Mechanical Synchrony in Long-Distance Runners: Importance of Previous Exposure to Endurance Races
ABSTRACT Prolonged exercise has been shown to lead to elevated levels of cardiac troponin and altered cardiac function on echocardiography. It is not known if cardiac synchrony is altered by prolonged exercise. The aims of this study were to assess changes in intra-left ventricular mechanical synchrony and circulating levels of cardiac troponin following prolonged exercise and to evaluate the importance of prior exposure to endurance racing.
Forty-three male participants in a 30-km cross-country race (20 new participants at this event [median, 3 previous endurance races] age matched against 23 repeat participants [median, 31 previous endurance events]) were assessed prospectively 1 to 2 days before and 24 hours after the race using troponin T and Doppler tissue imaging analyzing the standard deviation of time to peak myocardial systolic velocity (T(s)-SD) in a six-basal, six-midventricular segment model measuring myocardial synchrony. The insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene was also analyzed, as I allele carriers reportedly have superior endurance performance, while the D allele predisposes to renin-angiotensin system-induced cardiac remodeling.
Prerace troponin T was undetectable in all runners, and postrace levels were higher in new runners (median, 0.03 microg/L; interquartile range [IQR], 0.01-0.04 microg/L) than in repeat runners (median, 0.01 microg/L; IQR, 0.01-0.02 microg/L) (P = .03). Although new and repeat runners had similar T(s)-SD at baseline (32 msec [IQR, 22-43 msec] vs 34 msec [IQR, 29-45 msec], P = .13), dyssynchrony increased only in new runners (40 msec [IQR, 31-47 msec], P < .001; in repeat runners, median, 38 msec [IQR, 29-43 msec], P = .30; median relative difference, +13% vs +5%, P = .02). ACE genotype distribution was similar in both groups. Multivariate analysis showed that (1) a lack of prior endurance exposure; (2) more copies of the ACE D allele; and (3) lower peak systolic velocity were independent predictors of postrace dyssynchrony (P < .05 for all).
Prolonged exertion increased ventricular mechanical dyssynchrony in new endurance participants and in ACE D allele carriers. The long-term impact of such changes warrants future study.
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ABSTRACT: Examining the progress in cardiovascular medicine, through articles published in the Journal of Internal Medicine (from 1989), Acta Medica Scandinavica (from 1919 until 1989) and Nordiskt Medicinskt Arkiv (before 1919), is an attractive task but in reality not easy. A total of 149 articles were identified within this field since the first, which was published in 1877; however to cover all of these would make this review excessively long. Therefore I have decided (i) to consider only groups of articles reflecting fields in which Scandinavian contributions were pioneering or for other reasons were of particular interest, and (ii) to limit the review to articles published up to the time of my own first contribution to Acta Medica Scandinavica in 1970. Despite the second limitation, an impressive number of 126 reports remained to be considered and, if fulfilling the first limitation, to be discussed in this review. This article is protected by copyright. All rights reserved.Journal of Internal Medicine 09/2013; 274(6). DOI:10.1111/joim.12134 · 5.79 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of this study was to observe the changes in endothelial and inflammatory markers in middle-aged male runners with exercise-induced hypertension (EIH) at baseline and at 100-km, 200-km, and 308-km checkpoints during a prolonged endurance ultramarathon. DESIGN: Among a total of 62 ultramarathon volunteers, 8 with systolic blood pressure higher than 210 mm Hg and 8 with normal systolic blood pressure were selected for this study. The subjects were designated to EIH and control (CON) groups. Blood was collected for the analysis of soluble vascular cell adhesion molecule-1, soluble E-selectin, leukocytes, creatine kinase, and high-sensitivity C-reactive protein. RESULTS: Soluble vascular cell adhesion molecule-1 showed a significantly greater increase in the EIH group than in the CON group at 100 km and 200 km. Soluble E-selectin also showed a significantly greater increase in the EIH group than in the CON group at 100 km. Leukocytes significantly increased in the EIH group than in the CON group at 308 km. Creatine kinase and high-sensitivity C-reactive protein showed no group differences. CONCLUSIONS: Leukocytes, creatine kinase, and high-sensitivity C-reactive protein showed delayed-onset increases in both groups. Increased exercise intensity may stimulate greater endothelial responses independent of the inflammatory markers in EIH. The loss of a protective effect may be greater in those with EIH than in CONs. Acknowledging and prescribing proper exercise intensity may be critical in preventing possible vascular-related complications in runners with EIH.American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 06/2013; 92(6):513-522. DOI:10.1097/PHM.0b013e31829232db · 1.56 Impact Factor
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ABSTRACT: Changes in muscle mass and strength across the adult age span are variable and related to the ciliary neurotrophic factor (CNTF) genotype. In particular, a single CNTF haplotype (1357 G→A) is important for neuronal and muscular developments and may be associated with muscle strength response to resistance training. We examined whether CNTF genotype differentially influences the effect of resistance training on neuromuscular improvement in male college students. Resistance training of the upper extremities comprised 3 sets at 75%-85% intensity per 1 repetition maximum, 3 times a week, for a total of 8 weeks. We measured isokinetic muscle function of the elbow joint with regard to strength (60°/s) and endurance (180°/s) by using an isokinetic dynamometer. The biceps brachii (BB) and brachioradialis muscles were studied using surface electromyography with spike-triggered averaging to assess surface-detected motor unit potential (SMUP) area. After resistance training, the SMUP of the BB increased significantly at 60°/s (p < 0.05), but no difference in the CNTF genotype was observed. The SMUP of the BB at 180°/s increased significantly in the GG/AA genotype group compared with that in the GA genotype group (p < 0.05). The average power of the elbow flexor at 180°/s increased significantly after resistance training (p < 0.05), but again, no difference in the CNTF genotype was observed. Thus, improvements in muscle strength and endurance may have resulted directly from resistance training rather than from genetic factors related to nerves in muscle tissue. Key PointsResistance training improves muscle strength and endurance in young men.This improvement in muscular strength and endurance is irrespective of CNTF genotypes.