Left atrial remodeling, early repolarization pattern, and inflammatory cytokines in professional soccer players

Stumpf, Christian; Simon, Michael S.; Wilhelm, Matthias; Zimmermann, Stefan; Rost, Christian; Achenbach, Stephan; Brem, Matthias

doi:10.1016/j.jjcc.2015.08.013

Cited by 22 publications

(22 citation statements)

References 39 publications

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“…It has previously been reported that increased E/e 0 as seen in adult athletes reflected higher atrial filling pressures and higher LA volume which may contribute to atrial remodelling over time and thus also increase the risk of atrial fibrillation (Stumpf et al, 2016). This is in line with the increase in LA total strain and LV a 0 immediately after exercise which suggests that atrial function is enhanced and important in the response to exercise.…”

Section: Linear Regressionsupporting

confidence: 61%

“…Further, we confirmed that exercise-induced E/e 0 enhancement is not unique to endurance-trained adolescents, as similar patterns were found in both groups. It has previously been reported that increased E/e 0 as seen in adult athletes reflected higher atrial filling pressures and higher LA volume which may contribute to atrial remodelling over time and thus also increase the risk of atrial fibrillation (Stumpf et al, 2016). Mutual comparison between the groups in our study showed that the active group had higher E/e 0 both immediately and 15 min after ended exercise compared with the controls.…”

Section: Linear Regressionsupporting

confidence: 54%

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Left ventricular diastolic function is enhanced after peak exercise in endurance‐trained adolescents as well as in their non‐trained controls

Rundqvist

Engvall²,

Faresjö

et al. 2018

Clin Physio Funct Imaging

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The aims of the study were to explore the temporal change of cardiac function after peak exercise in adolescents, and to investigate how these functional changes relate to maximal oxygen uptake (VO ). The cohort consisted of 27 endurance-trained adolescents aged 13-19 years, and 27 controls individually matched by age and gender. Standard echocardiography and colour tissue Doppler were performed at rest, and immediately after as well as 15 min after a maximal cardio pulmonary exercise test (CPET) on a treadmill. The changes in systolic and diastolic parameters after exercise compared to baseline were similar in both groups. The septal E/e'-ratio increased immediately after exercise in both the active and the control groups (from 9·2 to 11·0; P<0·001, and from 8·7 to 10·2; P = 0·008, respectively). In a comparison between the two groups after CPET, the septal E/e'-ratio was higher in the active group both immediately after exercise and 15 min later compared to the control group (P = 0·007 and P = 0·006, respectively). We demonstrated a positive correlation between VO and cardiac function including LVEF and E/e' immediately after CPET, but the strongest correlation was found between VO and LVEDV (r = 0·67, P<0·001) as well as septal E/e' (r = 0·34, P = 0·013). Enhanced diastolic function was found in both groups, but this was more pronounced in active adolescents. The cardiac functional response to exercise, in terms of LVEF and E/e', correlates with the increase in VO uptake. These findings in trained as well as un-trained teenagers have practical implications when assessing cardiac function.

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Section: Linear Regressionsupporting

confidence: 61%

Section: Linear Regressionsupporting

confidence: 54%

Left ventricular diastolic function is enhanced after peak exercise in endurance‐trained adolescents as well as in their non‐trained controls

Rundqvist

Engvall²,

Faresjö

et al. 2018

Clin Physio Funct Imaging

View full text Add to dashboard Cite

show abstract

“…47 Atrial dilatation. Left atrial size is a risk factor for atrial fibrillation, 56 and cross-sectional studies show enlargements of the left atrium in athletes, 14,46,[57][58][59][60][61][62][63] which is also shown in experimental animal models. 64 Longitudinal studies confirm left atrial remodelling after a period of high-volume exercise.…”

Section: Potential Mechanisms Explaining An Increased Atrial Fibrillamentioning

confidence: 99%

The ambiguity of physical activity, exercise and atrial fibrillation

Morseth

Løchen

Ariansen

et al. 2018

Eur J Prev Cardiolog

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Although commonly associated with cardiovascular disease or other medical conditions, atrial fibrillation may also occur in individuals without any known underlying conditions. This manifestation of atrial fibrillation has been linked to extensive and long-term exercise, as prolonged endurance exercise has shown to increase prevalence and risk of atrial fibrillation. In contrast, more modest physical activity is associated with a decreased risk of atrial fibrillation, and current research indicates a J-shaped association between atrial fibrillation and the broad range of physical activity and exercise. This has led to the hypothesis that the mechanisms underlying an increased risk of atrial fibrillation with intensive exercise are different from those underlying a reduced risk with moderate physical activity, possibly linked to distinctive characteristics of the population under study. High volumes of exercise over many years performed by lean, healthy endurance trained athletes may lead to cardiac (patho)physiological alterations involving the autonomic nervous system and remodelling of the heart. The mechanisms underlying a reduced risk of atrial fibrillation with light and moderate physical activity may involve a distinctive pathway, as physical activity can potentially reduce the risk of atrial fibrillation through favourable effects on cardiovascular risk factors.

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“…While regular exercise reduces inflammatory markers, long‐term intense exercise may lead to chronic inflammatory states, perhaps via an over‐training syndrome mediated by excess cytokines . Vigorous exercise increases inflammatory factors such as C‐reactive protein (CRP), interleukin‐6 (IL‐6), and tumor necrosis factor‐alpha (TNF‐alpha) . These factors are released by atrial stretch caused by elevated atrial pressure as occurs during vigorous exercise …”

Section: Discussionmentioning

confidence: 99%

Excess of exercise increases the risk of atrial fibrillation

Müssigbrodt

Weber

Mandrola

et al. 2017

Scandinavian Med Sci Sports

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An interesting and still not well-understood example for old medical wisdom "Sola dosis facit venenum" is the increased prevalence of atrial fibrillation (AF) in athletes. Numerous studies have shown a fourfold to eightfold increased risk of AF in athletes compared to the normal population. Analysis of the existing data suggests a dose-dependent effect of exercise. Moderate exercise seems to have a protective effect and decreases the risk of AF, whereas excessive exercise seems to increase the risk of AF. The described cases illustrate clinical manifestations within the spectrum of AF in elderly athletes, that is, exercise-induced AF, vagal AF, chronic AF, and atrial flutter. As the arrhythmia worsened quality of life and exercise capacity in all patients, recovery of sinus rhythm was desired in all described cases. As the atrial disease was advanced on different levels, different treatment regimes were applied. Lifestyle modification and temporary anti-arrhythmic drug therapy could stabilize sinus rhythm in one patient, whereas others needed radiofrequency ablation to achieve a stable sinus rhythm. The patient with the most advanced atrial disease necessitated anti-arrhythmic drug therapy and another left atrial ablation. All described patients remained in sinus rhythm during the long-term follow-up.

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Left atrial remodeling, early repolarization pattern, and inflammatory cytokines in professional soccer players

Abstract: Athletes with an ER pattern had significantly higher E/e' ratios, reflecting higher atrial filling pressures, higher LA volume, and higher IL-6 plasma levels. All these factors may contribute to atrial remodeling over time and thus increase the risk of AF in long-term endurance sports.

Cited by 22 publications

References 39 publications

Left ventricular diastolic function is enhanced after peak exercise in endurance‐trained adolescents as well as in their non‐trained controls

Left ventricular diastolic function is enhanced after peak exercise in endurance‐trained adolescents as well as in their non‐trained controls

The ambiguity of physical activity, exercise and atrial fibrillation

Excess of exercise increases the risk of atrial fibrillation

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