Categories Ricerche e Studi Sport di resistenza e danni al cuore Scoperto su alcuni atleti che l’attività sportiva di durata potrebbe comportare danni al ventricolo destro del cuore Post author By Archivio Post date December 16, 2012 3 Comments on Sport di resistenza e danni al cuore CONTENUTO DISPONIBILE PER I SOLI ISCRITTI A NAL Tags allenamento, cuore, maratona, salute, sport di durata, sport endurance, sport in altura, triathlon ← Alimentazione durante la prestazione: i consigli nelle altre discipline → NAL è terza nel circuito UISP 2012 di nuoto in acque libere 3 replies on “Sport di resistenza e danni al cuore” Qualsiasi eccesso è dannoso ! Gli studi che sono stati effettuati soprattutto sull’effetto dell’allenamento a lungo termine e di endurance tipo ultramarathoner ecc dicono che la compliance del ventricolo destro è molto differente rispetto a quuella del ventricolo sinistro. POssono essere registrat delle alterazioni delle camere destre in particolari soggetti dediti ad allenamento esaustivo di alta intensità e con un volume di allenamento elevatissimo. Oltrettutto si tratta di popolazioni non del tutto standardizate e in questo senso si sta lavorando per acquisire dati piu’ precisi. Tali camere destre e sinistre sono state considerate simili per anni ma è stata studiata in modo approfondto quasi esclusivamente la camera ventricolare sinistra, anche per motivi pratici, difatti il ventricolo destro mediante ecocardiografia non è sempre facile a analizzare. La risonanza magnetica permette sicuramente una migliore definizione della morfostruttura. Inoltre Quello che p stato evidenziato riguarda imicrodanni a livello strutturale miocardico che con l eco sono visibili solo in stato avanzato, mentre con la risonanza grazie l delayed enhancement sono piu’ quantificabili. Ad ogni modo gli effetti acuti sono molto diversi dagli effetti a lungo termine. Consiglio di leggere i seguenti 3 articoli per chiarire abbastanza l direzione della ricerca in tal senso. E’ un argomento abbastanza nuovo che ha sollevato molti dubbi e perplessità. Le prime due sono del mio gruppo di ricerca. Eur J Echocardiogr. 2011 Jul;12(7):514-9. Epub 2011 Jun 8. Left ventricular systolic performance is improved in elite athletes. Caselli S, Di Pietro R, Di Paolo FM, Pisicchio C, di Giacinto B, Guerra E, Culasso F, Pelliccia A. Source Institute of Sports Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli 1, Rome, Italy. email@example.com Abstract AIMS: We sought to investigate the systolic time interval (STI) and efficiency of left ventricular (LV) contraction comparatively in elite athletes and healthy sedentary controls by means of three-dimensional echocardiography (3DE). METHODS AND RESULTS: Four hundred and twenty-nine elite athletes, involved in skill (n = 41), power (n = 63), mixed (n = 167), and endurance (n = 158) disciplines and 98 sedentary controls, matched for age, underwent 3DE. By off-line analysis, we measured the absolute and relative (normalized by the R-R interval) timing of LV systolic emptying (STI and STI%) and the systolic flow velocity (SFV = stroke volume/STI). Both STI and STI% were shorter in athletes, regardless of the sport discipline, compared with controls (respectively, 324 ± 36 vs. 345 ± 33 ms, P < 0.001; 30 ± 4 vs. 40 ± 4%; P< 0.001). Regression analysis showed that heart rate was the most important determinant of STI (R(2) = 0.38; P < 0.001), while age, body surface area, blood pressure, LV volumes, and mass had no significant association. After removing the effects of heart rate and gender, athletes showed a significant reduction (by 50.4 ms; 95% confidence interval, from 57.7 to 43.1) in STI compared with untrained subjects. Finally, higher SFV were identified in skill (256 ± 60 mL/s; P < 0.001), strength (297 ± 78 mL/s; P < 0.001), mixed (308 ± 67 mL/s; P < 0.001), and endurance (334 ± 74 mL/s; P < 0.001) athletes compared with controls (204 ± 50 mL/s). CONCLUSION: Elite athletes show a significant shortening of the systolic time duration in comparison with sedentary controls, in association with a significant increase in LV emptying velocity. This pattern characterizes the physiological LV adaptation of the athletes and may potentially be useful in differential diagnosis of the 'athlete heart'. J Am Coll Cardiol. 