Introduction:Among long term athletes there is always present hypertrophy of the left ventricle walls as well as increased cardiac mass. These changes are the result of the heart muscle adaptation to load during the years of training, which should not be considered as pathology. In people suffering from hypertrophic cardiomyopathy (HCM), there is also present hypertrophy of the left ventricle walls and increased mass of the heart, but these changes are the result of pathological changes in the heart caused by a genetic predisposition for the development HCM of. Differences between myocardial hypertrophy in athletes and HCM are not clearly differentiated and there are always dilemmas between pathological and physiological hypertrophy. The goal of the study is to determine and compare the echocardiographic cardiac parameters of longtime athletes to patients with hypertrophic cardiomyopathy.Material and methods:The study included 60 subjects divided into two groups: active athletes and people with hypertrophic cardiomyopathy.Results:Mean values of IVSd recorded in GB is IVSd=17.5 mm (n=20, 95% CI, 16.00–19.00 mm), while a significantly smaller mean value is recorded in GA, IVSd=10.0 mm (n=40, 95% CI, 9.00-11.00 mm). The mean value of the left ventricle in diastole (LVDd) recorded in the GA is LVDd=51 mm (n=40; 95% CI, 48.00 to 52.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVDd value is 42 mm (n=20; 95% CI, 40.00 to 48.00 mm). The mean value of the rear wall of the left ventricle (LVPWd) recorded in the GA is LVDd=10 mm (n=40; 95% CI, 9.00-10.00 mm) while in the group with hypertrophic cardiomyopathy (GB) mean LVDd is 14 mm (n=20; 95% CI, 12.00 to 16.00 mm). The mean of the left ventricle during systole (LVSD) observed in GA is LVSD=34 mm (n=40; 95% CI, 32.00 to 36.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVSD is 28 mm (n=20; 95% CI, 24.00 to 28.83 mm). The mean ejection fraction (EF%) observed in GA is EF=60% (n=40; 95% CI, 56.41 to 63.00%), while in the group with hypertrophic cardiomyopathy (GB) mean EF value is 69% (n=20; 95% CI, 62.00 to 70.83 mm). Somewhat higher mean diastolic left ventricular function (E/A) was observed in GA, E/A=1.76±0.15, and lower average values in the group with hypertrophic cardiomyopathy: (GB) E/A=0.78±0.02.Conclusion:Mean values of parameters intraventricular septum thickness in diastole (IVSd), the thickness of the rear wall of the left ventricle (LVPWd), the diameter of the left ventricle during systole (LVSD) were statistically different between groups of athletes (GA) compared to the group of patients with hypertrophic cardiomyopathy (GB).
Introduction: Osgood-Schlatter’s syndrome (Osgood-Schlatter disease [OSD]) is caused by an accumulation of repeated microtraumas and is classified as a type of chronic injury called “overload syndrome“. It is considered that the root causes of OSD are accelerated growth as well as excessive sports and recreational activity. Currently, more than 50% of children of school age are involved in sports activities. In this study, 40 external risk factors were analyzed. Considering that frequent medical examinations, expensive rehabilitation, time-consuming sports activities, and school obligations result in major socio-economic and financial consequences, a need to work on a preventive program was recognized. The aim of this study was to determine external risk factors and to develop an algorithm for the prevention of injuries caused by overload syndrome through a detailed analysis of Osgood-Schlatter’s syndrome concerning aerobic and anaerobic sports (football, basketball, karate, and taekwondo). Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups, each containing 100 patients, first group – aerobic sports (football and basketball) and the second group – anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. This clinical study was prospective, comparative, analytical, and descriptive. The research was conducted in the Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: Patients experienced the first symptoms of OSD at 4 years (football) and 6 years (taekwondo). About 60% of patients who trained in anaerobic sports and 38% of patients who trained in aerobic sports trained other sports more often as well. The research showed that a higher percentage of patients who trained anaerobic sports trained multiple sports at the same time (karate 88%, and taekwondo 82%) compared to patients who trained aerobic sports (football 68%, and basketball 76%). Patients who trained in anaerobic sports were also more likely to engage in recreational activities (58.3%) compared to patients who trained in aerobic sports (41.7%). On average, the number of hours per week which patients spent actively training (primary sport, additional sports activity, and recreational sport) was 17.2 h for basketball players, 16.8 h for taekwondo trainees, 16.7 h for caratists, and 15.7 h in case of football players. About 32% of football players, 24% of basketball players, 12% of karate trainees, and 18% of taekwondo trainees did not engage in additional sports or recreational activities. Only 36% of patients who trained in aerobic sports and 37% of patients who trained anaerobic sports respected the planned rest days, and in both groups, some subjects trained for 12 months. Conclusion: The research showed that patients who trained in anaerobic sports more frequently trained more than one sport at the same time and spent more hours doing recreational activities compared to patients who trained in aerobic sports. By analyzing weekly physical activity, it was concluded that the rest is limited. Future research aims to identify risk factors so that children, parents, and trainers can be educated to work on prevention through teamwork.
