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Pingitore A, Peruzzi M, Clarich SC, Palamà Z, Sciarra L, Cavarretta E. An overview of the electrocardiographic monitoring devices in sports cardiology: Between present and future. Clin Cardiol 2023; 46:1028-1037. [PMID: 37349944 PMCID: PMC10540029 DOI: 10.1002/clc.24073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Athletes represent a mainly healthy population, which however could be considered at risk of major arrhythmic events, especially in case of undiagnosed cardiomyopathies. For this reason, the periodical sports medicine examination and the electrocardiography are essential tools in the cardiovascular screening, even though they do not always succeed in identifying rhythm disturbances, particularly when asymptomatic or rarely symptomatic. HYPOTHESIS Prolonged cardiac monitoring often enables clinicians to stratify the arrhythmic risk and reach the diagnosis. The technological progress of the last decades has produced an always-increasing number of heart rhythm monitoring devices, starting from the 24-hour electrocardiogram Holter monitoring and ending with the wide world of wearable devices. METHODS In the literature, the extreme utility of this equipment in the patients affected by cardiovascular diseases and in the general population is well established. On the contrary, athletes-based randomized trials or large-scale epidemiological studies targeting the frequency of cardiac symptoms and the use of cardiac monitoring are missing, while an ever-growing number of case series and small observational studies are flourishing in recent years. RESULTS The present review showcases the available electrocardiographic monitoring options, principally in the medical setting, listing their characteristics, their indications, their supporting evidence, and their general pros and cons. CONCLUSIONS The ultimate goal of this review is guiding physicians through the wide variety of heart rhythm monitoring options in the specific subfield of sports cardiology, when an arrhythmia is suspected in an athlete, to tailor the diagnostic process and favor the best diagnostic accuracy.
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Affiliation(s)
- Annachiara Pingitore
- Department of General and Specialistic Surgery “Paride Stefanini”Sapienza University of RomeRomeItaly
| | - Mariangela Peruzzi
- Department of Clinical Internal, Anesthesiology and Cardiovascular SciencesSapienza University of RomeRomeItaly
- Mediterranea CardiocentroNaplesItaly
| | | | - Zefferino Palamà
- Electrophysiology Service, Division of CardiologyCasa di Cura Villa VerdeTarantoItaly
- Department of Clinical Medicine, Public Health, Life and Environmental SciencesUniversity of L'AquilaCoppitoItaly
| | - Luigi Sciarra
- Department of Clinical Medicine, Public Health, Life and Environmental SciencesUniversity of L'AquilaCoppitoItaly
| | - Elena Cavarretta
- Mediterranea CardiocentroNaplesItaly
- Department of Medical‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
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Rothschild CE. Exercise Considerations for the Masters Female Athlete. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Patel VI, Gradus-Pizlo I, Malik S, Barseghian El-Farra A, Dineen EH. Cardiodiagnostic sex-specific differences of the female athlete in sports cardiology. Am Heart J Plus 2022; 17:100149. [PMID: 38559879 PMCID: PMC10978368 DOI: 10.1016/j.ahjo.2022.100149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 04/04/2024]
Abstract
The cardiovascular care of highly active individuals and competitive athletes has developed into an important focus within the field of sports medicine. An evolving understanding of exercise-induced cardiovascular remodeling in athletes has led to a more robust characterization of physiologic adaptation versus pathological dysfunction, but this distinction is often challenging due to diagnostic commonalities. Current data reflects sporting-focused analyses of mainly male athletes, which may not be easily applicable to the female athletic heart. Increasingly female-specific cardiac dimensional and physiologic data are starting to emerge from comparative studies that may be utilized to address this growing need, and further guide individualized care. Here, we review current literature evaluating female-specific cardiovascular adaptations of the athletic heart, and formulate a discussion on cardiac remodeling, cardiodiagnostic findings, etiologic mechanisms, limitations of currently available data, and direction for future research in the cardiovascular care of female athletes.
