The incognita of the known: the athlete’s heart syndrome

Abstract

ÖZETUzun dönem sportif aktivite kalpte, sol ventrikül kavite ölçülerinde, duvar kalınlığında, kitlesinde artış ve ritim iletim değişiklikleri ile karakterize morfolojik ve fonksiyonel değişikliklere neden olur. Bu tablo 'sporcu kalbi sendromu' olarak tanımlanır. Klinik olarak görülen bu değişiklikler egzersize fizyolojik adaptasyon nedeniyle ortaya çıkar. Kardiyovasküler adaptasyon; egzersizin sıklığı, süresi, yoğunluğu kadar tipine de bağlıdır. Sporcuların fizik muayenesinde patolojik durumlarla karışabilen birçok değişiklik görülür. Ayrıca kardiyak hipertrofi, artmış vagal tonus ve repolarizasyon değişikliklerine bağlı birçok elektrokardiyografik değişiklik de mevcuttur. Sporculardaki bu fizyolojik değişiklikler, patolojik değişiklik-lerden her zaman için kolayca ayrılamayabilmektedir. Sporcu kalbindeki gelişen organik ve fonksiyonel değişikliklerin bilinmesi ve tanınması klinisyene, fizyolojik değişikliklerin sporcularda ani ölüm nedeni olabilen kardiyak patolojilerden ayrılmasında yardımcı olabilmektedir. (Anadolu Kardiyol Derg 2011; 11: 351-9) Anahtar kelimeler: Egzersiz, sporcu, elektrokardiyografi, ekokardiyografi, hipertrofik kardiyomiyopati, ani kalp ölümü ABSTRACT Long-term athletic activity causes morphological and functional changes in the heart characterized as left ventricle cavity dimension changes, wall thickness and mass increase and rhythm conduction changes. This condition is identified as "athlete's heart syndrome". The changes that are seen clinically occur as a result of physiological adaptation to exercise. Cardiovascular adaptation depends on the exercise's type as well as its frequency, duration and intensity. In the athlete's physical examination, various changes can be seen that are mistaken with pathological conditions. In addition, there are changes present due to cardiac hypertrophy, increased vagal tone and repolarization. The knowledge and recognition of the organic and functional changes developing in the athlete's heart is being helpful to differentiate physiological changes from cardiac pathologies that can cause sudden death in athletes. (Anadolu Kardiyol Derg 2011; 11: 351-9)

The effect of exercises on left ventricular systolic and diastolic heart function in sedentary women: Step-aerobic vs core exercises

“… 4 It is generally accepted that intensive and long-term physical training stimulates heart-balanced hypertrophy with increased cavity dimensions of right and left ventricles with increased left ventricular wall thickness. 14 , 52 In our study, as a result of SAG and CEG 16-week programs, the improvement in left ventricular cardiac parameters in both groups may be attributed to the ability of long-term aerobic and force exercises to increase the left ventricular dimension and ventricular septum to thicken the posterior wall, as well as to alter eccentric left ventricular hypertrophy. 53 , 54 Significant increases were observed in the LVEDD, IVS and LVPW values of SAG, while the LVEDD value of CEG was significantly increased, but the IVS and LVPW values were slightly improved.…”

Autonomic modulations of heart rate variability and performances in short-distance elite swimmers

“…Cardiac vagal tone has been also reported to increase after aerobic training (Aubert et al 2003), shifting the autonomic control of heart rate (HR) toward parasympathetic predominance. Together with morphological cardiac changes also caused by aerobic training, this results in lower HR at rest and during submaximal exercise (Ekblom et al 1973;Kasikcioglu 2011;Wilhelm et al 2011). The decreased cardiac rhythm for a given workload is usually associated with an increased stroke volume in response to training, and this is a positive factor in endurance competitions.…”