Isolated left ventricular non compaction as possible cause of athletic training suspension: a preliminary study on screened athletes.

AIM: The aim of this paper was to determine the prevalence of isolated left ventricular noncomapction (ILVNC) in a sample of 150 athletes send by sports doctors to the Valmontone Hospital's Cardiology Division in a span of about three years, with particular interest in non-compacted segments evaluation. The prevention of cardiovascular complications occurring during sporting activity requires detection of pathologies most often clinically latent but whose first presentation can be sudden cardiac death. In Italy, the pre-participation screening program comprises family history and personal cardiac history, clinical examination and electrocardiography. Subjects with abnormalities are further investigated by stress test, echocardiography and laboratory investigations, and those with significant abnormalities are disqualified from sports training and competition. ILVNC results in multiple trabeculations in the left ventricular myocardium and it is postulated to be caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. This cardiomyopathy should be considered one of the structural cardiac abnormalities responsible for sudden cardiac death. METHODS: There were 150 athletes seen in the Cardiology Division from 2007 to 2010 for an echocardiographic evaluation in order to clarify the nature of physical examination and/or electrocardiogram abnormalities. Echocardiographic diagnosis of ILVNC was based on criteria published by Jenni et al., and by Stölberger et al. RESULTS: Twenty-four of the 150 tested resulted positive for ILVNC (16.0%). This high prevalence is justified because it was a population originally selected because of electrocardiographic abnormalities. CONCLUSION: We believe that in case of unspecific ECG findings, it would be useful to perform echocardiographic examination in order to highlight structural defects. We also believe that it is very important to contemplate ILVNC between the causes of sudden death in young competitive athletes.

Sex differences in body fat parameters from the early reproductive to the postreproductive period of life: a multivariate analysis.

Sex diversity has been observed for many body parameters, and special attention has been paid to changes during puberty and menopause. In the present study we performed a multivariate analysis on several body fat parameters to obtain a synthetic overview of sex differences from the early reproductive period to the postreproductive period. The sample study is composed of 373 healthy Italian adults (294 females and 79 males). We have examined the amount of fat (in kilograms, as measured by dual-energy x-ray absorptiometry) in the left arm, left leg, left trunk hemisphere, right arm, right leg, and right trunk hemisphere, waist to hip ratio, and BMI. The sex differentiation from the early reproductive to the postreproductive period of life has been based on differences between the position of male and female centroids on the discriminant functions obtained for various periods of life. The difference between males and females increases suddenly after 20 years, reaching a maximum at 30 years. In the period between 30 and 40 years the difference decreases quickly, and after 40 years the difference is relatively small and remains practically constant. The fact that maximum sex differentiation coincides with age of best reproductive efficiency points to a relationship between the body parameters investigated and hormone production related to human reproduction.

Functional aspects of genetic variability in the GH genomic region.

Because of the small differences among genotypes, it would be difficult in basal conditions to detect the effect of genetic polymorphism in endocrine function, but this could emerge during provocative tests. We have studied four polymorphic sites of the GH gene region (17q24.2), MSPIA, MSPIB, BGLIIA, and BGLIIB. Gene and haplotype distributions in classes of growth retardation have been studied. The outcome of GH diagnostic test in relation to GH region genotypes has been evaluated by the analysis of area under the GH secretory curve. Ninety-eight growth retarded children have been studied. On the basis of provocative GH test these children were classified as total GH deficit (TD), partial GH deficit (PD), and familial short stature (FSS) with no deficit of GH. Sixty-three healthy controls were also considered. An increased frequency of MSPIA*2 allele in PD and TD as compared with FSS children and controls has been observed suggesting that this allele is associated with a decreased GH release. BGLIIA*2 allele appears decreased in PD and TD as compared with FSS and controls, suggesting that this allele is associated with an increased release of GH. Carriers of MSPIA*2 allele show a lower GH release as compared with MSPIA *1/*1 subjects on the provocative test by insulin, while carriers of BGLIIA*2 allele show a higher GH release as compared with BGLIIA *1/*1 subjects on the provocative test by clonidine. The functional aspects of genetic variability within the GH genomic area parallel the genetic differences observed between TD and PD versus FSS and control children.

