (n=28, 61%) had elevated blood pressure (≥140/90 mm Hg). RP had higher vascular adhesion molecule-1 (VCAM-1) (p=0.004) and intracellular adhesion molecule-1 (ICAM-1) (p=0.002) than healthy controls. RP had lower CRP than patients with RA (p=0.009), while one-third (n=15) displayed equivalent ICAM-1 and VCAM-1 levels. Multivariate clustering and principal component analysis biplots revealed higher triglycerides, inflammatory markers, and worse body composition were associated with forwards. Conclusions Despite athletic status, most of this rugby cohort had at least one cardiovascular risk factor. Concomitantly, these RP demonstrated increased levels of inflammation, with one-third, primarily forwards, displaying equivalent levels to patients with inflammatory disease. Further studies are needed to unravel the prognostic implications of increased inflammation in RP because unchecked, chronic inflammation may lead to increased cardiovascular disease risk.
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Affiliation(s)
- Clíodhna McHugh
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | - Karen Hind
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Aine Kelly
- Department of Physiology, Trinity Biomedical Science Institute, Trinity College Dublin, Dublin, Ireland
| | - Ursula Fearon
- Department Molecular Rheumatology, Trinity Biomedical Science Institute, Trinity College Dublin, Dublin, Ireland
| | - Meagan Wasfy
- Football Player Health Study, Harvard Medical School, Boston, Massachusetts, USA
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Achilleas Floudas
- Department Molecular Rheumatology, Trinity Biomedical Science Institute, Trinity College Dublin, Dublin, Ireland
| | - Zsuzsanna Barad
- Department of Physiology, Trinity Biomedical Science Institute, Trinity College Dublin, Dublin, Ireland
| | - Kathryn Dane
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | | | - Fiona Wilson
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
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12
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Romano S, Minardi S, Patrizi G, Palamà Z, Sciahbasi A. Sport in ischemic heart disease: Focus on primary and secondary prevention. Clin Cardiol 2023; 46:1021-1027. [PMID: 37246477 PMCID: PMC10540006 DOI: 10.1002/clc.24052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 05/30/2023] Open
Abstract
Ischemic heart disease (IHD) is one of the leading causes of death and morbidity in the world. The role of primary prevention is particularly relevant since IHD can be for a long time asymptomatic until the occurrence of a condition that could lead to plaque instabilization or increased oxygen demand. Secondary prevention is also essential to improve patients' prognosis and quality of life. The aim of this review is to provide a detailed and updated description of the role of sport and physical activity both in primary prevention and secondary prevention. In primary prevention, sport and physical activity are effective through the control of the main cardiovascular risk factors, such as hypertension and dyslipidemia. In secondary prevention, sport and physical activity can lead to a reduction in subsequent coronary events. Every effort must be made to encourage the performance of physical and sports activity both in asymptomatic subjects at risk and those with a history of IHD.
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Affiliation(s)
- Silvio Romano
- Cardiology, Department of Health, Life, and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Simona Minardi
- Cardiology, Department of Health, Life, and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Giampiero Patrizi
- Department of CardiologyB. Ramazzini Hospital, Ausl ModenaCarpiItaly
| | - Zefferino Palamà
- Cardiology, Department of Health, Life, and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
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13
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Pelliccia A, Borrazzo C, Maestrini V, D'Ascenzi F, Caselli S, Lemme E, Squeo MR, Di Giacinto B. Determinants of LV mass in athletes: the impact of sport, constitutional traits and cardiovascular risk factors. Eur J Appl Physiol 2023; 123:769-779. [PMID: 36449099 DOI: 10.1007/s00421-022-05098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Whether cardiovascular (CV) risk factors might impact Left Ventricular (LV) mass in athletes is unknown. METHODS The impact of CV risk factors (Total/LDL cholesterol, triglycerides, positive family history, smoking, body fat, blood pressure), constitutional characteristics (age, sex, body mass index) and type of sport was assessed in 1111 Olympic athletes. RESULTS Multivariate logistic regression analysis demonstrated a significant impact: BMI ≥ 30 kg/m2 (odds ratio [OR] = 2.8. 95° Confidence Interval [CI] 0.9-13.7; < 0.001; in males); age ≥ 20-year (OR = 2.1, CI 1.4-3.3; p < 0.001) in males; (OR = 2.3; CI 1.4-3.7) in females; systolic blood pressure ≥ 130 mmHg (OR = 1.1, CI 1.01-1.16; p < 0.001) in males; (OR = 1.03; CI 1.01-1.06; p < 0.03) in females; diastolic ≥ 85 mmHg (OR = 1.1, CI 1.03-1.2; p = 0.003) in males; (OR = 1.05, CI 1.02-1.08, p < 0.001) in females. No association was found for family history, smoking, body fat, LDL, total cholesterol, triglycerides. Overall, constitutional traits explain > 60% of the LV mass. Sport explains on average 14%, but large differences existed among disciplines, i.e., endurance showed the highest impact (55%, mixed: 20%, power: 17%, skill: 8%; p < 0.001). CONCLUSION LV mass in athletes is largely governed by constitutional traits and type of sport, and independent from CV risk factors, except for systolic and diastolic blood pressure. Overall, constitutional traits explain more than 60% of LV mass. The impact of sport is largely different in relation to the discipline, and highest in endurance, moderate mixed and power and mild in skill disciplines.
