Electrocardiographic Changes in Male and Female Amateur Marathon Runners: A Comparison Study

2021 ◽  
Author(s):  
Zofia Lasocka ◽  
Alicja Dąbrowska-Kugacka ◽  
Anna Maria Kaleta ◽  
Zuzanna Lewicka-Potocka ◽  
Anna Faran ◽  
...  
Keyword(s):  
P Wave ◽  
Right Atrial ◽  
Marathon Runners ◽  
Male And Female ◽  
Cardiac Adaptation ◽  
Before And After ◽  
Atrial Enlargement ◽  
Electrocardiographic Changes ◽  
Exercise Induced ◽  
Stage 1

AbstractPhysical training is gaining popularity among amateurs. Males and females exhibit different cardiac adaptation to exercise. The aim of the study was to compare the incidence of electrocardiographic abnormalities before and after the marathon between sexes. 12-lead electrocardiogram was performed in 40 male (39±8 years) and 27 female (40±7 years) amateur runners: 2–3 weeks before (Stage 1) and immediately after (Stage 2) the marathon. Abnormalities in the resting (Stage 1) and exercise (Stage 2) electrocardiograms were compared between sexes. At rest left atrial enlargement was more frequent in females than males (48 vs. 20%; p<0.05). The incidence of right atrial enlargement was significantly more common at Stage 2 than 1, both in men (43 vs. 0%; p<0.001) and in women (48 vs. 4%; p=0.001). Significant increase of P-wave amplitude was found in male runners after the marathon (0.12±0.05 vs. 0.21±0.09 mV; p<0.001 Stage 1 vs. 2), but was absent in females. QTc prolongation was observed in both sexes, however to a higher degree in males (p<0.05 for the interaction stage and sex). Although both male and female amateur marathon runners exhibit abnormalities in resting and exercise electrocardiograms, men present more exercise-induced electrocardiographic changes, which might indicate a higher propensity for post-marathon arrhythmias. Electrocardiographic screening in amateurs should be considered.

P-wave morphology during right atrial pacing before and after atrial flutter ablation—A new marker for success

1997 ◽  
Vol 79 (10) ◽  
pp. 1417-1420 ◽  
Author(s):  
Mohamed H. Hamdan ◽  
Jonathan M. Kaiman ◽  
Hal V. Barron ◽  
Michael D. Lesh
Keyword(s):  
Atrial Flutter ◽  
P Wave ◽  
Right Atrial ◽  
Atrial Pacing ◽  
Before And After ◽  
Wave Morphology ◽  
Atrial Flutter Ablation

scholarly journals How recreational marathon runners hit the wall: A large-scale data analysis of late-race pacing collapse in the marathon

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251513
Author(s):  
Barry Smyth
Keyword(s):  
Large Scale ◽  
Marathon Runners ◽  
Male And Female ◽  
Large Scale Data ◽  
Trade Offs ◽  
Energy Stores ◽  
Before And After ◽  
Definition Of ◽  
Race Performance ◽  
Scale Data