2010 Apr 13;55(15):1619-25. Long-term clinical consequences of intense, uninterrupted endurance training in olympic athletes. Pelliccia A, Kinoshita N, Pisicchio C, Quattrini F, Dipaolo FM, Ciardo R, Di Giacinto B, Guerra E, De Blasiis E, Casasco M, Culasso F, Maron BJ. Source Institute of Sports Medicine and Science, Italian National Olympic Committee, Rome, Italy. firstname.lastname@example.org Abstract OBJECTIVES: The aim of this study was to assess incidence of cardiac events and/or left ventricular (LV) dysfunction in athletes exposed to strenuous and uninterrupted training for extended periods of time. BACKGROUND: Whether highly intensive and uninterrupted athletic conditioning over a long period of time might be responsible for cardiac events and/or LV dysfunction is unresolved. METHODS: We assessed clinical profile and cardiac dimensions and function in 114 Olympic athletes (78% male; mean age 22 +/- 4 years), free of cardiovascular disease, participating in endurance disciplines, who experienced particularly intensive and uninterrupted training for 2 to 5 consecutive Olympic Games (total, 344 Olympic events), over a 4- to 17-year-period (mean 8.6 +/- 3 years). RESULTS: Over the extended period of training and competition, no cardiac events or new diagnoses of cardiomyopathies occurred in the 114 Olympic athletes. Global LV systolic function was unchanged (ejection fraction: 62 +/- 5% to 63 +/- 5%; p = NS), and wall motion abnormalities were absent. In addition, LV volumes (142 +/- 26 ml to 144 +/- 25 ml; p = 0.52) and LV mass index (109 +/- 21 g/m(2) to 110 +/- 22 g/m(2); p = 0.74) were unchanged, and LV filling patterns remained within normal limits, although left atrial dimension showed a mild increase (37.8 +/- 3.7 mm to 38.9 +/- 3.2 mm; p < 0.001). CONCLUSIONS: In young Olympic athletes, extreme and uninterrupted endurance training over long periods of time (up to 17 years) was not associated with deterioration in LV function, significant changes in LV morphology, or occurrence of cardiovascular symptoms or events. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. Comment in J Am Coll Cardiol. 2010 Oct 5;56(15):1263; author reply 1263-4. J Am Coll Cardiol. 2010 Apr 13;55(15):1626-8. PMID: 20378081 [PubMed – indexed for MEDLINE] Send to: Eur Heart J. 2011 Dec 6. [Epub ahead of print] Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, Macisaac AI, Heidbüchel H, Prior DL. Source University of Melbourne Department of Medicine, St Vincent's Hospital, 29 Regent Street, Fitzroy VIC 3065, Australia. Abstract AimsEndurance training may be associated with arrhythmogenic cardiac remodelling of the right ventricle (RV). We examined whether myocardial dysfunction following intense endurance exercise affects the RV more than the left ventricle (LV) and whether cumulative exposure to endurance competition influences cardiac remodelling (including fibrosis) in well-trained athletes.Methods and resultsForty athletes were studied at baseline, immediately following an endurance race (3-11 h duration) and 1-week post-race. Evaluation included cardiac troponin (cTnI), B-type natriuretic peptide, and echocardiography [including three-dimensional volumes, ejection fraction (EF), and systolic strain rate]. Delayed gadolinium enhancement (DGE) on cardiac magnetic resonance imaging (CMR) was assessed as a marker of myocardial fibrosis. Relative to baseline, RV volumes increased and all functional measures decreased post-race, whereas LV volumes reduced and function was preserved. B-type natriuretic peptide (13.1 ± 14.0 vs. 25.4 ± 21.4 ng/L, P = 0.003) and cTnI (0.01 ± .03 vs. 0.14 ± .17 μg/L, P < 0.0001) increased post-race and correlated with reductions in RVEF (r = 0.52, P = 0.001 and r = 0.49, P = 0.002, respectively), but not LVEF. Right ventricular ejection fraction decreased with increasing race duration (r = -0.501, P < 0.0001) and VO(2)max (r = -0.359, P = 0.011). Right ventricular function mostly recovered by 1 week. On CMR, DGE localized to the interventricular septum was identified in 5 of 39 athletes who had greater cumulative exercise exposure and lower RVEF (47.1 ± 5.9 vs. 51.1 ± 3.7%, P = 0.042) than those with normal CMR.ConclusionIntense endurance exercise causes acute dysfunction of the RV, but not the LV. Although short-term recovery appears complete, chronic structural changes and reduced RV function are evident in some of the most practiced athletes, the long-term clinical significance of which warrants further study. 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