Making prudent recommendations for return-to-play in adult athletes with cardiac conditions.

Clinicians who treat millions of adult athletes throughout the world may be faced with participation or return-to-play decisions in individuals with known or suspected cardiac conditions. Here we review existing published participation guidelines and analyze emerging data from ongoing registries and population-based studies pertaining to return-to-play decisions for cardiac conditions specifically affecting adult athletes. Considerations related to return-to-play decisions will vary according to age of the athlete, with inherited disorders being the main consideration in younger adult athletes aged 18 to 40 yr, and coronary artery disease being the main consideration in older adult athletes aged 40 yr and older.

Insights from internet-based remote intrathoracic impedance monitoring as part of a heart failure disease management program.

Changes in intrathoracic impedance (Z) leading to crossing of a derived fluid index (FI) threshold has been associated with heart failure (HF) hospitalization. The authors developed a remote monitoring program as part of HF disease management and prospectively examined the feasibility and resource utilization of monitoring individuals with an implanted device capable of measuring Z. An HF nurse analyzed all transmitted data daily, as they were routinely uploaded as part of quarterly remote device monitoring, and called the patient if the FI crossed the threshold (arbitrarily defined at 60 Omega) to identify clinically relevant events (CREs) that occurred during this period (eg, worsening dyspnea or increase in edema or weight).

Hypertension update and cardiovascular risk reduction in physically active individuals and athletes.

Hypertension is a prevalent disease worldwide. Its inadequate treatment leads to major cardiovascular complications, such as myocardial infarction, stroke, and heart failure. These conditions decrease life expectancy and are a substantial cost burden to health care systems.

Emerging cardiovascular risk factors that account for a significant portion of attributable mortality risk in chronic kidney disease.

Chronic kidney disease (CKD) increases cardiovascular risk and mortality. However, traditional cardiovascular risk factors do not adequately account for the substantial increase in mortality observed in CKD. The aim of this study was to examine the relative contributions of novel cardiovascular risk factors to the risk between CKD and mortality.

Pyridostigmine reduces QTc interval during recovery from maximal exercise in ischemic heart disease.

Following a randomized, cross-over, and double-blind design, 14 patients with coronary heart disease were submitted, to maximal cardiopulmonary exercise tests on a treadmill, 2 h after the oral administration of either placebo or pyridostigmine bromide (45 mg), a reversible cholinesterase inhibitor. One observer, who was blind to the experimental condition, measured RR and QT intervals over the 12 electrocardiographic leads in the first and third minute of active recovery from exercise. Paired t test was used to compare each variable measured in the same moment after placebo and pyridostigmine.