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Affiliation(s)
- Antonio Pelliccia
- The Institute of Sport Medicine and Science, Largo Piero Gabrielli 1, 00197, Rome, Italy.
| | - Cristian Borrazzo
- Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy
| | - Viviana Maestrini
- The Institute of Sport Medicine and Science, Largo Piero Gabrielli 1, 00197, Rome, Italy
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Stefano Caselli
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Seestrasse 247, Zurich, Switzerland
| | - Erika Lemme
- The Institute of Sport Medicine and Science, Largo Piero Gabrielli 1, 00197, Rome, Italy
| | - Maria Rosaria Squeo
- The Institute of Sport Medicine and Science, Largo Piero Gabrielli 1, 00197, Rome, Italy
| | - Barbara Di Giacinto
- The Institute of Sport Medicine and Science, Largo Piero Gabrielli 1, 00197, Rome, Italy
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Abstract
ABSTRACT Introduction Strengthening research on cardiac function risk assessment in running sports is beneficial to prevent sport-related cardiovascular injuries and sudden deaths in sports. Objective To study changes in cardiovascular response in athletes after long-distance running. Methods Changes in cardiovascular response indicators of long-distance runners before and after the five-kilometer race were monitored. Analyzed indices included heart rate, blood pressure, hemoglobin, and a cardiac function index. Results There were no statistically significant differences in heart rate, blood pressure, and hemoglobin levels before and after the long-distance run (P>0.05). There was no significant difference in the proportion of sinus arrhythmia before and after long-distance running (P>0.05). Conclusion Long-distance running did not cause abnormal changes in blood indicators. No cardiovascular discomfort or changes in the electrocardiogram, heart rate, blood pressure, hemoglobin, and cardiac function index were reported. These young men were not enlisted, despite undergoing adaptive training. In conclusion, the five-kilometer run is safe for young men in the reserve. Evidence Level II; Therapeutic Studies - Investigating the result.
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15
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Małek ŁA, Jankowska A, Greszata L. Mild Left Ventricular Hypertrophy in Middle-Age Male Athletes as a Sign of Masked Arterial Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10038. [PMID: 36011673 PMCID: PMC9407928 DOI: 10.3390/ijerph191610038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Mild left ventricular hypertrophy (LVH) has been considered as one of the possible structural, physiological adaptations to regular, intensive physical activity. However, it may also appear as one of the subclinical complications of hypertension. In athletes, the differential diagnosis between these two entities may be complicated as regular physical activity may potentially mask the presence of arterial hypertension. We sought to determine the relation between LVH in middle-age athletes and the presence of hypertension. The study included 71 healthy, male long-time amateur athletes (mean age 41 ± 6 years, 83% endurance and 17% power sports) without known hypertension or any other cardiovascular diseases and with normal self-measured and office blood pressure. All subjects underwent resting electrocardiogram, transthoracic echocardiography, maximal exercise test on a treadmill and ambulatory blood pressure monitoring. LVH was diagnosed as left ventricular wall diameter >11 mm. Hypertension was defined as mean 24 h systolic blood pressure (SBP) ≥ 130 mmHg and/or diastolic blood pressure (DBP) ≥ 80 mmHg. Exaggerated blood pressure response (EBPR) to exercise was defined as SBP ≥ 210 mmHg. LVH (range > 11 to 14 mm) was found in 20 subjects (28%) and hypertension was diagnosed in 33 subjects (46%). Athletes with LVH were more likely to have hypertension than those without LVH (70% vs. 37%, p = 0.01). EBPR to exercise was found equally common in athletes with and without LVH (35% vs. 29%, p = 0.68), but more often in subjects with hypertension (51% vs. 13%, p < 0.001). Presence of LVH and hypertension was equally common in the studied endurance and power sport athletes (p = 0.66 and p = 0.79, respectively). In comparison to athletes without LVH, those with LVH had larger left atrial size (26 ± 6 vs. 21 ± 4 cm2, p < 0.001) and a tendency for lower left ventricular diastolic function (E/A 1.2 ± 0.4 vs. 1.5 ± 0.4, p = 0.05) and a larger ascending aorta diameter (34 ± 3 vs. 32 ± 3, p = 0.05), but a similar left ventricular end-diastolic diameter (51 ± 3 vs. 51 ± 4, p = 0.71). The presence of mild left ventricular hypertrophy in middle-age male amateur athletes with normal home and office blood pressure may be considered as a potential sign of masked hypertension. It should not be overlooked as an element of a physiological adaptation to exercise and may warrant further medical evaluation with ambulatory blood pressure monitoring.