Introduction In the marathon, how runners pace and fuel their race can have a major impact on race outcome. The phenomenon known as hitting the wall (HTW) refers to the iconic hazard of the marathon distance, in which runners experience a significant slowing of pace late in the race, typically after the 20-mile mark, and usually because of a depletion of the body’s energy stores. Aim This work investigates the occurrence of significant late-race slowing among recreational marathoners, as a proxy for runners hitting the wall, to better understand the likelihood and nature of such slowdowns, and their effect on race performance. Methods Using pacing data from more than 4 million race records, we develop a pacing-based definition of hitting the wall, by identifying runners who experience a sustained period of slowing during the latter stages of the marathon. We calculate the cost of these slowdowns relative to estimates of the recent personal-best times of runners and compare slowdowns according to runner sex, age, and ability. Results We find male runners more likely to slow significantly (hit the wall) than female runners; 28% of male runners hit the wall compared with 17% of female runners, χ2(1, N = 1, 928, 813) = 27, 693.35, p < 0.01, OR = 1.43. Such slowdowns are more frequent in the 3 years immediately before and after a recent personal-best (PB) time; for example, 36% of all runners hit the wall in the 3 years before a recent PB compared with just 23% in earlier years, χ2(1, N = 509, 444) = 8, 120.74, p < 0.01, OR = 1.31. When runners hit the wall, males slow more than females: a relative slowdown of 0.40 vs. 0.37 is noted, for male and female runners, when comparing their pace when they hit the wall to their earlier race (5km-20km) pace, with t(475, 199) = 60.19, p < 0.01, d = 0.15. And male runners slow over longer distances than female runners: 10.7km vs. 9.6km, respectively, t(475, 199) = 68.44, p < 0.01, d = 0.17. Although, notably the effect size of these differences is small. We also find the finish-time costs of hitting the wall (lost minutes) to increase with ability; r2(7) = 0.91, p < 0.01 r2(7) = 0.81, p < 0.01 for male and female runners, respectively. Conclusions While the findings from this study are consistent with qualitative results from earlier single-race or smaller-scale studies, the new insights into the risk and nature of slowdowns, based on the runner sex, age, and ability, have the potential to help runners and coaches to better understand and calibrate the risk/reward trade-offs that exist as they plan for future races.

P4424Detailed characterization of atrial remodeling induced by exercise training in a rodent model of exercise-induced cardiac hypertrophy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Olah ◽  
E Urban ◽  
B A Barta ◽  
A A Sayour ◽  
M Ruppert ◽  
...  
Keyword(s):  
Gene Expression ◽  
Atrial Fibrillation ◽  
Exercise Training ◽  
P Wave ◽  
Right Atrial ◽  
Atrial Remodeling ◽  
Altered Expression ◽  
Programmed Stimulation ◽  
Exercise Induced

Abstract Introduction Atrial fibrillation and heart failure share common risk factors and frequently coexist as atrial fibrillation leads to impaired myocardial function. Although regular exercise training is associated with cardiovascular benefits, the increased risk of atrial arrhythmias has been observed, with differences regarding prevalence between genders. While multiple mechanisms are likely, the atrial alterations induced by long-term physical exercise still need to be elucidated. Purpose We aimed at investigating exercise-induced atrial remodeling in a rat model of athlete's heart and determining sex-specific differences. Methods Age-matched young adult rats were divided into female exercised (FEx), female control (FCo), male exercised (MEx) and male control (MCo) groups. After exercised animals completed a 12-week-long swim training protocol, echocardiography was used to describe atrial alterations. In vivo electrophysiologic investigation was performed by programmed stimulation with an octapolar catheter inserted into the right atrium and atrial gene expression analysis was carried out. Results Post-mortem atrial weight data revealed marked atrial hypertrophy (atrial weight to tibial length: 18.6±2.7g/cm FEx, 10.3±1.0g/cm FCo, 23.7±2.2g/cm MEx, 15.8±1.9g/cm MCo pex<0.01), while echocardiography data showed slight atrial dilatation and improved contraction in both exercised groups. Exercise training was associated with bradycardia, P-wave enlargement and prolonged right atrial effective refractory period (RAERP: 45.7±4.3ms FEx, 40.2±5.9ms, FCo, 49.8±4.2ms MEx, 43.1±4.6ms MCo pex<0.01). Sinus node recovery time (SNRT) did not differ between groups and we could not induce significant number of arrhytmias by programmed stimulation (double extrastimulation, burst pacing) in any groups. We found increased atrial gene expression of antioxidant enzymes (e.g. NADPH oxidase 2, superoxide dismutase 2) in both genders. Despite the marked atrial hypertrophy, no gene expression alteration was found regarding markers that describe pathological remodeling (atrial natriuretic factor), proinflammatoric (tumor necrosis factor-α) and profibrotic [e.g. transforming growth factor-β (TGF-β), matrix metalloproteinase-2 (MMP-2)] processes. While exercise training did not affect on the expression of profibrotic markers, female gender was associated with lower TGF-β and MMP-2 expression. We found altered expression of ion channels participating in atrial depolarization and repolarization. Conclusions Our data suggests that long-term exercise-induced atrial hypertrophy is not associated with harmful electrical remodeling and no inflammatory or profibrotic response was observed in the atrium of exercised rats. Acknowledgement/Funding NKFIH (K 120277), ÚNKP-17-4 (to A.O.), STIA-KF-17 (to A.O.)

