Physiologic and Clinical Features of the Paralympic Athlete's Heart.

Importance: Paralympic medicine is a newly adopted term to describe the varied health care issues associated with athletes in the Paralympics. Scarce scientific data, however, are currently available describing the cardiac remodeling in Paralympic athletes.

Objective: To investigate the physiological and clinical characteristics of the Paralympic athlete's heart and derive the normative values.

Pre-participation health evaluation in adolescent athletes competing at Youth Olympic Games: proposal for a tailored protocol.

Objective: To promote sports participation in young people, the International Olympic Committee (IOC) introduced the Youth Olympic Games (YOG) in 2007. In 2009, the IOC Consensus Statement was published, which highlighted the value of periodic health evaluation in elite athletes. The objective of this study was to assess the efficacy of a comprehensive protocol for illness and injury detection, tailored for adolescent athletes participating in Summer or Winter YOG.

Cardiovascular diseases in Paralympic athletes.

Background: Sport participation (SP) of individuals with impairments has recently grown exponentially. Scarce scientific data, however, exist regarding cardiovascular (CV) risk associated with competitive SP.

Objective: Assessing the prevalence of CV abnormalities and the risk for SP in Paralympic athletes (PA).

Clinical significance of J-wave in elite athletes.

The J-wave pattern on 12-lead ECG is traditionally defined as a positive deflection at junction between the end of the QRS and the beginning of the ST-segment. This pattern has recently been associated with increased risk for idiopathic ventricular fibrillation in the absence of cardiovascular disease. The interest for the clinical significance of J-wave pattern as a potential ECG hallmark of high risk for cardiac arrest has recently been reinforced by the growing practice of ECG screening, such as occurs in large population of young competitive athletes.

Upper limb aerobic training improves aerobic fitness and all-out performance of America's Cup grinders.

This research on "America's Cup" grinders investigated the effects of a specific eight-week long-arm cranking ergometer (ACE) training on upper body (UB) aerobic fitness (ventilatory threshold - Tvent, respiratory compensation point- RCP, -oxygen uptake peak - VO₂peak) and high intensity working capacity. The training consisted of sessions carried out for 20-30 mins, three times per week, at an intensity between the UB-Tvent and UB-RCP, and replaced part of a typical lower limb aerobic training whilst maintaining the usual weekly schedule of callisthenics, resistance training and sailing. Seven sailors, including four grinders and three mastmen (age 30 ± 5.

Benign clinical significance of J-wave pattern (early repolarization) in highly trained athletes.

Background: J wave/QRS slurring (early repolarization) on 12-lead ECG has been associated with increased risk for ventricular fibrillation in the absence of cardiovascular (CV) disease.

Objective: The purpose of this study was to assess the prevalence and clinical significance of J wave/QRS slurring in a large population of competitive athletes.

Methods: Seven hundred four athletes (436 males [62%], age 25 ± 5 years) free of CV disease who had engaged in 30 different sports were examined.

[Physiological versus pathological left ventricular remodeling in athletes].

Intense and chronic athletic training is associated with left ventricular remodeling, including an increase in wall thickness, cavity size and mass. The extent of morphological cardiac changes depends on a variety of factors, namely body size, gender, type of sport, ethnicity and, likely, genetic factors. A subset of male athletes engaged in intense endurance sports, such as cycling and rowing, develops a more substantial increase in left ventricular dimensions that may overlap with the phenotypic expression of cardiomyopathies.

Aortic root dilatation in athletic population.

Remodeling of the aortic root may be expected to occur in athletes as a consequence of hemodynamic overload associated with exercise training; however, there are few data reporting its presence or extent. This review reports the current knowledge regarding the prevalence, upper limits, and clinical significance of aortic remodeling induced by athletic training. Several determinants impact aortic dimension in healthy, nonathletic individuals, including height, body size, age, sex, and blood pressure.

Three-dimensional echocardiographic characterization of left ventricular remodeling in Olympic athletes.

