Medicine and Science in Sports and Exercise, Jun 15, 2023
ABSTRACT Purpose Concerns on whether athletes––particularly older ones––are at an increased risk ... more ABSTRACT Purpose Concerns on whether athletes––particularly older ones––are at an increased risk of pathological aortic dilation exist, and the prevalence of aortic calcifications in these individuals is unknown. We aimed to compare the dimensions, distensibility, and prevalence of calcifications in the thoracic aorta between former male professional cyclists (cases) and sex/age-matched controls. Methods We used a retrospective cohort design, where cases were former finishers of at least one Grand Tour (Tour de France, Giro d’ Italia or Vuelta a España) and controls were untrained individuals with no previous sports history and free of cardiovascular risk. All participants underwent magnetic resonance and computer tomography assessments for the measurement of aortic dimensions and calcifications, respectively. Results Cases showed larger (P < 0.05) dimensions than controls for aortic annulus, sinus, and arch, as well as for ascending and descending aorta. However, none of the participants presented with pathological aortic dilation (all diameters <40 mm). A slightly higher prevalence of calcifications in the ascending aorta was observed in cases (13% vs 0% in controls, P = 0.020). Subanalyses confirmed that cases who were still competing (masters category, n = 8) had larger aortic diameters (P < 0.05) and a greater presence of calcifications in the ascending/descending aorta (38% vs 0% for both segments, P = 0.032) than those who had become inactive (n = 15). No between-group differences were found for aortic distensibility. Conclusions Former professional cyclists, particularly those who are still competing after retirement, show enlarged aortic diameters (albeit without exceeding upper limits of normality). Former professional cyclists also showed a slightly higher prevalence of calcifications in the ascending aorta than controls, although aortic distensibility was not compromised. The clinical relevance of these findings should be the subject of future studies.
Introduction: The diagnosis of aortic (Ao) disorders in athletes is complicated by the belief tha... more Introduction: The diagnosis of aortic (Ao) disorders in athletes is complicated by the belief that prolonged and intense exercise training may induce Ao enlargement as a physiological response. There are few studies with a large population of elite athletes (EA) regarding the effects of training on the aorta (Ao). This study was designed to establish the physiological limits of Ao remodeling associated to exercise training. Hypothesis: Since exercise training in EA could induce Ao remodeling, normal Ao dimensions could be greater in EA than in the general population. Method: Cross-sectional study including 4,267 healthy Spanish EA. All of them completed subsequently a minimal follow-up of 4 years without developing any event that precluded them to continue in high competition. There were 1,520 women (age 20.3±5.4 y, BSA 1.65±0.18 m2, 7.7±4.3 years/training and 19.6±10.6 hours/day of training) and 2,742 men (age 22.2±6.2 y, BSA 1.93±0.22 m2, 8.6±5 years/training and 18.9±8.8 hours/day of training). They we...
Background Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes ha... more Background Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes have not been well determined yet. Using CMR normal reference values derived from the general population may be misleading in athletes and may have clinical implications. Aims To determine reference ventricular dimensions and function parameters and ratios by CMR in high performance athletes. Methods Elite athletes and age‐ and gender‐matched sedentary healthy controls were included. Anatomical and functional variables, including biventricular volumes, mass, systolic function, wall thickness, sphericity index and longitudinal function were determined by CMR. Results A total of 148 athletes (29.2 ± 9.1 years; 64.8% men) and 124 controls (32.1 ± 10.5 years; 67.7% men) were included. Left ventricular (LV) mass excluding papillary muscles was 67 ± 13 g/m2 in the control group and increased from 65 ± 14 g/m2 in the low intensity sport category to 83 ± 16 g/m2 in the high cardiovascular demand s...
Medicine & Science in Sports & Exercise, 1999
The purpose of this study was to analyze the short-term effects of a marathon race (Madrid Marath... more The purpose of this study was to analyze the short-term effects of a marathon race (Madrid Marathon) on both markers of cardiac damage and echocardiographic parameters in a group of 22 runners (17 male and 5 female; 34 +/- 5 yr; VO2max: 55.7 +/- 9.1 mL x kg(-1) x min(-1) with a wide range of fitness levels. Venous blood samples were collected from each subject 48 h before the race, at race finish, and 6, 24, and 48 h postexercise for the determination of myoglobin, total creatine kinase catalytic activity (total CK), mass concentration of creatine kinase isoenzyme MB (CK-MB mass), and cardiac isoforms of troponin T and I (TnT-c and TnI-c, respectively). In addition, echocardiographic parameters (M-mode two-dimensional and Doppler analysis) indicative of both left ventricular (LV) systolic and diastolic function were obtained three times from each runner: 2-5 d before the race, at race finish, and 24-36 h after exercise. Except in one subject, levels of TnT-c and TnI-c were within normal limits (<0.1 ng x mL(-1)) in all the samples collected before or after the race. Overall LV systolic function was not altered by marathon running. Finally, LV diastolic function was transiently altered after the race since the ratio between peak early and late transmitral filling velocities (E/A) was significantly reduced at race finish (P < 0.01) and returned to resting levels after 24-36 h. Our findings suggest that marathon running does not adversely affect the hearts of healthy individuals independently from their training status.
... tipo I, el síndrome de Brugada, la taquicar-dia ventricular polimórfica catecolaminérgica o t... more ... tipo I, el síndrome de Brugada, la taquicar-dia ventricular polimórfica catecolaminérgica o también a la commotio cordis(14,18-20 ... En contraposición a este planteamiento se encuentra la organización médico-deportiva ita-liana que propugna un procedimiento diagnósti-co de ...