scholarly journals The impact of marathon running on atrial remodeling in male and female amateur athletes assessed by three-dimensional echocardiography

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Z.B Lasocka ◽  
A Dabrowska-Kugacka ◽  
A Kaleta-Duss ◽  
Z Lewicka-Potocka ◽  
A Faran ◽  
...  
Keyword(s):  
Three Dimensional ◽  
3D Echocardiography ◽  
Marathon Running ◽  
Atrial Remodeling ◽  
Male And Female ◽  
Amateur Athletes ◽  
Exercise Induced ◽  
And Function ◽  
Stage 1 ◽  
The Impact

Abstract Introduction Endurance athletes have an increased risk of atrial remodeling and atrial arrhythmias. However, data regarding atrial adaptation to physical exercise in non-elite athletes are limited. We aimed to assess exercise-induced alternations in atrial morphology and function in male and female amateur marathon runners, using real-time three-dimensional (3D) echocardiography. Methods The study group consisted of 40 male (39±8 years) and 27 female (40±7 years) amateur athletes. 3D echocardiography was performed 2–3 weeks before (Stage 1) and immediately after (Stage 2) the marathon run. Right (RA) and left atrial (LA) remodeling was assessed by volumetric measures, total ejection fraction (EF) and volume (EV). Speckle tracking was used to determine the temporal evaluation of atrial function by strain analysis. Results The main results are presented in Table 1. At rest, male athletes demonstrated greater RA size and decreased RA contractility, as assessed by EF and atrial strains, in comparison to females. At Stage 1, LA morphology and function did not differ significantly between genders. After the marathon, a remarkable increase in RA maximal volume (RAVmax, 32.9±8.6 vs. 36.4±8.2 ml/m2, p=0.016) and RAEF (49.5±9.7 vs. 57.3±9.2%, p=0.002) was observed only in female athletes (p&lt;0.05 for both interactions sex and stage). Whereas in male runners, LA measures, such as LAVmax (30.7±6.4 vs. 26.8±6.2 ml/m2, p=0.007), LAEF (56.7±4.3 vs. 52.7±5.3%, p=0.037) and LA conduit strain (LAScd, −18.7±8 vs. −13.6±8%, p=0.045), significantly decreased postrace. This observation was absent in females (p&lt;0.05 for all interactions sex and stage). Conclusions In amateur athletes, marathon running promotes biatrial remodelling with significant gender discrepancies. Females are more susceptible to exercise-induced morphological and functional changes of RA, while postrace alternations in males concern principally LA. 3D echocardiography of the atria is a useful indicator of exercise capacity, not only in elite, but also in amateur athletes. FUNDunding Acknowledgement Type of funding sources: None.

The Clinical, Roentgenological and Morphological Effects of an Acute Exposure of Phosgene on the Lungs of Dogs

1971 ◽  
Vol 29 ◽  
pp. 236-237
Author(s):  
R. F. Bils ◽  
W. F. Diller ◽  
F. Huth
Keyword(s):  
Latent Period ◽  
Chemical Industry ◽  
Toxic Substance ◽  
Lung Edema ◽  
X Rays ◽  
Beagle Dogs ◽  
Male And Female ◽  
Morphological Alterations ◽  
Before And After ◽  
Electron Microscopes

Phosgene still plays an important role as a toxic substance in the chemical industry. Thiess (1968) recently reported observations on numerous cases of phosgene poisoning. A serious difficulty in the clinical handling of phosgene poisoning cases is a relatively long latent period, up to 12 hours, with no obvious signs of severity. At about 12 hours heavy lung edema appears suddenly, however changes can be seen in routine X-rays taken after only a few hours' exposure (Diller et al., 1969). This study was undertaken to correlate these early changes seen by the roengenologist with morphological alterations in the lungs seen in the'light and electron microscopes.Forty-two adult male and female Beagle dogs were selected for these exposure experiments. Treated animals were exposed to 94.5-107-5 ppm phosgene for 10 min. in a 15 m3 chamber. Roentgenograms were made of the thorax of each animal before and after exposure, up to 24 hrs.

