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

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<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<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.

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The impact of catheter ablation of atrial fibrillation on the left atrial volume and function: study using three-dimensional echocardiography

Journal of Interventional Cardiac Electrophysiology ◽

10.1007/s10840-019-00696-8 ◽

2019 ◽

Vol 57 (1) ◽

pp. 87-95

Author(s):

Jongmin Hwang ◽

Hyoung-Seob Park ◽

Seongwook Han ◽

Seung-Woon Jun ◽

Na-Young Kang ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Left Atrial ◽

Three Dimensional ◽

Left Atrial Volume ◽

Volumetric Assessment ◽

Dimensional Echocardiography ◽

Three Dimensional Echocardiography ◽

And Function ◽

The Impact

Abstract Purpose The exact correlation between the baseline left atrial (LA) volume (LAV) and atrial fibrillation (AF) radiofrequency catheter ablation (RFCA) outcomes and changes to the LA after AF RFCA has not yet been fully understood. We sought to evaluate the serial changes in the LAV and LA function after RFCA using 3D echocardiography. Methods Consecutive patients who received RFCA of paroxysmal (PAF) or persistent AF (PeAF) at our center between January 2013 and March 2016 were included. Real-time 3D apical full-volume images were acquired, and a 3D volumetric assessment was performed using an automated three-beat averaging method. The LAV index (LAVI) was calculated and the LA ejection fraction (LAEF) was calculated as [LAVmax − LAVmin]/LAVmax. Results Ninety-nine total patients were enrolled, and the mean age was 58.0 ± 8.2 years and 75 (74.7%) were male. There were 59 (59.6%) PAF patients and the remaining 40 (40.4%) had PeAF. AF recurred in 5 of 59 (8.5%) PAF and in 10 of 40 (25%) PeAF patients. The LAVImax increased on 1 day, decreased at 3 months, and then increased again at 1 year but was lower than that at baseline. The LAEF changes were similar to the volume changes but were more prominent in PeAF than PAF patients. The baseline 3D LAVImax was an independent predictor of AF recurrence after RFCA and the cut-off value was 44.13 ml/m2. Conclusion In our study, even after 3 months of scar formation due to ablation, structural remodeling of the LA continued. The changes were more prominent in the non-recurrent, PeAF patients.

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Susceptibility of protein therapeutics to spontaneous chemical modifications by oxidation, cyclization, and elimination reactions

Amino Acids ◽

10.1007/s00726-019-02787-2 ◽

2019 ◽

Vol 51 (10-12) ◽

pp. 1409-1431 ◽

Cited By ~ 5

Author(s):

Luigi Grassi ◽

Chiara Cabrele

Keyword(s):

Small Molecules ◽

Three Dimensional ◽

Drug Market ◽

Structure And Function ◽

Dimensional Structure ◽

Chemical Modifications ◽

Small Molecule Drugs ◽

And Function ◽

The Impact

Abstract Peptides and proteins are preponderantly emerging in the drug market, as shown by the increasing number of biopharmaceutics already approved or under development. Biomolecules like recombinant monoclonal antibodies have high therapeutic efficacy and offer a valuable alternative to small-molecule drugs. However, due to their complex three-dimensional structure and the presence of many functional groups, the occurrence of spontaneous conformational and chemical changes is much higher for peptides and proteins than for small molecules. The characterization of biotherapeutics with modern and sophisticated analytical methods has revealed the presence of contaminants that mainly arise from oxidation- and elimination-prone amino-acid side chains. This review focuses on protein chemical modifications that may take place during storage due to (1) oxidation (methionine, cysteine, histidine, tyrosine, tryptophan, and phenylalanine), (2) intra- and inter-residue cyclization (aspartic and glutamic acid, asparagine, glutamine, N-terminal dipeptidyl motifs), and (3) β-elimination (serine, threonine, cysteine, cystine) reactions. It also includes some examples of the impact of such modifications on protein structure and function.