Normal weight obese (NWO) women: an evaluation of a candidate new syndrome.

BACKGROUND AND AIMS: Obesity, an independent risk factor for cardiovascular disease (CVD), has been associated with the early development of coronary atherosclerosis in adolescents and young men. A subset of metabolically obese but normal weight individuals was identified, with potentially increased risks for development of the metabolic syndrome despite their normal body mass index. We determined the relationship among body fat distribution and selected CVD risk factors to distinguish normal weight obese from controls with normal metabolic profiles. METHODS AND RESULTS: We analysed anthropometric variables, body composition by DXA, RMR by indirect calorimetry and bioumoral variables of 74 clinically healthy Caucasian Italian women. Significant differences were observed in the biochemical HDL-chol values between NWO and controls and pre-obese-obese. Significant correlations were found among cardiovascular risk indexes, LEAN of the right part of the trunk and TC/HDL (R=-0.69, p<0.001) and LDL/HDL (R=-0.72, p<0.001), and LEAN and RMR (R=0.44, p=0.022) of NWO women. CONCLUSIONS: In normal weight obese women the cardiovascular risk indexes are related to metabolic variables and to body fat mass distribution. NWO individuals showed a relationship between the decrease in LEAN of the left leg and an increase in CVD risk factors. We suggest that LEAN distribution seems to be a potential predictor of CVD.

Resting metabolic rate incremented by pulsating electrostatic field (PESF) therapy.

Pulsating electrostatic field (PESF) therapy was investigated to assess the possibility of increasing the resting metabolic rate (RMR) in 14 adult females. The pumping effect of positive calcium and hydrogen ions was obtained by 30 min daily exposure to negative PESF, adjusted individually between 2 and 9 kV. This treatment could result in a buffering effect on blood pH and reduction of the rouleaux formation of erythrocytes, thus ameliorating the oxygen exchange potential and the red cell circulation in the capillary system. After PESF therapy, the average RMR (measured by indirect calorimetry) of 1255 kcal was increased on average by 323 kilocalories, indicating a possible role of PESF in the obesity treatment.

Total body water estimation using bioelectrical impedance: a meta-analysis of the data available in the literature.

Bioelectric impedance analysis (BIA) is commonly used in clinical settings and field studies for estimating total, extracellular, and intracellular water compartments. The objective of the present study was to carry out a meta-analysis of published reports in which total body water (TBW) was estimated using BIA techniques and comparisons were made with reference values. We identified 16 reports conducted among healthy and obese adults and individuals with chronic renal failure. Based on the weighted mean difference, we found that those studies using only multi-frequency BIA did not significantly overestimate the TBW compared with the reference values. Thus, among BIA techniques, multi-frequency BIA seems to be a more accurate method for estimating the TBW compartment for healthy and obese adults and for those with chronic renal failure.

The application of body cell mass index for studying muscle mass changes in health and disease conditions.

Body mass index (BMI) fails to detect altered nutritional state in the presence of overweight or obesity, since malnutrition can be present and masked by the abnormal amount of fat mass. Measuring body cell mass (BCM) contents for the evaluation of muscle mass and protein tissue states is well accepted. The aim of the present study was to apply body cell mass index (BCMI) to monitor the muscular mass changes of male and female Olympic athletes, renal dialysis patients, and anorexia nervosa patients in comparison with healthy subjects. The BCMI values of male subjects from the healthy group and Olympic athletes groups, but not the renal dialysis group, were significantly higher ( p<0.0001) than those of female subjects from the same groups. In addition, subjects with normal or high BMI values may be malnourished as highlighted by a low BCMI. We believe the BCMI is more sensitive than the BMI for studying the nutritional status of the individual.

A program for fitting of hypnograms and other biological data by orthogonal polynomials.

Many biological phenomenon are nonlinear and poorly approximated by linear regression. The program POLFIT calculates curvilinear regressions by fitting of orthogonal polynomials. This program, as well as two supporting programs (CORREC: disk storage, and CALCML: calculation of cumulated values of series of observations), was primarily designed for the study of the temporal organization of sleep components. They can be used as well for any other kind of biological data.