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Affiliation(s)
- Łukasz A. Małek
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-628 Warsaw, Poland
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Di Credico A, Perpetuini D, Izzicupo P, Gaggi G, Cardone D, Filippini C, Merla A, Ghinassi B, Di Baldassarre A. Estimation of Heart Rate Variability Parameters by Machine Learning Approaches Applied to Facial Infrared Thermal Imaging. Front Cardiovasc Med 2022; 9:893374. [PMID: 35656402 PMCID: PMC9152459 DOI: 10.3389/fcvm.2022.893374] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/04/2022] [Indexed: 01/18/2023] Open
Abstract
Heart rate variability (HRV) is a reliable tool for the evaluation of several physiological factors modulating the heart rate (HR). Importantly, variations of HRV parameters may be indicative of cardiac diseases and altered psychophysiological conditions. Recently, several studies focused on procedures for contactless HR measurements from facial videos. However, the performances of these methods decrease when illumination is poor. Infrared thermography (IRT) could be useful to overcome this limitation. In fact, IRT can measure the infrared radiations emitted by the skin, working properly even in no visible light illumination conditions. This study investigated the capability of facial IRT to estimate HRV parameters through a face tracking algorithm and a cross-validated machine learning approach, employing photoplethysmography (PPG) as the gold standard for the HR evaluation. The results demonstrated a good capability of facial IRT in estimating HRV parameters. Particularly, strong correlations between the estimated and measured HR (r = 0.7), RR intervals (r = 0.67), TINN (r = 0.71), and pNN50 (%) (r = 0.70) were found, whereas moderate correlations for RMSSD (r = 0.58), SDNN (r = 0.44), and LF/HF (r = 0.48) were discovered. The proposed procedure allows for a contactless estimation of the HRV that could be beneficial for evaluating both cardiac and general health status in subjects or conditions where contact probe sensors cannot be used.
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Affiliation(s)
- Andrea Di Credico
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Reprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - David Perpetuini
- Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Giulia Gaggi
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Reprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Daniela Cardone
- Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Chiara Filippini
- Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Reprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Reprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
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Achmad BF, Alim S, Kusumawati HI, Fitriawan AS, Kurniawan D, Kafil RF. Cardiovascular Disease Risk Profiles in Indonesian Athletes. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Notwithstanding how physical exercise lessens cardiovascular and all-cause mortality, young and active athletes might have cardiovascular risk factors or fundamental cardiovascular diseases (CVDs), putting them at increased risk for sudden cardiac death during times of strenuous exercise.
AIM: The study aimed to assess the cardiovascular risk profile possessed by Indonesian athletes.
METHODS: This research was a quantitative study using a cross-sectional design, involving 234 Indonesian athletes (163 men and 71 women) from three sports, including football, basketball, and swimming. Data were collected between December 2020 to March 2021 using the Jakarta Cardiovascular Risk Score instrument adapted from the Framingham risk score. Descriptive statistics were utilized to dissect data information for frequency distribution, percentage, mean, and standard deviation.
