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Cirovic S, Malmgren A, Kurdie R, Bilal D, Dencker M, Gudmundsson P. Vortex formation time in female athletes. Int J Cardiovasc Imaging 2024; 40:373-384. [PMID: 38008878 PMCID: PMC10884071 DOI: 10.1007/s10554-023-02995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/25/2023] [Indexed: 11/28/2023]
Abstract
Regular, vigorous physical activity can have a significant impact on cardiac function, leading to cardiac morphological alterations that may be challenging to distinguish from pathological changes. Therefore, new screening methods are needed to accurately differentiate between adaptive changes and pathological alterations in athletes. Vortex formation time (VFT) is an emerging method that shows potential in this regard, as it involves the formation of a rotating vortex ring in the left ventricle during the early filling phase of diastole. In this study, we investigated the difference in VFT between two groups of women: professional handball players and healthy middle-aged female athletes, along with their corresponding control groups. By using echocardiography-Doppler analysis of the heart, VFT was calculated based on the left ventricular ejection fraction, the ratio between the end-diastolic volume and the diameter of the mitral annulus, and the ratio of the atrial contraction volume to the total inflow via the mitral valve. The study reveals a significant increase in VFT in both professional handball players and middle-aged female athletes compared to their respective control groups. Moreover, statistically significant differences between handball players and middle-aged female athletes were observed, indicating that the level of physical activity may affect the VFT. These results suggest that VFT could be a promising screening tool for identifying cardiac adaptations due to long-term vigorous training, potentially enabling more accurate diagnoses of cardiac morphological alterations in athletes.
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Affiliation(s)
- Stefan Cirovic
- Biomedical Sciences, Faculty of Health and Society, Malmö University, Malmö, 205 06, Sweden.
| | - Andreas Malmgren
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, 205 06, Sweden
| | - Rayane Kurdie
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, 205 06, Sweden
| | - Dejan Bilal
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, 205 06, Sweden
| | - Magnus Dencker
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, 205 06, Sweden
| | - Petri Gudmundsson
- Biomedical Sciences, Faculty of Health and Society, Malmö University, Malmö, 205 06, Sweden
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Finocchiaro G, Westaby J, Sheppard MN, Papadakis M, Sharma S. Sudden Cardiac Death in Young Athletes: JACC State-of-the-Art Review. J Am Coll Cardiol 2024; 83:350-370. [PMID: 38199713 DOI: 10.1016/j.jacc.2023.10.032] [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: 08/10/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 01/12/2024]
Abstract
Athletes epitomize the healthiest segment of society. Despite this premise, sudden cardiac death may occur in apparently healthy athletes, attracting significant attention not only in the medical community but also in laypersons and media. The incidence of sudden cardiac death is variably reported, and epidemiological burden differs among cohorts. Athletes appear to be at risk of developing fatal arrhythmias when harboring a quiescent cardiac disorder. Primary cardiomyopathies, ion channelopathies, and coronary artery anomalies are prevalent causes in young individuals. Cardiac assessment of athletes can be challenging because these individuals exhibit a plethora of electrical, structural, and functional physiological changes that overlap with cardiac pathology. A diagnosis of cardiac disease in a young athlete is not necessarily an indication to terminate competition and sports participation. International guidelines, traditionally focused on disqualification of individuals with cardiac disease, have recently adopted a more liberal attitude, based on a careful assessment of the risk and on a shared-decision making approach.
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Affiliation(s)
- Gherardo Finocchiaro
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Joseph Westaby
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Mary N Sheppard
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Michael Papadakis
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom
| | - Sanjay Sharma
- Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom.
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Grabitz C, Sprung KM, Amagliani L, Memaran N, Schmidt BMW, Tegtbur U, von der Born J, Kerling A, Melk A. Cardiovascular health and potential cardiovascular risk factors in young athletes. Front Cardiovasc Med 2023; 10:1081675. [PMID: 37332595 PMCID: PMC10272594 DOI: 10.3389/fcvm.2023.1081675] [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: 10/27/2022] [Accepted: 03/27/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Cardiovascular disease remains the most common cause of death worldwide, and early manifestations are increasingly identified in childhood and adolescence. With physical inactivity being the most prevalent modifiable risk factor, the risk for cardiovascular disease is deemed low in people engaging in regular physical exercise. The aim of this study was to investigate early markers and drivers of cardiovascular disease in young athletes pursuing a career in competitive sports. Methods One hundred and five athletes (65 males, mean age 15.7 ± 3.7 years) were characterized by measurement of body impedance to estimate body fat, blood pressure (BP), carotid femoral pulse wave velocity (PWV) to evaluate arterial elasticity, ergometry to assess peak power output, echocardiography to calculate left ventricular mass, and blood tests. Results Systolic BP was elevated in 12.6% and thereby more than twice as high as expected for the normal population. Similarly, structural vascular and cardiac changes represented by elevated PWV and left ventricular mass were found in 9.5% and 10.3%. Higher PWV was independently associated with higher systolic BP (β = 0.0186, p < 0.0001), which in turn was closely correlated to hemoglobin levels (β = 0.1252, p = 0.0435). In this population, increased left ventricular mass was associated with lower resting heart rate (β = -0.5187, p = 0.0052), higher metabolic equivalent hours (β = 0.1303, p = 0.0002), sport disciplines with high dynamic component (β = 17.45, p = 0.0009), and also higher systolic BP (β = 0.4715, p = 0.0354). Conclusion Despite regular physical exercise and in the absence of obesity, we found an unexpected high rate of cardiovascular risk factors. The association of PWV, systolic BP, and hemoglobin suggested a possible link between training-induced raised hemoglobin levels and altered vascular properties. Our results point toward the need for thorough medical examinations in this seemingly healthy cohort of children and young adults. Long-term follow-up of individuals who started excessive physical exercise at a young age seems warranted to further explore the potential adverse effects on vascular health.
