Physiological and echocardiographic findings in ironman athletes - Are there signs of cardiac fatigue?;Leistungsdiagnostik und echokardiographische befunde bei ironman-triathleten - Gibt es hinweise für eine myokardiale schädigung?

Journal fur Kardiologie

Volumn 21, Issue 5-6, 2014, Pages 144-152

  Leischik, Roman ^a   Spelsberg, N ^a  

^a UNIVERSITY OF WITTEN HERDECKE   (Germany)

Author keywords

Cardiac fatigue; Echocardiography; Ironman; Triathlon

Indexed keywords

ARTICLE; ATHLETE; BLOOD PRESSURE; CARDIO PULMONARY PERFORMANCE; CARDIOVASCULAR PARAMETERS; CARDIOVASCULAR SYSTEM EXAMINATION; ECHOCARDIOGRAPHY; ERGOMETRY; EXERCISE; FEMALE; HEART FUNCTION; HUMAN; LEFT VENTRICULAR ENDDIASTOLIC DIAMETER; LEFT VENTRICULAR MUSCLE MASS; LUNG FUNCTION; MALE; NORMAL HUMAN; OXYGEN CONSUMPTION; PHYSIOLOGY; SPIROERGOMETRY; TRIATHLETE; TRIATHLON;

EID: 84901231773     PISSN: 10240098     EISSN: 1680936X     Source Type: Journal    
DOI: None     Document Type: Article

References (84)

