Consequence Of Exercise Training Research Articles

The Prevalence of Cardiovascular Diseases in Paralympic Athletes.

Paralympic participants represent a special subset of athletes. Although sudden cardiac death in this group is a rare event, it should be underlined that, in particular, Paralympians with movement restrictions have a higher prevalence of coronary heart disease. Numerous reports have focused on comparing athletes with spinal cord injury (SCI) and the ones with non-spinal cord injury-NSCI. The first group is more prone to develop arrhythmias, arterial hypertension, hyperlipidaemia including atrial fibrillation and atrial flutter, and this group potentially may have a higher risk of cardiovascular mortality. In ECGs of the disabled athletes with SCI, we more often find changes typically established as consequences of exercise training, such as T-wave inversions. The potential differences in the cardiovascular status of disabled athletes may depend not only on the class of impairment, but also on the discipline of sport and environmental conditions, which makes the analysis relatively complex. The paper analyses up-to-date articles discussing the cardiovascular problems in disabled athletes, pointing to scarce data in several fields of interest. Previous studies on the frequency of abnormalities of the cardiovascular system in Paralympic athletes highlighted the need to intensify preventive cardiology care for this group of athletes, and some activities could be proposed for sportsmen and sportswomen in this group, including more frequent screening ECG, application of 24 h ECG Holter monitoring, echocardiography and cardiological care. Due to the relatively few data available and existing discrepancies in this area, further research is necessary.

Abnormal ECG findings in athletes

Athlete's heart, as a consequence of exercise training, is characterized by hypervagotonia and enlargement of cardiac chambers. Such modifications influence the electrocardiogram. In fact, athletes frequently present with common cardiac alterations, including sinus bradycardia, first and second degree atrioventricular block, increased QRS voltage, and early repolarization. In addition, uncommon alterations (borderline or abnormal) may be discovered incidentally during screening, which may underline cardiac disease in a preclinical phase. The challenge of sports cardiology, which daily engages sports medicine physicians, is to differentiate in athletes benign alterations from those that may be due to dangerous heart diseases.

Effects of Exercise Training in Patients With Abdominal Aortic Aneurysm

No effective medical therapy exists for early abdominal aortic aneurysm (AAA) disease. Lower extremity exercise improves aortic hemodynamics and reduces inflammation, but the safety and efficacy of exercise training in AAA disease is unknown. As an interim analysis of our prospective, randomized, longitudinal trial of exercise for AAA suppression, we investigated whether subjects with early disease could safely achieve target metabolic and hemodynamic goals. One hundred eight participants were randomized to exercise training (EX) or usual care (UC). EX subjects participated in a combination of in-house and home exercise training, with efforts directed toward moderate daily exercise participation. Comparisons were made between EX and UC subjects who completed 1 year of follow-up (n = 26 and 31, respectively, mean age 72 ± 8 years). EX and UC groups were compared for safety, cardiopulmonary exercise test responses, weekly energy expenditure, and biometric indices. No paradoxical increase in AAA growth rate or adverse clinical events occurred as a consequence of exercise training. EX participants expended an average of 2269 ± 1207 kcal/wk and increased exercise capacity (42% increase in treadmill time, 24% increase in estimated metabolic equivalents, P = .01 and .08 between groups, respectively). EX participants demonstrated a significant reduction in C-reactive protein and tended to reduce waist circumference and waist-to-hip ratio (P = .06 and .07, respectively). Preliminary analyses suggest that exercise training is well tolerated and sustainable in small AAA subjects over 1 year. Despite age and comorbidities, exercising AAA subjects achieve meaningful exercise targets and significantly modify activity-dependent variables.

Effects of different training protocols on Ca2+ handling and oxidative capacity in skeletal muscle of Atlantic salmon (Salmo salarL.)

The modulation of calcium channel density and oxidative capacity in skeletal muscle after different training protocols were studied in 3-year-old Atlantic salmon smolts. The effect of endurance exercise on dihydropyridine (DHP) and ryanodine (Ry) receptor densities as well as on muscle metabolism were determined by immunoblot and histochemical analysis from swimming muscles of fish subjected to nine different training protocols varying in duration and water current velocity. In general, exercise training caused a significant increase in the density of both DHP and Ry receptors in both muscle types studied. In red muscle, the most notable increase in DHP and Ry receptor expression was observed in muscle sections from fish swimming against intermediate current velocity for a 2-week period (182.3+/-16.3%, 234.6+/-30.3%, respectively). In white muscle, the expression of DHP and Ry receptors was most upregulated after a 6-week swimming period also at intermediate water current velocity (270.4+/-23.9%, 114.4+/-15.3%, respectively). As with the activity of enzymes involved in muscle energy supply, endurance exercise resulted in a significant increase in succinate dehydrogenase (SDH) activity, but a significant decrease in phosphorylase activity. We conclude that the expression of both DHP and Ry receptors was upregulated in the swimming muscles of salmon as a consequence of exercise training. This, along with the increased oxidative enzyme activity, provides benefits to the contraction efficiency of fish muscles while swimming. However, it was also observed that optimal oxidative swimming capacity is achieved only with a proper exercise program, since the most relevant changes in DHP and Ry receptor expression, as well as in oxidative capacity, were seen in the group training with the intermediate swimming velocity.