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In amateur athletes with type 1 diabetes, a 9-day period of cycling at moderate-to-vigorous intensity unexpectedly increased the time spent in hyperglycemia, which was associated with impairment in heart rate variability

10.2337/figshare.12517397.v1 ◽

2020 ◽

Author(s):

Elodie Lespagnol ◽

Olivia Bocock ◽

Joris Heyman ◽

François-Xavier Gamelin ◽

Serge Berthoin ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Glycemic Variability ◽

Amateur Athletes ◽

Positive Effects ◽

Vigorous Intensity ◽

Exercise Induced ◽

The Impact

Objective In type 1 diabetes, autonomic dysfunction may occur early as a decrease in heart rate variability (HRV). In nondiabetic populations, the positive effects of exercise training on HRV are well documented. However, exercise in individuals with type 1 diabetes, particularly if strenuous and prolonged, can lead to sharp glycemic variations, which can negatively impact HRV. This study explores the impact of a 9-day cycling tour on HRV in this population, with a focus on exercise-induced glycemic excursions. Research Design and Methods Twenty amateur athletes with uncomplicated type 1 diabetes cycled 1500km. HRV and glycemic variability were measured by heart rate and continuous glucose monitoring. Linear mixed models were used to test the effects of exercise on HRV, considering concomitant glycemic excursions and subject characteristics as covariates. Results Nighttime HRV tended to decrease with the daily distance traveled. The more time the subjects spent in hyperglycemia, the lower the parasympathetic tone was. This result is striking given that hyperglycemic excursions progressively increased throughout the 9 days of the tour, and to a greater degree on the days a longer distance was traveled, while time spent in hypoglycemia surprisingly decreased. This phenomenon occurred despite no changes in insulin administration and a decrease in carbohydrate intake from snacks. Conclusions <a>In sports enthusiasts with type 1 diabetes</a>, multiday prolonged exercise at moderate-to-vigorous intensity worsened hyperglycemia with the latter being negatively associated with parasympathetic cardiac tone. Considering the putative deleterious consequences on cardiac risks, future work should focus on understanding and managing exercise-induced hyperglycemia.

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Using AlphaFold to predict the impact of single mutations on protein stability and function

10.1101/2021.09.19.460937 ◽

2021 ◽

Author(s):

Marina A Pak ◽

Karina A Markhieva ◽

Mariia S Novikova ◽

Dmitry S Petrov ◽

Ilya S Vorobyev ◽

...

Keyword(s):

Protein Folding ◽

Protein Stability ◽

Structure Prediction ◽

Large Scale ◽

3D Structure ◽

Three Dimensional ◽

Single Mutation ◽

Before And After ◽

And Function ◽

The Impact

AlphaFold changed the field of structural biology by achieving three-dimensional (3D) structure prediction from protein sequence at experimental quality. The astounding success even led to claims that the protein folding problem is "solved". However, protein folding problem is more than just structure prediction from sequence. Presently, it is unknown if the AlphaFold-triggered revolution could help to solve other problems related to protein folding. Here we assay the ability of AlphaFold to predict the impact of single mutations on protein stability (ΔΔG) and function. To study the question we extracted metrics from AlphaFold predictions before and after single mutation in a protein and correlated the predicted change with the experimentally known ΔΔG values. Additionally, we correlated the AlphaFold predictions on the impact of a single mutation on structure with a large scale dataset of single mutations in GFP with the experimentally assayed levels of fluorescence. We found a very weak or no correlation between AlphaFold output metrics and change of protein stability or fluorescence. Our results imply that AlphaFold cannot be immediately applied to other problems or applications in protein folding.

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Post-marathon Decline in Right Ventricular Radial Motion Component Among Amateur Sportsmen

Frontiers in Physiology ◽

10.3389/fphys.2021.811764 ◽

2022 ◽

Vol 12 ◽

Author(s):

Zuzanna Lewicka-Potocka ◽

Anna Maria Kaleta-Duss ◽

Ewa Lewicka ◽

Marcin Kubik ◽

Anna Faran ◽

...