Medicine and Science in Sports and Exercise, Jun 15, 2023
ABSTRACT Purpose Concerns on whether athletes––particularly older ones––are at an increased risk ... more ABSTRACT Purpose Concerns on whether athletes––particularly older ones––are at an increased risk of pathological aortic dilation exist, and the prevalence of aortic calcifications in these individuals is unknown. We aimed to compare the dimensions, distensibility, and prevalence of calcifications in the thoracic aorta between former male professional cyclists (cases) and sex/age-matched controls. Methods We used a retrospective cohort design, where cases were former finishers of at least one Grand Tour (Tour de France, Giro d’ Italia or Vuelta a España) and controls were untrained individuals with no previous sports history and free of cardiovascular risk. All participants underwent magnetic resonance and computer tomography assessments for the measurement of aortic dimensions and calcifications, respectively. Results Cases showed larger (P < 0.05) dimensions than controls for aortic annulus, sinus, and arch, as well as for ascending and descending aorta. However, none of the participants presented with pathological aortic dilation (all diameters <40 mm). A slightly higher prevalence of calcifications in the ascending aorta was observed in cases (13% vs 0% in controls, P = 0.020). Subanalyses confirmed that cases who were still competing (masters category, n = 8) had larger aortic diameters (P < 0.05) and a greater presence of calcifications in the ascending/descending aorta (38% vs 0% for both segments, P = 0.032) than those who had become inactive (n = 15). No between-group differences were found for aortic distensibility. Conclusions Former professional cyclists, particularly those who are still competing after retirement, show enlarged aortic diameters (albeit without exceeding upper limits of normality). Former professional cyclists also showed a slightly higher prevalence of calcifications in the ascending aorta than controls, although aortic distensibility was not compromised. The clinical relevance of these findings should be the subject of future studies.
Introduction: The diagnosis of aortic (Ao) disorders in athletes is complicated by the belief tha... more Introduction: The diagnosis of aortic (Ao) disorders in athletes is complicated by the belief that prolonged and intense exercise training may induce Ao enlargement as a physiological response. There are few studies with a large population of elite athletes (EA) regarding the effects of training on the aorta (Ao). This study was designed to establish the physiological limits of Ao remodeling associated to exercise training. Hypothesis: Since exercise training in EA could induce Ao remodeling, normal Ao dimensions could be greater in EA than in the general population. Method: Cross-sectional study including 4,267 healthy Spanish EA. All of them completed subsequently a minimal follow-up of 4 years without developing any event that precluded them to continue in high competition. There were 1,520 women (age 20.3±5.4 y, BSA 1.65±0.18 m2, 7.7±4.3 years/training and 19.6±10.6 hours/day of training) and 2,742 men (age 22.2±6.2 y, BSA 1.93±0.22 m2, 8.6±5 years/training and 18.9±8.8 hours/day of training). They we...
Background Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes ha... more Background Data regarding cardiovascular magnetic resonance (CMR) reference values in athletes have not been well determined yet. Using CMR normal reference values derived from the general population may be misleading in athletes and may have clinical implications. Aims To determine reference ventricular dimensions and function parameters and ratios by CMR in high performance athletes. Methods Elite athletes and age‐ and gender‐matched sedentary healthy controls were included. Anatomical and functional variables, including biventricular volumes, mass, systolic function, wall thickness, sphericity index and longitudinal function were determined by CMR. Results A total of 148 athletes (29.2 ± 9.1 years; 64.8% men) and 124 controls (32.1 ± 10.5 years; 67.7% men) were included. Left ventricular (LV) mass excluding papillary muscles was 67 ± 13 g/m2 in the control group and increased from 65 ± 14 g/m2 in the low intensity sport category to 83 ± 16 g/m2 in the high cardiovascular demand s...
Medicine & Science in Sports & Exercise, 1999
The purpose of this study was to analyze the short-term effects of a marathon race (Madrid Marath... more The purpose of this study was to analyze the short-term effects of a marathon race (Madrid Marathon) on both markers of cardiac damage and echocardiographic parameters in a group of 22 runners (17 male and 5 female; 34 +/- 5 yr; VO2max: 55.7 +/- 9.1 mL x kg(-1) x min(-1) with a wide range of fitness levels. Venous blood samples were collected from each subject 48 h before the race, at race finish, and 6, 24, and 48 h postexercise for the determination of myoglobin, total creatine kinase catalytic activity (total CK), mass concentration of creatine kinase isoenzyme MB (CK-MB mass), and cardiac isoforms of troponin T and I (TnT-c and TnI-c, respectively). In addition, echocardiographic parameters (M-mode two-dimensional and Doppler analysis) indicative of both left ventricular (LV) systolic and diastolic function were obtained three times from each runner: 2-5 d before the race, at race finish, and 24-36 h after exercise. Except in one subject, levels of TnT-c and TnI-c were within normal limits (<0.1 ng x mL(-1)) in all the samples collected before or after the race. Overall LV systolic function was not altered by marathon running. Finally, LV diastolic function was transiently altered after the race since the ratio between peak early and late transmitral filling velocities (E/A) was significantly reduced at race finish (P < 0.01) and returned to resting levels after 24-36 h. Our findings suggest that marathon running does not adversely affect the hearts of healthy individuals independently from their training status.
... tipo I, el síndrome de Brugada, la taquicar-dia ventricular polimórfica catecolaminérgica o t... more ... tipo I, el síndrome de Brugada, la taquicar-dia ventricular polimórfica catecolaminérgica o también a la commotio cordis(14,18-20 ... En contraposición a este planteamiento se encuentra la organización médico-deportiva ita-liana que propugna un procedimiento diagnósti-co de ...
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