Alterations in Heart Rate, Blood Lactate Accumulation and Perceived Exertion at Lactate Threshold as a Consequence of Exercise Training in the Elderly

OBJECTIVE. The purpose of this investigation was to examine the alterations in heart rate, blood lactate accumulation and perceived exertion (RPE) at lactate threshold (LT) as a consequence of exercise training in elderly. METHODS. Thirty-seven elderly aged>65 yr., served as training group (n=20) and control group (n=17). All participants performed the submaximal bench stepping test before and after the twelve-week intervention in order to determine the metabolic equivalents (METs), heart rate, lactate concentration and RPE at LT. The subjects in the training group performed the bench stepping exercise at LT for 20 minutes or more every day during the intervention. RESULTS. After the intervention, METs and heart rate at LT significantly increased compared with those at baseline level in the training group (p<0.01), whereas neither RPE nor lactate concentration at LT changed significantly. Furthermore the increase of heart rate at LT significantly correlated with the increase of METs at LT or heart rate at LT for baseline level (p<0.01). CONCLUSION. The heart rate at LT may increase in association with the increase of the aerobic capacity especially in individuals with lower fitness level and /or at the beginning of the training program, in contrast to RPE and lactate concentration at LT.

Exercise Training Differentially Affects Intrinsic Excitability of Autonomic and Neuroendocrine Neurons in the Hypothalamic Paraventricular Nucleus

Oxytocinergic and vasopressinergic brain stem projections have been shown to play an important role in mediating cardiovascular adjustments during exercise training (ET). The aim of the present work was to determine whether the intrinsic excitability of hypothalamic neurons giving rise to brain stem peptidergic projections is altered as a consequence of ET. Whole cell patch-clamp recordings were obtained from nucleus of the solitarii tract (NTS)-projecting paraventricular nucleus of the hypothalamus (PVN) neurons and from supraoptic nucleus (SON) and PVN magnocellular cells (MNCs), in hypothalamic slices obtained from sedentary (S) and ET rats. Our results indicate that intrinsic excitability of PVN neurons that innervate the NTS (PVN-NTS) is enhanced by ET, resulting in a more efficient input-output function (increase number of evoked actions potentials, steeper frequency/current relationships and slower decaying frequency/time relationships). Changes in input-output function were accompanied by smaller hyperpolarizing afterpotentials (HAPs) and afterhyperpolarizing potentials (AHPs), during and after trains of spikes, respectively. On the other hand, a decreased efficacy in the input-output function was observed in SON/PVN MNCs during ET. Altogether, our results indicate that ET differentially affects the intrinsic excitability of autonomic and neurosecretory SON and PVN neurons. Increased excitability in PVN-NTS neurons may contribute to enhanced release of OT and VP peptides in the dorsal brain stem, and cardiovascular fine-tuning during exercise training.

Regulation of dihydropyridine receptor levels in skeletal and cardiac muscle by exercise training.

To examine the influence of exercise training on the expression of dihydropyridine (DHP)-sensitive Ca2+ channels in skeletal and cardiac muscle, we have determined DHP receptor levels by [3H]PN200-110-binding and immunoblot analysis in homogenates and microsomal fractions of slow- and fast-twitch muscles and heart from rats subjected to a 12-week programme of moderate endurance training. We found that exercise increases the amount of DHP receptor in homogenates of the slow-twitch soleus (42%) and the fast-twitch extensor digitorum longus (60%). Comparable increases in DHP receptor density with training were also observed in the microsomal fractions isolated from both skeletal muscles; these increases were not due to differences in the membrane composition of the microsomal fractions, since the relative proportion of specific enzyme markers was not affected by exercise training. Levels of DHP receptor were not modified in cardiac muscle as a result of the exercise programme. These data suggest an up-regulation of the DHP receptor in the skeletal muscle as a consequence of exercise training, which may play a role in the adaptation of skeletal muscle to increased contractile activity.

The Upper Limit of Physiologic Cardiac Hypertrophy in Highly Trained Elite Athletes

In some highly trained athletes, the thickness of the left ventricular wall may increase as a consequence of exercise training and resemble that found in cardiac diseases associated with left ventricular hypertrophy, such as hypertrophic cardiomyopathy. In these athletes, the differential diagnosis between physiologic and pathologic hypertrophy may be difficult. To address this issue, we measured left ventricular dimensions with echocardiography in 947 elite, highly trained athletes who participated in a wide variety of sports. The thickest left ventricular wall among the athletes measured 16 mm. Wall thicknesses within a range compatible with the diagnosis of hypertrophic cardiomyopathy (greater than or equal to 13 mm) were identified in only 16 of the 947 athletes (1.7 percent); 15 were rowers or canoeists, and 1 was a cyclist. Therefore, the wall was greater than or equal to 13 mm thick in 7 percent of 219 rowers, canoeists, and cyclists but in none of 728 participants in 22 other sports. All athletes with walls greater than or equal to 13 mm thick also had enlarged left ventricular end-diastolic cavities (dimensions, 55 to 63 mm). On the basis of these data, a left-ventricular-wall thickness of greater than or equal to 13 mm is very uncommon in highly trained athletes, virtually confined to athletes training in rowing sports, and associated with an enlarged left ventricular cavity. In addition, the upper limit to which the thickness of the left ventricular wall may be increased by athletic training appears to be 16 mm. Therefore, athletes with a wall thickness of more than 16 mm and a nondilated left ventricular cavity are likely to have primary forms of pathologic hypertrophy, such as hypertrophic cardiomyopathy.