Keyword(s):

Right Ventricular ◽

Troponin I ◽

Positive Impact ◽

Systolic Function ◽

Stage Ii ◽

Moderate Physical Activity ◽

Marathon Running ◽

Amateur Athletes ◽

Cardiac Fatigue ◽

The Impact

Moderate physical activity has a positive impact on health, although extreme forms of sport such as marathon running may trigger exercise-induced cardiac fatigue. The explicit distinction between the right ventricular (RV) physiological response to training and maladaptive remodeling has not yet been determined. In this study, we aimed to analyze the impact of running a marathon on RV mechanics in amateur athletes using three-dimensional (3D) echocardiography (ECHO) and the ReVISION method (RV separate wall motion quantification). A group of 34 men with a mean age of 40 ± 8 years who successfully finished a marathon underwent ECHO three times, i.e., 2 weeks before the marathon (stage I), at the marathon finish line (stage II), and 2 weeks after the marathon (stage III). The ECHO findings were then correlated with the concentrations of biomarkers related to myocardial injury and overload and also obtained at the three stages. On finishing the marathon, the amateur athletes were found to have a significant (p < 0.05) increase in end-diastolic (with a median of 51.4 vs. 57.0 ml/m2) and end-systolic (with a median of 24.9 vs. 31.5 ml/m2) RV volumes indexed to body surface area, reduced RV ejection fraction (RVEF) (with a median of 51.0% vs. 46.0%), and a decrease in RV radial shortening [i.e., radial EF (REF)] (with a mean of 23.0 ± 4.5% vs. 19.3 ± 4.2%), with other RV motion components remaining unchanged. The post-competition decrease in REF was more evident in runners with larger total volume of trainings (R2 = 0.4776, p = 0.0002) and higher concentrations of high-sensitivity cardiac troponin I (r = 0.43, p < 0.05) during the preparation period. The decrease in REF was more prominent in the training of marathoners more than 47 km/week. At stage II, marathoners with a more marked decrease in RVEF and REF had higher galectin-3 (Gal-3) levels (r = −0.48 and r = −0.39, respectively; p < 0.05). Running a marathon significantly altered the RV performance of amateur athletes. Transient impairment in RV systolic function resulted from decreased radial shortening, which appeared in those who trained more extensively. Observed ECHO changes correlated with the concentrations of the profibrotic marker Gal-3.

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Exercise in Hypertrophic Cardiomyopathy: Restrict or Rethink??

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00850.2020 ◽

2021 ◽

Author(s):

Adaya Weissler Snir ◽

Kim A. Connelly ◽

Jack M. Goodman ◽

David Dorian ◽

Paul Dorian

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Animal Studies ◽

Critical Evaluation ◽

Sports Participation ◽

Potential Benefits ◽

Underlying Mechanisms ◽

Exercise Induced ◽

And Function ◽

The Impact ◽

Exercise Restriction

The detailed physiological consequences of aerobic training, in patients with hypertrophic cardiomyopathy (HCM) are not well understood. In athletes and non-athletes with HCM, there are two hypothetical concerns with respect to exercise: exercise-related worsening of the phenotype (e.g. promoting hypertrophy, fibrosis), and/or triggering of arrhythmia. The former concern is unproven and animal studies suggest an opposite effect, where exercise has been shown to be protective. The main reason for exercise restriction in HCM is fear of exercise-induced arrhythmia. Whilst the safety of sports in HCM has been reviewed, even more recent data suggest a substantially lower risk for sudden cardiac death (SCD) in HCM than previously thought, and there is an ongoing debate about restrictions of exercise imposed on individuals with HCM. This review outlines the pathophysiology of HCM, the impact of acute and chronic exercise (and variations of exercise intensity, modality, and athletic phenotype) in HCM including changes in autonomic function, blood pressure, cardiac dimensions and function, and cardiac output, and the underlying mechanisms that may trigger exercise-induced lethal arrhythmias. It provides a critical evaluation of the evidence regarding risk of SCD in athletes and the potential benefits of targeted exercise prescription in adults with HCM. Finally, it provides considerations for personalized recommendations for sports participation based on the available data.