RESULTS: Most of the participants in this study had excessive weekly exercise duration (more than 255 minutes/week) (n=177 athletes, 75.64%). Twenty-one participants (8.97%) had a higher MAP more than normal, and 51 participants (21.79%) had overweight BMI. In addition, 142 participants (60.68%) had a cardiovascular genetic disease from their parents (family history) and most of the participants also were active smokers (n=150, 64.10%). Based on the Jakarta Cardiovascular Risk Score, the Indonesian athletes who participated in this study had a mean cardiovascular risk of -1.5 (SD= 3.088, min-max= (-7) – 6). Most of the participants had low cardiovascular risk (n= 193, 82.48%). However, some participants had moderate and high cardiovascular risk, 32 (13.67%) and 9 (3.85%), respectively.
CONCLUSION: Most of the participants had low cardiovascular risk, however some of the participants had moderate and high cardiovascular risk.
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18
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Xu J. SPORTS IMPROVE THE INDEXES CARDIOVASCULAR PHYSIOLOGICAL EFFECTS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228022021_0480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Cardiovascular function is one of the main factors affecting health. The influence of different exercise intensities on cardiovascular function needs further research. Objective: To study the relationship between physical activity and cardiovascular disease in the elderly. Method: The article conducted a follow-up survey of 1,564 older adults. Elders who practice sports and those who do not went through the hemodynamic index test, which analyzed the relevant effects of physical exercise on their cardiovascular function. Results: Older adults who exercise regularly show good adaptability to exercise. Conclusion: Physical exercise can promote the function of the cardiovascular system. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Jia Xu
- Changzhou College of Information Technology, China
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19
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Abstract
Hereditary diseases under the age of 35 are the most common underlying heart disease, leading to sudden cardiac death (SCD) in competitive sports, while in older people, atherosclerotic coronary artery disease (CAD) is the main cause. The following preventive measures are recommended: (a) The pre-participation cardiovascular screening, (b) the genetic testing, (c) the use of implantable cardioverter-defibrillator (ICD), (d) the prohibition of doping in sports, (e) the prevention of 'exercise-induced' cardiac complications, (f) the reduction of high-risk factors for CAD, and (g) the use of cardiopulmonary resuscitation. The cost-effectiveness of the electrocardiograms in the pre-participation screening programs remains questionable. Genetic testing is recommended in borderline cases and positive family history. Athletes with ICD can, under certain conditions, participate in competitive sports. Excessive endurance exercise appears to harm the endothelium, promotes inflammatory processes and leads to fibrosis in the myocardium, and calcium deposition in the coronary vessels. Cardiac arrest may be reversed if cardiopulmonary resuscitation is performed and a defibrillator is immediately used. Thus, equipping all fields with automatic external defibrillators are recommended.
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Affiliation(s)
- Asterios Deligiannis
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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Qin M, Peng C, Wang Q. PHYSICAL ACTIVITY TO IMPROVE THE PHYSIOLOGICAL INDEX OF CARDIOVASCULAR EFFECT. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127082021_0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Physical exercise can enhance the body's ability to adapt to the external environment and improve the contractility of the heart. At the same time, it can help improve blood circulation and increase lung capacity. Objective: This article explores the critical role of sports in the prevention of cardiovascular diseases. Methods: This article conducts tests on related physiological indicators such as hemodynamic rheology for students who regularly participate in physical exercise and those who do not participate in physical exercise. Results: Students who exercise regularly and those who do not exercise mobilize faster cardiovascular function at the beginning of work. This shows good adaptability to sports. Conclusion: The use of fitness exercise prescription by students who exercise comprehensively has the most pronounced effect on improving vascular function. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Mei Qin
- Jiangsu Union Technical Institute, China
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21
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Abstract
Abstract
Study aim: The aim of the study was to analyse the lifespan of Polish male Olympic medallists in comparison to the general male population.
Material and methods: The study included 238 Polish male Olympic medallists who participated in the Olympic games in 1924–1992. Duration of life in relation to the general Polish population was assessed. The age of acquiring their first medal, type and number of medals won and sports discipline were taken into consideration.
Results: Polish male Olympic medallists born before 1940 lived over 8 years longer in comparison to the general population (p < 0.0001, d = 0.689 and d = 0.750). Over 80% of them lived up to 65 years of age and over 40% up to 80. In the general population only <70% and <30%, respectively, reached the equivalent lifespan (p = 0.010 and p = 0.040, RR = 0.480 and RR = 0.783). Kaplan-Meier analysis demonstrated that survival was shorter in Olympic medallists who won their first medal before the age of 25 (p = 0.040) and in those engaging in endurance or power sports vs. mixed or skill disciplines (p = 0.010).