The aim of the present study was to assess, using 3-dimensioanl echocardiography, the morphologic characteristics, determinants, and physiologic limits of left ventricular (LV) remodeling in 511 Olympic athletes (categorized in skill, power, mixed, and endurance sport disciplines) and 159 sedentary controls matched for age and gender. All subjects underwent 3-dimensional echocardiography for the assessment of LV volumes, ejection fraction, mass, remodeling index (LV mass/LV end-diastolic volume), and systolic dyssynchrony index (obtained by the dispersion of the time to minimum systolic volume in 16 segments). Athletes had higher LV end-diastolic volumes (157 ± 35 vs 111 ± 26 ml, p <0.

Effects of aging and training status on ventilatory response during incremental cycling exercise.

The aim of this study was to examine the effect of aging and training status on ventilatory response during incremental cycling exercise. Eight young (24 ± 5 years) and 8 older (64 ± 3 years) competitive cyclists together with 8 young (27 ± 4 years) and 8 older (63 ± 2 years) untrained individuals underwent a continuous incremental cycling test to exhaustion to determine ventilatory threshold (VT), respiratory compensation point (RCP), and maximal oxygen uptake (VO₂max). In addition, the isocapnic buffering (IB) phase was calculated together with the hypocapnic hyperventilation.

Prevalence and clinical significance of aortic root dilation in highly trained competitive athletes.

Background: Few data are available that address the impact of athletic training on aortic root size. We investigated the distribution, determinants, and clinical significance of aortic root dimension in a large population of highly trained athletes.

Methods And Results: Transverse aortic dimensions were assessed in 2317 athletes (56% male), free of cardiovascular disease, aged 24.

Physiological adaptation in noncompetitive rock climbers: good for aerobic fitness?

The present investigation aimed to establish whether noncompetitive rock climbing fulfills sports medicine recommendations for maintaining a good level of aerobic fitness. The physiological profile of 13 rock climbers, 8 men (age, 43 +/- 8 years) and 5 women (age, 31 +/- 8 years) was assessed by means of laboratory tests. Maximal aerobic power (VO2peak) and ventilatory threshold (VT) were assessed using a cycloergometer incremental test.

Outcomes in athletes with marked ECG repolarization abnormalities.

Background: Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs characterized by marked repolarization abnormalities.

Energy balance and dietary habits of America's Cup sailors.

This research, which was conducted with crew members of an America's Cup team, had the following objectives: (a) to assess energy expenditure and intake during training; (b) to evaluate the sailors' diet, and (c) to identify any dietary flaws to determine the appropriate intake of nutrients, correct possible dietary mistakes, and improve their food habits. Energy expenditure was estimated on 15 sailors using direct measurements (oxygen consumption) and a 3-day activity questionnaire. Oxygen consumption was measured on sailors during both on-water America's Cup sailing training and dry-land fitness training.

Physiological characteristics of America's Cup sailors.

The aim of this study was to assess the physiological profile of America's Cup grinders and mastmen, by measuring energy expenditure during sailing and assessing their aerobic and anaerobic fitness. The study focused on estimating the energy used during grinding activity, by measuring oxygen uptake (VO(2)) during sail setting in real sailing conditions. In the laboratory, using an arm-cranking ergometer, we measured VO(2peak) during an incremental maximal exercise test and total energy expended during the effort and recovery phases of an all-out test that simulated grinding activity, in six grinders and mastmen and ten sailors of the same crew.

Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes.

Aims: Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden death in young athletes, and substantial interest persists in strategies for timely identification. We assessed the diagnostic efficacy of Italian pre-participation screening programme with 12-lead ECG (in addition to history and physical examination) for identification of HCM.

Methods And Results: Four thousand four hundred and fifty members of the Italian national teams, initially judged eligible for competition as a result of systematic pre-participation screening across Italy, subsequently underwent clinical and echocardiographic examination at the Institute of Sports Medicine and Science (Rome) to assess the presence of previously undetected HCM.

Prevalence and clinical significance of left atrial remodeling in competitive athletes.

Objectives: In the present study we assessed the distribution and clinical significance of left atrial (LA) size in the context of athlete's heart and the differential diagnosis from structural heart disease, as well as the proclivity to supraventricular arrhythmias.

Background: The prevalence, clinical significance, and long-term arrhythmic consequences of LA enlargement in competitive athletes are unresolved.

Methods: We assessed LA dimension and the prevalence of supraventricular tachyarrhythmias in 1,777 competitive athletes (71% of whom were males), free of structural cardiovascular disease, that were participating in 38 different sports.