Introduction:“Athlete’s heart syndrome” is a condition characterized by structural, electrophysiologic and functional adaptation of the myocardium to physical activity (training), depending on the activity intensity, duration and type. In athletes left ventricular hypertrophy often resembles comorbid conditions (hypertension or hypertrophic cardiomyopathy) so the differential diagnosis of the disease is very important and crucial, especially in people who are in active training. In fact, if an athlete has finding which indicate thickening of the left ventricle walls, should be distinguished hypertrophy which occurred as a result of many years of training from accidental existence of hypertension or hypertrophic cardiomyopathy in the same person. Therefore, it is important to make a diagnostic difference between healthy and sick heart.Material and methods:The study involved male persons aged 20-45 which have increased muscle mass of the left ventricle due to different etiology. Definite sample included 80 respondents divided into two groups. All respondent underwent interview, clinical examination, ECG and echocardiography.Results:Average systolic blood pressure (SBP) for the athletes were 115.8±7.2 mmHg, and in patients, with hypertension 154.4±3.5 mmHg, average values of diastolic blood pressure (DBP) for the athletes were 74.2±8.1 mmHg in patients, hypertensive 96.2 ± 3.9 mmHg. Values of SBP and DBP were significantly lower in the group of athletes compared to patients with hypertension (p=0.001). The value of the SFO/min was significantly lower in the group of athletes compared to patients with hypertension (p <0.001). There was a statistically significant difference in the sum of SV2 RV5 and between groups of athletes and groups of patients with hypertension (p<0.05). There was no significant difference in the echocardiography parameters between two groups. There was a statistically significant difference in the sum of SV2 and RV5 between groups of athletes and groups of patients with hypertension (p<0.05).Conclusion:ECG parameters, PQ, QRS, QT did not prove to be useful in the differentiation between the groups because no statistically significant differences in their values were found. Echocardiography is a reliable diagnostic tool in differentiating physiologic hypertrophy of athletes compared to hypertrophy in patients with hypertension.
Introduction: Two findings can be highlighted from recent medical research, first children of a young age are involved in organized sports activities more frequently than ever and second the first symptoms of Osgood-Schlatter disease (OSD) have been reported in children at the age of 5.5 years. The latest research has shown that children from ages 10 to 12 years have already been actively involved in sports activities for 5–7 years. In recent years, the practice of young children training to master sports has become a trend. Said exposes young children who are training intensively to various external risk factors such as social isolation, addiction, frequent injuries, and syndrome of overload. Enablers of this behavior are commonly parents and coaches who notice the child’s abilities stand out from those of other children in the group and find that such talent requires intensive sport-specific training. The purpose of this study was to determine the average age of the patients and the average age when the first symptoms of the disease appeared as well as to provide an analysis of the average duration of children being actively involved in sports activities before the first symptoms of OSD appeared. Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups each containing 100 patients, first group –aerobic sports (football and basketball) and the second group –anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. The study was prospective, clinical, comparative, analytical, and descriptive. The research was conducted in Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: The average age when the patients started with intensive training was highest with basketball players (7.8 years) following with karate trainees (6.8 years). Basketball players had statistically the lowest duration of being actively involved in sports activities before the first symptoms of OSD appeared (5.4 years). No statistically significant difference in the average duration of training was discovered between the test groups. The average age when knee pain or swelling under the knee first appeared was at the age of 11.4 years with players of aerobic sports and 11.8 years with players of anaerobic sports. Furthermore, no statistically significant difference was found between test groups and subgroups. Before the first appearance of knee pain, the taekwondo patients had been in training the longest (4.7 years) and basketball players the least amount of time (3.4 years). Conclusion: By conducting retrospective analysis, it has been concluded that children had started training at the age of 3 or 4 years and had encountered the first symptoms of OSD at the ages of 4 years (football) and 6 years (taekwondo). Research showed that the early involvement of children in sports and their early specialization in sports are both external risk factors that have a dominant influence on OSD development.
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