Conclusions: Polish male Olympic medallists lived significantly longer than the general population of Polish men. The longevity of male Olympic medallists was affected by the age of acquiring their first medal and by the category of sport practised.
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22
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Sangha GS, Goergen CJ, Prior SJ, Ranadive SM, Clyne AM. Preclinical techniques to investigate exercise training in vascular pathophysiology. Am J Physiol Heart Circ Physiol 2021; 320:H1566-H1600. [PMID: 33385323 PMCID: PMC8260379 DOI: 10.1152/ajpheart.00719.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Atherosclerosis is a dynamic process starting with endothelial dysfunction and inflammation and eventually leading to life-threatening arterial plaques. Exercise generally improves endothelial function in a dose-dependent manner by altering hemodynamics, specifically by increased arterial pressure, pulsatility, and shear stress. However, athletes who regularly participate in high-intensity training can develop arterial plaques, suggesting alternative mechanisms through which excessive exercise promotes vascular disease. Understanding the mechanisms that drive atherosclerosis in sedentary versus exercise states may lead to novel rehabilitative methods aimed at improving exercise compliance and physical activity. Preclinical tools, including in vitro cell assays, in vivo animal models, and in silico computational methods, broaden our capabilities to study the mechanisms through which exercise impacts atherogenesis, from molecular maladaptation to vascular remodeling. Here, we describe how preclinical research tools have and can be used to study exercise effects on atherosclerosis. We then propose how advanced bioengineering techniques can be used to address gaps in our current understanding of vascular pathophysiology, including integrating in vitro, in vivo, and in silico studies across multiple tissue systems and size scales. Improving our understanding of the antiatherogenic exercise effects will enable engaging, targeted, and individualized exercise recommendations to promote cardiovascular health rather than treating cardiovascular disease that results from a sedentary lifestyle.
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Affiliation(s)
- Gurneet S Sangha
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana.,Purdue University Center for Cancer Research, Purdue University, West Lafayette, Indiana
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland.,Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center, Baltimore, Maryland
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Alisa M Clyne
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
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23
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Keep Them in the Game: Screening for Cardiovascular Disease and Diabetes in Aging Athletes. Cardiopulm Phys Ther J 2020. [DOI: 10.1097/cpt.0000000000000148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Jørstad HT, Piek JJ. COVID-19, sports, and myocardial consequences. Neth Heart J 2020; 28:563-564. [PMID: 33030658 PMCID: PMC7543669 DOI: 10.1007/s12471-020-01499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 12/05/2022] Open
Affiliation(s)
- H T Jørstad
- Department of Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - J J Piek
- Department of Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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25
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Jorstad HT, van den Aardweg JG. Balancing act: when is an elite athlete who has had COVID-19 safe to return to play? When does prudent investigation go offside into overmedicalising? Br J Sports Med 2020; 54:1134-1135. [PMID: 32839183 DOI: 10.1136/bjsports-2020-103259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Harald T Jorstad
- Heart Center, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands
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26
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D’Ascenzi F, Fiorentini C, Anselmi F, Mondillo S. Left ventricular hypertrophy in athletes: How to differentiate between hypertensive heart disease and athlete’s heart. Eur J Prev Cardiol 2020; 28:1125-1133. [PMID: 33611377 DOI: 10.1177/2047487320911850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022]
Abstract
Abstract
Athlete’s heart is typically accompanied by a remodelling of the cardiac chambers induced by exercise. However, although competitive athletes are commonly considered healthy, they can be affected by cardiac disorders characterised by an increase in left ventricular mass and wall thickness, such as hypertension. Unfortunately, training-induced increase in left ventricular mass, wall thickness, and atrial and ventricular dilatation observed in competitive athletes may mimic the pathological remodelling of pathological hypertrophy. As a consequence, distinguishing between athlete’s heart and hypertension can sometimes be challenging. The present review aimed to focus on the differential diagnosis between hypertensive heart disease and athlete’s heart, providing clinical information useful to distinguish between physiological and pathological remodelling.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | | | - Sergio Mondillo
- Department of Medical Biotechnologies, University of Siena, Italy
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27
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Małek ŁA, Bucciarelli-Ducci C. Myocardial fibrosis in athletes-Current perspective. Clin Cardiol 2020; 43:882-888. [PMID: 32189357 PMCID: PMC7403702 DOI: 10.1002/clc.23360] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 01/06/2023] Open
Abstract
Several previous studies suggested that prolonged and extensive physical activity might lead to increased prevalence of myocardial fibrosis in athletes. The review summarizes these studies focusing on common patterns of myocardial fibrosis observed in athletes, their potential causes and significance. It also presents recent research on parametric imaging shedding new light on diffuse myocardial fibrosis in athletes. Finally, it reviews how these traditional and novel cardiac magnetic resonance (CMR) techniques can be incorporated in the diagnostic work up to differentiate athlete's heart from cardiomyopathies.