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Affiliation(s)
- Vishal I. Patel
- Corresponding author at: Division of Cardiology, Department of Internal Medicine, University of California, Irvine, School of Medicine, 101 The City Drive South, Building 200, Room 414, Orange, CA 92868, United States of America.
| | - Irmina Gradus-Pizlo
- Division of Cardiology, University of California, Irvine, School of Medicine, Orange, CA 92868, United States of America
- Susan Samueli Integrative Health Institute, UCI Health, Orange, CA 92868, United States of America
| | - Shaista Malik
- Division of Cardiology, University of California, Irvine, School of Medicine, Orange, CA 92868, United States of America
- Susan Samueli Integrative Health Institute, UCI Health, Orange, CA 92868, United States of America
| | - Ailin Barseghian El-Farra
- Division of Cardiology, University of California, Irvine, School of Medicine, Orange, CA 92868, United States of America
- Susan Samueli Integrative Health Institute, UCI Health, Orange, CA 92868, United States of America
| | - Elizabeth H. Dineen
- Division of Cardiology, University of California, Irvine, School of Medicine, Orange, CA 92868, United States of America
- Susan Samueli Integrative Health Institute, UCI Health, Orange, CA 92868, United States of America
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Catapano M, Ahmed M, Breslow RG, Borg-Stein J. The aging athlete. PM R 2022; 14:643-651. [PMID: 35441493 DOI: 10.1002/pmrj.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022]
Abstract
Aging athletes, those 60 years and older, are a growing population of mature, active individuals who value sports and exercise participation throughout their lifespan. Although recommendations for younger and masters athletes have been extrapolated to this population, there remains a paucity of specific guidelines, treatment algorithms, and considerations for aging athletes. The benefits of living an active lifestyle must be weighed against the risks for unique cardiovascular, metabolic, and musculoskeletal injuries requiring diagnostic and therapeutic interventions. In this article, we review the unique cardiovascular and muscular physiology of aging athletes and how it influences the risk of specific medical conditions. We also discuss general prevention and treatment strategies. Finally, we identify areas of future research priorities and emerging treatments.
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Affiliation(s)
- Michael Catapano
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marwa Ahmed
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Latorre-Román PÁ, García-Pinillos F, Salas Sánchez J, Jiménez MM, Serrano Huete V, Martínez Redondo M, Vela JA, Párraga-Montilla JA. A New Approach for Evaluation of Cardiovascular Fitness and Cardiac Responses to Maximal Exercise Test in Master Runners: A Cross-Sectional Study. J Clin Med 2022; 11. [PMID: 35329974 DOI: 10.3390/jcm11061648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to analyze the cardiac autonomic function at rest, at maximum exercise, and in recovery after exercise and to determine sex-specific and age-specific values for resting heart rate (RHR), hear rate (HR)-peak, HR recovery (HRR), and HR variability at rest in master runners. Fifty endurance runners (21 women) participated in this study (43.28 ± 5.25 years). The subjects came from different athletic clubs in Andalusia (Spain), and the testing protocol was performed in-season. A 3-km running test was performed and the cardiovascular response was monitored. Regarding sex, no significant differences were found regarding cardiovascular autonomic function at rest, during exercise, and following maximal exercise, only at rest, the standard deviation of all R-R intervals and low frequency values displayed significantly (p < 0.05) lower scores in women. 46% of athletes showed an RHR < 60 bpm. Additionally, HR-peak showed a significant correlation with age (r = −0.369; p = 0.009) and HRR5min (r = 0.476, p = 0.001). Also, endurance performance was inversely associated with obesity traits and cardiometabolic risk factors. In summary, age, sex, fitness, or anthropometrics characteristics did not show a relevant influence on cardiovascular autonomic modulation in master runners. However, the 3-km performance displayed a significant negative association with several factors of cardiometabolic risk.
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Abstract
The higher performance level of master athletes compared to non-athletes is often associated with better health throughout life. However, even the physical performance of master athletes declines with age, and this decline accelerates from about the age of 70 years onwards. A progressive loss of muscle mass, declines in force- and power-generating capacity, decreased flexibility, and the concomitant decline in specific tension characterize the muscular changes underlying performance declines. In the cardiovascular system, declines in stroke volume and cardiac output, and cardiac and vascular stiffness contribute to decreasing performance. Recent studies have shown that long-term endurance exercise in master athletes does not only have positive effects, but is associated with an increased incidence of atrial fibrillation, atherosclerotic plaques, and aortic dilation, and even more so in men than in women. Recently, larger longitudinal datasets were analysed and showed that the age-related decline in performance was similar in longitudinal and cross-sectional data. In conclusion, regular physical activity enhances the exercise capacity, and hence quality of life in old age, but it is not without risks.
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Affiliation(s)
- Bergita Ganse
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland.,Innovative Implant Development, Clinics and Institutes of Surgery, Universität des Saarlandes, Homburg, Germany
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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Affiliation(s)
- M Carmen Adamuz
- Sports Medicine Department, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar
| | - Domingo Pascual Figal
- Head of Cardiology Department, Hospital Virgen de la Arrixaca, University of Murcia, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Murcia, Spain.
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