A consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology.
Cardiac injuries, specifically acute myocarditis, are a common complication of COVID-19. Recent studies in the literature have supported the beneficial and safe results of colchicine administration in the general population in cases of COVID-19 infection, especially in cases of myocardial injuries. However, the frequency of occurrence in athletes, its treatment, and management of these individuals concerning the return to competitive sports have not yet been clarified. The present case description is a novelty in that it refers to the onset of a mild form of acute myopericarditis secondary to COVID-19 infection in an athlete that was successfully treated as an outpatient with only colchicine. A 45-year-old marathon runner with no underlying health problems showed clinical symptoms of acute pericarditis and mild febrile infection. The biochemical tests were characterized by an increase in the level of troponin. MRI established the diagnosis of mild myopericarditis. In addition, he has been tested positive for COVID-19 by molecular/PCR test. The patient was treated with colchicine alone for three months. After that time, all the clinical and laboratory findings of myopericarditis were subsided. Six months after the onset of the disease, the athlete returned to full competitive action.
Anabolic steroid administration and planned exercise have been the two main methods applied to improve the function and morphology of atrophied muscle tissue. The effects of these two factors-specifically nandrolone decanoate administration and exercise by swimming on muscle weight, EMG activity, work capacity and on contractile protein content of rat gastrocnemius muscle, following experimentally induced atrophy by immobilization, were investigated. The results appear to support the conclusion that although both types of treatment obtain significant positive results exercise acts more effectively than the anabolic steroid in this respect.
Arterial baroreflex sensitivity (BRS) evaluation has been increasingly used as an index of cardiac autonomic control. Cardiac autonomic dysfunction leading to depressed BRS has been associated with an increased risk of ventricular arrhythmias and sudden death in patients with chronic kidney disease (CKD) on hemodialysis (HD).The purpose of this study was to investigate the effects of an exercise training program during hemodialysis on BRS in CKD patients.43 HD patients participated in the study. They were randomly assigned into either a 7-month exercise training program during HD (Group A: n=22 patients) or a sedentary control group (Group B: n=21 patients). Additionally, 20 sex- and age-matched sedentary individuals comprised a healthy control group (Group C). All patients at the beginning and the end of the study underwent a tilt test for evaluation of BRS and an exercise testing with spiroergometric study for cardiorespiratory capacity estimation. The level of Hb, medications and the HD procedure remained stable during the study.At baseline BRS was found to be reduced by 51.5% (p<0.05) and baroreflex effectiveness index (BEI) by 36.4% (p<0.05) in Group A compared with Group C. Initially, all HD patients had also significantly lower exercise time and VO2 peak than the healthy subjects. After training, Group A showed a significant improvement in BRS by 23.0% (p<0.05), in BEI by 27.0% (p<0.05), in event and ramp count by 35.0% (p<0.05) and 29.0% (p<0.05), respectively as well as in VO2 peak by 22.4% (p<0.05) and in exercise time by 40.9% (p<0.05). Significant correlations were found between BRS and METs (r=0.476, p<0.05), BRS and VO2 peak (r=0.443, p<0.05), BEI and METs (r = 0.492, p<0.05), BEI and VO2 peak (r=0.467, p<0.05), event count and VO2 peak (r=0.715, p<0.01), event count and exercise time (r=0.799, p<0.01), in Group A at the end of the study.Our results indicate that HD patients had considerably reduced cardiorespiratory capacity and impaired cardiac BRS compared to healthy sedentary individuals. Importantly, exercise training during HD yielded a marked increase of the indices representing baroreflex activity in association to the improvement of their functional capacity.