TO STUDY THE EFFECT OF BMV ON P WAVE DISPERSION AND SHORT TERM PROGNOSTIC IMPACT OF P WAVE DISPERSION IN PREDICTION OF CLINICAL OUTCOME AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS AND SINUS RHYTHM

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Ashish Kumar Agarwal ◽  
Daulat Singh Meena ◽  
Vijay Pathak ◽  
Anoop Jain ◽  
Rakesh Kumar Ola
Keyword(s):  
Clinical Outcome ◽  
Right Ventricular ◽  
Wave Dispersion ◽  
Tissue Doppler ◽  
P Wave ◽  
Short Term ◽  
P Wave Dispersion ◽  
Mitral Valvuloplasty ◽  
Percutaneous Balloon ◽  
Before And After

Background: The aim of the present study was to study the effect of percutaneous balloon mitral  valvuloplasty (PBMV) on P wave dispersion and to test the correlation between P-maximum and  P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV. Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Methods: 75 patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month and one year after PBMV . We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events. Results: There were significant decrease in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Accompany these hemodynamic changes after PMBV. P-maximum and P-wave dispersion were found to be decreased (P < 0.001). Conclusion: Successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV.  The P-maximum and P-wave dispersion changes were correlated with significant impairment of right dysfunction and the degree of pulmonary artery pressure. Keywords: PBMV.PAP,LA

Analysis of the exercise-induced orthogonal P wave changes in normal subjects and patients with coronary artery disease.

1986 ◽  
Vol 27 (4) ◽  
pp. 443-460 ◽  
Author(s):  
Mitsuhiro YOKOTA ◽  
Shoji NODA ◽  
Masafumi KOIDE ◽  
Naoki KAWAI ◽  
Reiki YOSHIDA ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Normal Subjects ◽  
P Wave ◽  
Artery Disease ◽  
Exercise Induced

scholarly journals Spinal Muscular Atrophy after Nusinersen Therapy: Improved Physiology in Pediatric Patients with No Significant Change in Urine, Serum, and Liquor 1H-NMR Metabolomes in Comparison to an Age-Matched, Healthy Cohort

Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 206
Author(s):  
Leon Deutsch ◽  
Damjan Osredkar ◽  
Janez Plavec ◽  
Blaž Stres
Keyword(s):  
Machine Learning ◽  
Spinal Muscular Atrophy ◽  
1H Nmr ◽  
Pediatric Patients ◽  
Muscular Atrophy ◽  
Male And Female ◽  
Before And After ◽  
Healthy Cohort ◽  
Males And Females ◽  
Urine Serum

Spinal muscular atrophy (SMA) is a genetically heterogeneous group of rare neuromuscular diseases and was until recently the most common genetic cause of death in children. The effects of 2-month nusinersen therapy on urine, serum, and liquor 1H-NMR metabolomes in SMA males and females were not explored yet, especially not in comparison to the urine 1H-NMR metabolomes of matching male and female cohorts. In this prospective, single-centered study, urine, serum, and liquor samples were collected from 25 male and female pediatric patients with SMA before and after 2 months of nusinersen therapy and urine samples from a matching healthy cohort (n = 125). Nusinersen intrathecal application was the first therapy for the treatment of SMA by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Metabolomes were analyzed using targeted metabolomics utilizing 600 MHz 1H-NMR, parametric and nonparametric multivariate statistical analyses, machine learning, and modeling. Medical assessment before and after nusinersen therapy showed significant improvements of movement, posture, and strength according to various medical tests. No significant differences were found in metabolomes before and after nusinersen therapy in urine, serum, and liquor samples using an ensemble of statistical and machine learning approaches. In comparison to a healthy cohort, 1H-NMR metabolomes of SMA patients contained a reduced number and concentration of urine metabolites and differed significantly between males and females as well. Significantly larger data scatter was observed for SMA patients in comparison to matched healthy controls. Machine learning confirmed urinary creatinine as the most significant, distinguishing SMA patients from the healthy cohort. The positive effects of nusinersen therapy clearly preceded or took place devoid of significant rearrangements in the 1H-NMR metabolomic makeup of serum, urine, and liquor. Urine creatinine was successful at distinguishing SMA patients from the matched healthy cohort, which is a simple systemic novelty linking creatinine and SMA to the physiology of inactivity and diabetes, and it facilitates the monitoring of SMA disease in pediatric patients through non-invasive urine collection.