1. Potts S, Marathon, Battle of (490 BCE). The Encyclopedia of War. Wiley Online Library, 2011.
2. Frost F. The dubious origin of marathon. Am J Ancient Hist 1979; 4: 159-63.
3. Harris KM, Henry JT, Rohman E, Haas TS, Maron BJ. Sudden death during the triathlon. JAMA 2010; 303: 1255-7.
4. Shave R, Oxborough D. Exercise-induced cardiac injury: evidence from novel imaging techniques and highly sensitive cardiac troponin assays. Prog Cardiovasc Dis 2012; 54: 407-15.
5. Rifai N, Douglas PS, O'Toole M, Rimm E, Ginsburg GS. Cardiac troponin T and I, echocardiographic [correction of electrocardiographic] wall motion analyses, and ejection fractions in athletes participating in the Hawaii Ironman Triathlon. Am J Cardiol 1999; 83: 1085-9. (Pubitemid 29162796)
6. Douglas PS, O'Toole ML, Hiller WD, Hackney K, Reichek N. Cardiac fatigue after prolonged exercise. Circulation 1987; 76: 1206-13. (Pubitemid 18007059)
7. La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor WJ, Bogaert J, MacIsaac AI, Heidbüchel H, Prior DL. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 2012; 33: 998-1006.
8. O'Toole ML, Douglas PS. Applied physiology of triathlon. Sports Med 1995; 19: 251-67.
9. Dengel DR, Flynn MG, Costill DL, Kirwan JP. Determinants of success during triathlon competition. Res Q Exerc Sport 1989; 60: 234-8.
10. Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H, Toussaint JF, Desnos M, Rieu M, Benameur N, Le Heuzey LJ, Empana JP, Jouven X. Sports-related sudden death in the general population. Circulation 2011; 124: 672-81.
11. Corrado D, Migliore F, Basso C, Thiene G. Exercise and the risk of sudden cardiac death. Herz 2006; 31: 553-8. (Pubitemid 44579728)
12. Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, Dimeff R, Douglas PS, Glover DW, Hutter AM. Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update. A Scientifi c Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation. Circulation 2007; 115: 1643-55. (Pubitemid 46648650)
13. Claessen C, Claessens P, Claessens M, Claessens J. Echocardiographic and physiological performance characteristics of triathletes. Can J Cardiol 2000; 16: 993-1002.
14. Douglas PS, O'Toole ML, Hiller WD, Reichek N. Left ventricular structure and function by echocardiography in ultraendurance athletes. Am J Cardiol 1986; 58: 805-9. (Pubitemid 17004246)
15. Douglas PS, O'Toole ML, Katz SE, Ginsburg GS, Hiller WD, Laird RH. Left ventricular hypertrophy in athletes. Am J Cardiol 1997; 80: 1384-8. (Pubitemid 27513352)
16. George KP, Wolfe LA, Burggraf GW. The "athletic heart syndrome". A critical review. Sports Med 1991; 11: 300-30.
17. Fagard R. Athlete's heart. Heart 2003; 89: 1455-61. (Pubitemid 37465249)
18. Dickhuth H, Hipp A, Niess A, Röcker K, Mayer F, Horstmann T. Differenzialdiagnostik der physiologischen Herzhypertrophie (Sportherz). Dt Z Sportmed 2001; 52: 205-10. (Pubitemid 33799737)
19. Hollmann W. Herz und Sportmedizin: historische Entwicklungen und Perspektiven. Herz 2006; 31: 500-6. (Pubitemid 44579721)
20. Henschen S. Skilanglauf und Skiwettlauf. Eine medizinische Sportstudie. Mitt Med Klin Upsala 1899; 2: 74.
21. Hoogsteen J, Hoogeveen A, Schaffers H, Wijn PF, van der Wall EE. Left atrial and ventricular dimensions in highly trained cyclists. Int J Cardiovasc Imaging 2003; 19: 211-7. (Pubitemid 36705695)
22. Fagard R, Aubert A, Staessen J, Eynde EV, Vanhees L, Amery A. Cardiac structure and function in cyclists and runners. Comparative echocardiographic study. Br Heart J 1984; 52: 124-9. (Pubitemid 14052255)
23. Abergel E, Chatellier G, Hagege AA, Oblak A, Linhart A, Ducardonnet A, Menard J. Serial left ventricular adaptations in world-class professional cyclists: implications for disease screening and follow-up. J Am Coll Cardiol 2004; 44: 144-9. (Pubitemid 38968473)
24. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart a meta-analysis of cardiac structure and function. Circulation 2000; 101: 336-44. (Pubitemid 30054163)
25. Fagard R. Athlete's heart: a meta-analysis of the echocardiographic experience. Intern J Sports Med 1996; 17: S140-S144.
26. Bove KE, Rowlands DT, Scott RC. Observations on the assessment of cardiac hypertrophy utilizing a chamber partition technique. Circulation 1966; 33: 558-68.
27. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy fi ndings. Am J Cardiol 1986; 57: 450-8. (Pubitemid 16119719)
28. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard HM, Roman MJ, Seward J, Shanewise J. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7: 79-108.
29. Nagueh SF. Echocardiographic assessment of left ventricular relaxation and cardiac filling pressures. Curr Heart Fail Rep 2009; 6: 154-9.
30. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation 2008; 117: 1436-48. (Pubitemid 351501496)
31. Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 1986; 60: 2020-7. (Pubitemid 16066969)
32. Wasserman K, Whipp BJ, Koyl SN, Beaver WL. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol 1973; 35: 236-43.
33. Heidbuchel H, La Gerche A. The right heart in athletes. Evidence for exercise-induced arrhythmogenic right ventricular cardiomyopathy. Herzschrittmacherther Elektrophysiol 2012; 23: 82-6.
34. Sleivert GG, Rowlands DS. Physical and physiological factors associated with success in the triathlon. Sports Med 1996; 22: 8-18. (Pubitemid 26235975)
35. O'Toole ML, Douglas PS, Hiller WD. Lactate, oxygen uptake, and cycling performance in triathletes. Int J Sports Med 1989; 10: 413-8. (Pubitemid 20045889)
36. D'Andrea A, Riegler L, Golia E, Cocchia R, Scarafile R, Salerno G, Pezzullo E, Nunziata L, Citro R, Cuomo S. Range of right heart measurements in top-level athletes: the training impact. Int J Cardio 2013; 164: 48-57.
37. Prior DL, La Gerche A. The athlete's heart. Heart 2012; 98: 947-55.
38. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42: 1959-63. (Pubitemid 37485572)
39. Sollberg EE, Gjertsen F, Haugstad E, Kolsrud L. Sudden death in sports among young adults in Norway. Eur J Cardiovasc Prev Rehabil 2010; 17: 337-41.
40. Wike J, Kernan M. Sudden cardiac death in the active adult: causes, screening, and preventive strategies. Curr Sports Med Rep 2005; 4: 76-82.
41. Breuckmann F, Mohlenkamp S, Nassenstein K, Lehmann N, Ladd S, et al. Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology 2009; 251: 50-7.
42. La Gerche A. Can intense endurance exercise cause myocardial damage and fibrosis? Curr Sports Med Rep 2013; 12: 63-9.
43. Oxborough D, Birch K, Shave R, George K. Exercise-induced cardiac fatigue - a review of the echocardiographic literature. Echocardiography 2010; 27: 1130-40.
44. Landry F, Bouchard C, Dumesnil J. Cardiac dimension changes with endurance training. Indications of a genotype dependency. JAMA 1985; 254: 77-80. (Pubitemid 15071702)
45. Venckunas T, Stasiulis A, Raugaliene R. Concentric myocardial hypertrophy after one year of increased training volume in experienced distance runners. Br J Sports Med 2006; 40: 706-9. (Pubitemid 44197148)
46. Hoogsteen J, Hoogeveen A, Schaffers H, Wijn PF, van Hemel NM, van der Wall EE. Myocardial adaptation in different endurance sports: an echocardiographic study. Int J Cardiovasc Imaging 2004; 20: 19-26. (Pubitemid 38324836)
47. Devereux RB. Does increased blood pressure cause left ventricular hypertrophy or vice versa? Ann Intern Med 1990; 112: 157-9. (Pubitemid 20045202)
48. Allison TG, Cordeiro MA, Miller TD, Daida H, Squires RW, Gau GT. Prognostic signifi cance of exercise-induced systemic hypertension in healthy subjects. Am J Cardiol 1999; 83: 371-5. (Pubitemid 29066496)
49. Schultz MG, Otahal P, Cleland VJ, Blizzard L, Marwick TH, Sharman JE. Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: a systematic review and metaanalysis. Am J Hypertens 2013; 26: 357-66.
50. Pelliccia A, Fagard R, Bjørnstad HH, Anastassakis A, Arbustini E, Assanelli D, Biffi A, Borjesson M, Carrè F, Corrado D. Recommendations for competitive sports participation in athletes with cardiovascular disease 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. Eur Heart J 2005; 26: 1422-45.
51. Bekaert I, Pannier JL, Van de Weghe C, Van Durme JP, Clement DL, Pannier R. Non-invasive evaluation of cardiac function in professional cyclists. Br Heart J 1981; 45: 213-8. (Pubitemid 11184107)
52. Whyte GP, George K, Nevill A, Shave R, Sharma S, McKenna WJ. Left ventricular morphology and function in female athletes: a meta-analysis. Int J Sports Med 2004; 25: 380-3. (Pubitemid 38916417)
53. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991; 324: 295-301.
54. Atchley AE, Jr., Douglas PS. Left ventricular hypertrophy in athletes: morphologic features and clinical correlates. Cardiol Clin 2007; 25: 371-82. (Pubitemid 47603212)
55. D'Andrea A, Riegler R, Cocchia R, Scarafile R, Salerno G, et al. Left atrial volume index in highly trained athletes. Am Heart J 2010; 159: 1155-61.
56. Venckunas T, Raugaliene R, Mazutaitiene B, Ramoskeviciute S. Endurance rather than sprint running training increases left ventricular wall thickness in female athletes. Eur J Appl Physiol 2008; 102: 307-11. (Pubitemid 350245954)
57. Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the "Morganroth hypothesis". Sports Med 2008; 38: 69-90. (Pubitemid 350261960)
58. Hollmann W. [Heart and sports medicine-history and perspectives]. Herz 2006; 31: 500-6.