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Pathomechanics and gait analysis

The Foot and Ankle in Rheumatology ◽

10.1093/med/9780198734451.003.0013 ◽

2019 ◽

pp. 227-248

Author(s):

Graham Chapman ◽

Philip Helliwell

Keyword(s):

Gait Analysis ◽

Measurement Techniques ◽

Three Dimensional ◽

Clinical History ◽

Joint Disease ◽

Core Knowledge ◽

Analysis Techniques ◽

Physical Treatments ◽

And Function ◽

The Impact

Gait analysis is the systematic study of human walking. This chapter summarizes currently available gait analysis techniques that are available to the clinician and researcher. Gait analysis can be used alongside clinical history and examination and other special investigations to gain a better understanding of the relationship between joint disease, impairment, and compensatory gait mechanisms. Abnormal pathology leads to abnormal biomechanics, and tools that demonstrate these changes can lead to insights into the effects of the disease on function, in disease progression, and the impact of physical treatments. Plantar pressure measurement techniques yield valuable information on structure and function and are probably the most likely tool to be used in clinical practice. Three-dimensional joint kinematic and kinetic analyses are more difficult to perform and interpret and are likely to remain largely research tools. Gait analysis techniques will drive experimental work to further advance core knowledge and inform future development of customized approaches to conservative therapies such as footwear and orthosis manufacture, as well as foot surgery.

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In amateur athletes with type 1 diabetes, a 9-day period of cycling at moderate-to-vigorous intensity unexpectedly increased the time spent in hyperglycemia, which was associated with impairment in heart rate variability

10.2337/figshare.12517397 ◽

2020 ◽

Author(s):

Elodie Lespagnol ◽

Olivia Bocock ◽

Joris Heyman ◽

François-Xavier Gamelin ◽

Serge Berthoin ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Glycemic Variability ◽

Amateur Athletes ◽

Positive Effects ◽

Vigorous Intensity ◽

Exercise Induced ◽

The Impact

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Assessment of serum free light chain levels in healthy adults immediately after marathon running

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0431 ◽

2016 ◽

Vol 54 (3) ◽

Cited By ~ 3

Author(s):

John P. Campbell ◽

Thijs M.H. Eijsvogels ◽

Yanyun Wang ◽

Maria T.E. Hopman ◽

Joannes F.M. Jacobs

Keyword(s):

Renal Function ◽

Plasma Cells ◽

Renal Diseases ◽

Marathon Running ◽

Heavy Chains ◽

Serum Free Light Chain ◽

Plasma Cell Dyscrasias ◽

Exercise Induced ◽

The Impact ◽

Activation Status

AbstractImmunoglobulin κ and λ free light chains (FLC) are important serum biomarkers for diagnosing and monitoring plasma cell dyscrasias (via the κ:λ FLC ratio), and assessing immune competence and activation status (via ∑FLC). FLCs are produced, in excess of heavy chains, from healthy plasma cells during immunoglobulin production, but unlike intact immunoglobulins that are cleared by cellular catabolism over a number of weeks, FLC are rapidly cleared from the bloodstream by the renal glomerulus with a half-life of 3 (κ FLC)–6 (λ FLC) hours. Marathon running has been shown to acutely and transiently decrease renal function, however, the impact of prolonged aerobic exercise on FLC levels remains unknown.We measured serum FLC levels in 60 runners before, and immediately after, the 2010 Eindhoven Marathon.A significant increase (p<0.01) in κ FLC levels was observed after the marathon, and κ FLC correlated positively with serum creatinine levels. No changes were observed for λ FLC, and thus, there were subtle elevations in the ∑FLC and FLC ratio in some participants. Indeed, we found that 13% of participants had an abnormally increased FLC ratio upon completion of the marathon; a phenomenon previously observed in renal diseases.Abnormal FLC ratios observed after exercise reflected an increase in serum κ FLC levels, which may be due to acute and transient reductions in renal function during exercise, though we also observed an increase in serum IgG and IgA and thus cannot exclude exercise-induced immune stimulation or immunoglobulin redistribution.

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