scholarly journals Atrial dilation as a substrate for atrial fibrillation in the canine complete chronic atrioventricular block model

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Smoczynska ◽  
H.D.M Beekman ◽  
R.W Chui ◽  
S Rajamani ◽  
M.A Vos
Keyword(s):  
Atrial Fibrillation ◽  
Atrioventricular Block ◽  
Volume Overload ◽  
Right Atrial ◽  
Funding Source ◽  
Private Company ◽  
Structural Remodeling ◽  
2D Echocardiography ◽  
Atrial Enlargement ◽  
The Right

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia treated in clinical practice. Structural remodeling is characterized by atrial enlargement and contributes to the therapeutic resistance in patients with long-standing AF. Purpose To study the atrial arrhythmogenic and echocardiographic consequences induced by volume overload in the complete chronic atrioventricular block (CAVB) dog. Methods Echocardiographic and electrophysiological data was obtained in 14 anaesthetized Mongrel dogs, in acute AV-block (AAVB), after 6 weeks of CAVB (CAVB6) and CAVB10. Left atrial (LA) volume was determined with 2D echocardiography by using the biplane method. An electrocardiogram and monophasic action potentials (MAP) at the right atrial (RA) free wall were recorded. Atrial effective refractory period (AERP) was determined by continuous programmed electrical stimulation (PES) of 20 beats with a cycle length of 400 ms and an extrastimulus with decremental design until refractoriness was reached. A continuous PES protocol of 20 beats with an extrastimulus 5 ms longer than the AERP was applied for 150 seconds to trigger AF. After 5 min without arrhythmias, autonomic neuromodulation was performed by intravenous infusion (IV) of acetylcholine (1,5μg/kg/min to 6,0μg/kg/min) for 20 min followed by prompt IV infusion of isoprenaline (3μg/min) until the atrial heart rate increased by 20 bpm. PES with an extrastimulus was repeated for 150 seconds to induce AF. Results LA volume increased from 13.7±3.2 ml at AAVB to 20.5±5.9 ml* at CAVB6, and 22.7±6.0 ml* at CAVB10 (Fig. 1A). AERP was similar at AAVB, CAVB6, and CAVB10 (115.8±11.9, 117.3±11.7, and 106.8±12.1 ms respectively). Repetitive AF paroxysms of &gt;10 seconds were induced in 1/14 (7%) dogs at AAVB, 1/11 (9%) at CAVB6, and 5/10 (50%)* at CAVB10 (*p&lt;0.05) upon PES (Fig. 1B). Combined neuromodulation and PES did not increase the AF inducibility rate, but prolonged the longest episode of AF in the inducible dogs from 55±49 seconds to 236±202 seconds* at CAVB10 (Fig. 1C). LA volume was higher in inducible dogs 25.0±4.9 ml compared to 18.4±4.2 ml in non-inducible dogs at CAVB10. Conclusion Sustained atrial dilation forms a substrate for repetitive paroxysms of AF. Neuro-modulation prolongs AF episode duration in susceptible dogs. This animal model can be used to study structural remodeling of the atria and possible therapeutic advances in the management of AF. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Research

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