Foods rich in polyphenols have beneficial effects on health. This study aimed to examine the impact of dark chocolate on endurance runners’ arterial function. Forty-six male amateur runners, aged 25–55, participated. The initial assessments included clinical testing, arterial stiffness measurements, and a cardiopulmonary exercise test. The participants then consumed 50 g of dark chocolate (70% cocoa) daily for two weeks, maintaining their usual training routine. After this period, the baseline assessment was repeated. The results showed significant improvements. Pulse wave velocity decreased by 11.82% (p < 0.001), and augmentation index by 19.47% (p < 0.001). Systolic brachial blood pressure reduced by 2.12% (p < 0.05), diastolic by 2.79% (p < 0.05), and mean pressure by 2.41% (p < 0.05). Central arterial pressure also decreased, with systolic by 1.24% (p < 0.05), diastolic by 2.80% (p < 0.05), and mean pressure by 2.43% (p < 0.05). Resting heart rate increased by 4.57% (p < 0.05) and left ventricular ejection time decreased by 4.89% (p < 0.05), particularly in athletes over 40. Exercise time increased by 2.16% (p < 0.05), heart rate (max) by 1.15% (p < 0.05), VO2max by 2.31% (p < 0.05), and anaerobic threshold shifted by 6.91% (p < 0.001) in exercise time and 6.93% (p < 0.001) in VO2max. In conclusion, dark chocolate improves arterial function in endurance runners, enhancing vascular health.
This study aimed to examine the acute and chronic effects of an exercising table tennis program on cardiac Autonomic Nervous System (ANS) and functional capacity in people with tetraplegia. Twenty males with tetraplegia (C6-C7), with a mean age of 38.50 ± 4.04 years old, were randomly assigned into two equal groups: A, who followed a 6-month exercise training program with table tennis 3 times per week, and B, who remained untrained. Additionally, 11 healthy sedentary men (group C) with a mean age of 39.71 ± 5.87 years old participated in the study as healthy controls. At baseline, all participants underwent a short-term (5 min) and a long-term (24 h ambulatory) ECG monitoring to evaluate the heart rate variability (HRV) indices and a maximal arm ergometric and dynamometric testing of the upper limbs. Moreover, the acute cardiac autonomic responses to maximal arm cycle exercise test were evaluated by Polar S810i sensor chest strap. At the end of the 6-month study, all parameters were revaluated only in groups A and B. At baseline, there was no statistically significant difference between the two patient groups. However, intra-group changes at the end of the 6-month study regarding the 24-h HRV monitoring indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 13.9% (
Abstract Background It is well documented that prolonged intense exercise such as a marathon, transitorily alters cardiac function. However, the impact of ultra-endurance (UE) exercise on global and segmental longitudinal deformation of all cardiac chambers and on inter-chamber functional relationships has not yet been thoroughly investigated. Purpose The aim of the study was the evaluation of the acute effects of UE exercise on longitudinal deformation of all cardiac chambers and on intra-, inter- and atrioventricular functional relationships. Methods Echocardiographic assessment was performed the day before and at the finish line of “Spartathlon”: a 246 Km ultra-marathon. 2D speckle-tracking echocardiography was performed in all 4 chambers during the same cardiac cycle, allowing a simultaneous strain-time data display of all cardiac chambers (Figure 1). Peak global deformation values and temporal parameters adjusted for the heart rate were extracted from the derived curves, while a segmental analysis for left (LV) and right ventricle (RV) was also performed. Results Out of 60 participants initially screened, 27 athletes (17 male, age 45±7 years) finished the race in 33:34±1:59 hours. Both LV (−20.9±2.3 pre- to −18.8±2% post-, p=0.009) and RV global strains (−22.9±3.6 pre- to −21.2±3% post-, p=0.04) decreased post-race, even though remained within normal range for the 85% of the participants. Peak atrial strains [right (RA) and left (LA)] did not change (p=0.12 and 0.95). Basal and mid segmental strain values significantly decreased post-race, while both LV and RV apical strain values remained unaffected (p=0.899 and p=0.46, accordingly) (Figure). Concerning interchamber relationships, RV and RA strain curves were constantly larger in magnitude than those of the LV and LA, with RV/LV, LV/LA, RV/RA and RA/LA peak values' ratios remaining unchanged from pre- to post-race. Finally, although right chambers' time-to-peak values were shorter compared to the left ones, all chambers' strain curves peaked later post-race (p<0.001 for all). Conclusions Despite subtle changes in LV and RV strain, 4-chamber deformation values remained within normal range even after running a 246 km ultra-marathon. Following a segmental analysis, this finding could be explained for both ventricles by a preservation of apical deformation. Additionally, inter- and atrioventricular concordance was also maintained. Figure 1 Funding Acknowledgement Type of funding source: None