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Affiliation(s)
- Łukasz A Małek
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland.,Msc in Sports Cardiology, St. George's University of London, London, UK
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, UK
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28
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Varaeva YR, Livantsova EN, Polenova NV, Kosyura SD, Nikitjuk DB, Starodubova AV. Characteristics of Blood Lipid Profiles of Professional Athletes: A Literature Review. Curr Pharm Des 2020; 26:98-102. [DOI: 10.2174/1381612825666191213115232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 12/15/2022]
Abstract
Regular physical activity significantly affects lipid status. In this literature review, the specific features
of athletes blood lipid profiles were analysed. Professional athletes blood lipid status was found considerably
preferable compared to sex- and age-matched sedentary population. Regardless of endurance or power type of
sports activities, athletes perform lower levels of TC, LDL-C and TG and comparable or higher blood levels of
HDL-C. The differences in blood lipids levels and sports disciplines were introduced. Although there are much
more factors as diet, place of origin, training regime, and even genetic predisposition that should be taken into
consideration for future research.
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Affiliation(s)
- Yurgita R. Varaeva
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Elena N. Livantsova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Natalia V. Polenova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Svetlana D. Kosyura
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Dmitriy B. Nikitjuk
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Antonina V. Starodubova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
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29
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D’Ascenzi F, Sciaccaluga C, Cameli M, Cecere A, Ciccone MM, Di Francesco S, Ganau A, Imbalzano E, Liga R, Palermo P, Palmiero P, Parati G, Pedrinelli R, Scicchitano P, Zito A, Mattioli AV. When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention. Eur J Prev Cardiol 2019; 28:361-369. [PMID: 33611390 DOI: 10.1177/2047487319893832] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022]
Abstract
Abstract
Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
- Department of Medicine, University of Pittsburgh, USA
| | - Carlotta Sciaccaluga
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Annagrazia Cecere
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Marco M Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D’Annunzio University of Chieti-Pescara, Italy
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, Italy
| | - Antonello Ganau
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Riccardo Liga
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | | | | | - Gianfranco Parati
- Department of Cardiovascular, Neural, and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Italy
- School of Medicine and Surgery, University Milano-Bicocca, Italy
| | - Roberto Pedrinelli
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy
| | - Piero Scicchitano
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy
| | - Annapaola Zito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
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30
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Piepoli MF, Abreu A, Albus C, Ambrosetti M, Brotons C, Catapano AL, Corra U, Cosyns B, Deaton C, Graham I, Hoes A, Lochen ML, Matrone B, Redon J, Sattar N, Smulders Y, Tiberi M. Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology. Eur J Prev Cardiol 2019; 27:181-205. [PMID: 31826679 DOI: 10.1177/2047487319893035] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.
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Affiliation(s)
- Massimo F Piepoli
- Department of Cardiology, Polichirurgico Hospital G Da Saliceto, Italy.,Institute of Life Sciences, Sant'Anna School of Advanced Studies, Italy
| | - Ana Abreu
- Serviço de Cardiologia, Universidade de Lisboa, Portugal
| | - Christian Albus
- Department of Pshychosomatics and Psychotherapy, University of Cologne, Germany
| | - Marco Ambrosetti
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Pavia, Italy
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau Research Unit, Sardenya Primary Health Care Center, Spain
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, Università degli studi di Milano, Italy
| | - Ugo Corra
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Veruno, Italy
| | - Bernard Cosyns
- Department of Cardiology, Universitair Ziekenhuis Brussel, Belgium
| | - Christi Deaton
- Department of Public Health and Primary Care, University of Cambridge, UK
| | - Ian Graham
- Cardiovascular Medicine, Trinity College Dublin, Ireland
| | - Arno Hoes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Maja-Lisa Lochen
- Department of Community Medicine, UiT the Artic University of Norway, Norway
| | - Benedetta Matrone
- Department of Cardiology, Polichirurgico Hospital G Da Saliceto, Italy
| | - Josep Redon
- INCLIVA Research Institute, University of Valencia, Spain
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Yvo Smulders
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
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