59. Bray MS, Hagberg JM, Perusse L, Rankinen T, Roth SM, et al. The human gene map for performance and health-related fi tness phenotypes: the 2006-2007 update. Med Sci Sports Exerc 2009; 41: 35-73.
60. Schabort EJ, Killian SC, St Clair Gibson A, Hawley JA, Noakes TD. Prediction of triathlon race time from laboratory testing in national triathletes. Med Sci Sports Exerc 2000; 32: 844-9. (Pubitemid 30226022)
61. Hue O, Le Gallais D, Chollet D, Prefaut C. Ventilatory threshold and maximal oxygen uptake in present triathletes. Can J Appl Physiol 2000; 25: 102-13.
62. Bunc V, Heller J, Horcic J, Novotny J. Physiological profi le of best Czech male and female young triathletes. J Sports Med Phys Fitness 1996; 36: 265-70. (Pubitemid 27110339)
63. Schneider DA, Lacroix KA, Atkinson GR, Troped PJ, Pollack J. Ventilatory threshold and maximal oxygen uptake during cycling and running in triathletes. Med Sci Sports Exerc 1990; 22: 257-64. (Pubitemid 20140170)
64. O'Keefe JH, Harshal RP, Lavie JC, Magalski A, Vogel RA, McCiiough PA. Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise. Mayo Clin Proc 2012; 87: 587-95.
65. Leischik R, Spelsberg N. Vegan Triple-Ironman (Raw Vegetables/Fruits). Case Rep Cardiol 2014; 2014: 1-4.
66. Calvo N, Brugada J, Sitges M, Mont L. Atrial fibrillation and atrial flutter in athletes. Br J Sports Med 2012; 46 (Suppl 1): i37-43.
67. Andersen K, Farahmand B, Ahlbom A, Held C, Ljunghall S, et al. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J 2013; 34: 3624-31.
68. Wilhelm M. Atrial fibrillation in endurance athletes. Eur J Prev Cardiol 2013 [Epub ahead of print].
69. Leischik R, Littwitz H. Slow recovery of the right and left ventricular deformation after conversion from atrial fibrillation. Am J Sports Sci 2014; 2: 13-6.
70. Farahmand BY, Ahlbom A, Ekblom O, Ekblom B, Hallmarker U, et al. Mortality amongst participants in Vasaloppet: a classical long-distance ski race in Sweden. J Intern Med 2003; 253: 276-83. (Pubitemid 36315198)
71. Gajewski AK, Poznanska A. Mortality of top athletes, actors and clergy in Poland: 1924-2000 follow-up study of the long term effect of physical activity. Eur J Epidemiol 2008; 23: 335-40.
72. Marijon E, Tafflet M, Antero-Jacquemin J, El Helou N, Berthelot G, et al. Mortality of French participants in the Tour de France (1947-2012). Eur Heart J 2013; 34: 3145-50.
73. Blair SN, Connelly JC. How much physical activity should we do? The case for moderate amounts and intensities of physical activity. Res Q Exerc Sport 1996; 67: 193-205. (Pubitemid 126421721)
74. Eaton SB, Eaton SB III. An evolutionary perspective on human physical activity: implications for health. Comp Biochem Physiol A Mol Integr Physiol 2003; 136: 153-9. (Pubitemid 37289414)
75. Wilson M, O'Hanlon R, Prasad S, Deighan A, Macmillan P, et al. Diverse patterns of myocardial fi brosis in lifelong, veteran endurance athletes. J Appl Physiol 1985; 2011: 1622-6.
76. Rowe WJ. A world record marathon runner with silent ischemia without coronary atherosclerosis. Chest 1991; 99: 1306-8.
77. Knez WL, Coombes JS, Jenkins DG. Ultraendurance exercise and oxidative damage : implications for cardiovascular health. Sports Med 2006; 36: 429-41.
78. Wesslen L, Pahlson C, Lindquist O, Hjelm E, Gnarpe J, et al. An increase in sudden unexpected cardiac deaths among young Swedish orienteers during 1979-1992. Eur Heart J 1996; 17: 902-10. (Pubitemid 26187180)
79. Herring MP, Sailors MH, Braym S. Genetic factors in exercise adoption, adherence and obesity. Obes Rev 2014; 15: 29-39.
80. Whyte G, Sheppard M, George K, Shave R, Prasad S, et al. Post-mortem evidence of idiopathic left ventricular hypertrophy and idiopathic interstitial myocardial fibrosis: is exercise the cause? BMJ Case Rep 2009; 2009. pii: bcr12.2008.1345. DOI: 10.1136/bcr.12.2008.1345.
81. Leischik R. Ugly duckling or Nosferatu? - Marathon running and cardiovascular function. How to screen the athletes? Eur Heart J 2014 [Epub ahead of print] doi:10.1093/eurheartj/eht502 2014; http://eurheartj. oxfordjournals.org/content/early/2014/01/08/eurheartj.eht502/reply#ehj-el-2040 (Zuletzt gesehen: 19.3.2014).
82. La Gerche A, Baggish AL, Knuuti J, Prior DL, Sharma S, et al. Cardiac imaging and stress testing asymptomatic athletes to identify those at risk of sudden cardiac death. JACC Cardiovasc Imaging, 2013; 6: 993-1007.
83. Leischik R, Dworrak B, Gülker H, Littwitz H. Prognostische Bedeutung der physikalischen Streßechokardiographie bei 3329 ambulanten Patienten (5-jährige Langzeitstudie). J Kardiol 2005; 12: 292-302. (Pubitemid 43116578)
84. Erbel R, Budoff M. Improvement of cardiovascular risk prediction using coronary imaging: subclinical atherosclerosis: the memory of lifetime risk factor exposure. Eur Heart J 2012; 33: 1201-13.