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Affiliation(s)
- Carl Grabitz
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Katharina M. Sprung
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Laura Amagliani
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Nima Memaran
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | | | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Jeannine von der Born
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Arno Kerling
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
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Luo H, Kou T, Su Y, Shen Y, Yin L. Experimental research on the evaluation of left ventricular systolic function by layered speckle tracking before and after berberine treatment in a cardiac hypertrophy rat model. Cardiovasc Diagn Ther 2023; 13:367-383. [PMID: 37583682 PMCID: PMC10423732 DOI: 10.21037/cdt-22-464] [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] [Received: 09/11/2022] [Accepted: 01/19/2023] [Indexed: 08/17/2023]
Abstract
Background To evaluate the effect of berberine (BBR) intervention on left ventricular hypertrophy and systolic function in rats by ultrasound layered strain imaging and cardiac hypertrophy model. Methods Eighty healthy male Sprague-Dawley (SD) rats were randomly divided into four groups: group A (normal saline control group), group B [isoproterenol (ISO) induced model group], group C (BBR hydrochloride 5 mg/kg + ISO group) and group D (BBR hydrochloride 10 mg/kg + ISO group). Echocardiography was performed on days 1, 7 and 14, respectively. The myocardial tissue was taken for pathological examination. The key proteins of Rho/ROCK signaling pathway were quantified by immunohistochemical staining. Results On day 7, compared with group A, peripheral strain values of the subendocardium and middle myocardium of rats in groups B, C and D were significantly decreased. The absolute value of circumferential strain (CS) in subendocardium and middle myocardium in group B was significantly lower than that in groups C and D (-24.21 vs. -26.68 vs. -27.69; -14.90 vs. -16.48 vs. -17.69). Pathological results showed that compared with the myocardial cells in control group A, the myocardial cells in group B had significantly increased cross-sectional area, and obvious myocardial interstitial fibrosis. Compared with group B, BBR intervention reduced the deposition of fibrosis in groups C and D, group D was more obvious. Immunohistochemical results showed that compared with group A, the protein expression levels of ROCK, RhoA and Bax in groups B, C and D were significantly increased, while the protein expression levels of Bcl-2 were significantly decreased. Conclusions Ultrasound layered strain imaging could evaluate the early left ventricular systolic function in isoprenaline-induced hypertrophy rat model. BBR might inhibit oxidative stress through the Rho/ROCK signaling pathway and slow down the progression of myocardial fibrosis after the formation of cardiac hypertrophy. This provides reference and direction for clinical decision-making and further research.
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Affiliation(s)
- Haorou Luo
- Ultrasonic Imaging Department of Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tuli Kou
- Ultrasonic Imaging Department, Chengdu Second People’s Hospital, Chengdu, China
| | - Ye Su
- Department of Cardiovascular Ultrasound and Cardiac Function, Sichuan Provincial People’s Hospital, School of Medicine, UESTC, Chengdu, China
| | - Yang Shen
- Department of Stomatology, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Lixue Yin
- Sichuan Provincial Key Laboratory of Ultrasound Cardiac Electrophysiology and Biomechanics, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, School of Medicine, UESTC, Chengdu, China
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Śliż D, Wiecha S, Gąsior JS, Kasiak PS, Ulaszewska K, Lewandowski M, Barylski M, Mamcarz A. Impact of COVID-19 Infection on Cardiorespiratory Fitness, Sleep, and Psychology of Endurance Athletes-CAESAR Study. J Clin Med 2023; 12:jcm12083002. [PMID: 37109342 PMCID: PMC10143025 DOI: 10.3390/jcm12083002] [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: 03/22/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
COVID-19 has a deteriorating impact on health which is especially important for endurance athletes (EAs) who need to maintain continuity of training. The illness affects sleep and psychology, which influence sport performance. The aims of this study were: (1) to assess the consequences of mild COVID-19 on sleep and psychology and (2) to assess the consequences of mild COVID-19 on cardiopulmonary exercise test (CPET) results. A total of 49 EAs (males = 43, 87.76%; females = 6, 12.24%; age = 39.9 ± 7.8 years; height = 178.4 ± 6.8 cm; weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m-2) underwent a maximal cycling or running CPET pre- and post-COVID-19 and completed an original survey. Exercise performance deteriorated after COVID-19 (maximal oxygen uptake, VO2max = 47.81 ± 7.81 vs. 44.97 ± 7.00 mL·kg·min-1 pre- and post-infection, respectively; p < 0.001). Waking up at night affected the heart rate (HR) at the respiratory compensation point (RCP) (p = 0.028). Sleep time influenced pulmonary ventilation (p = 0.013), breathing frequency (p = 0.010), and blood lactate concentration (Lac) (p = 0.013) at the RCP. The maximal power/speed (p = 0.046) and HR (p = 0.070) were linked to the quality of sleep. Stress management and relaxation techniques were linked with VO2max (p = 0.046), maximal power/speed (p = 0.033), and maximal Lac (p = 0.045). Cardiorespiratory fitness deteriorated after mild COVID-19 and was correlated with sleep and psychological indices. Medical professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.
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Affiliation(s)
- Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- School of Public Health, Postgraduate Medical Education Center, 01-813 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biala Podlaska, Poland
| | - Jakub S Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Przemysław Seweryn Kasiak
- Students' Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
| | - Katarzyna Ulaszewska
- Students' Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
| | - Marcin Lewandowski
- Department of Pharmacology and Clinical Pharmacology Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, 00-927 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Łódź, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
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