Beyond the absence of sleep disorder: spotlighting the cardiovascular benefits of sleep health.

Cardiovascular diseases (CVDs) are the leading cause of death globally. Among the objectives of preventive cardiology is the design to understand and neutralise the clinical overlap between disordered sleep and CVDs. Seldom do studies measure 'sleep health' beyond the absence of disease. Explored herein are the cardiovascular (CV) outcomes of sleep health on the grounds that, more than a corollary of sleep disorder research, sleep health constitutes a critical determinant of cardiac health and disease not unlike diet and physical activity. That sleep interventions can reverse the CV consequences of poor sleep habits lends credence to the notion that sleep health benefits CV health, and that the importance of sleep health percolates far beyond sleep disorder research. Overall, sleep health, and its practicable correlate: sleep hygiene, are clinical imperatives in the foreseeable future of cardiology in the 24-hour society.

Deformation Parameters of the Heart in Endurance Athletes and in Patients with Dilated Cardiomyopathy-A Cardiac Magnetic Resonance Study.

A better understanding of the left ventricle (LV) and right ventricle (RV) functioning would help with the differentiation between athlete's heart and dilated cardiomyopathy (DCM). We aimed to analyse deformation parameters in endurance athletes relative to patients with DCM using cardiac magnetic resonance feature tracking (CMR-FT). The study included males of a similar age: 22 ultramarathon runners, 22 patients with DCM and 21 sedentary healthy controls (41 ± 9 years). The analysed parameters were peak LV global longitudinal, circumferential and radial strains (GLS, GCS and GRS, respectively); peak LV torsion; peak RV GLS. The peak LV GLS was similar in controls and athletes, but lower in DCM (p < 0.0001). Peak LV GCS and GRS decreased from controls to DCM (both p < 0.0001). The best value for differentiation between DCM and other groups was found for the LV ejection fraction (area under the curve (AUC) = 0.990, p = 0.0001, with 90.9% sensitivity and 100% specificity for ≤53%) and the peak LV GRS diastolic rate (AUC = 0.987, p = 0.0001, with 100% sensitivity and 88.4% specificity for >-1.27 s-1). The peak LV GRS diastolic rate was the only independent predictor of DCM (p = 0.003). Distinctive deformation patterns that were typical for each of the analysed groups existed and can help to differentiate between athlete's heart, a nonathletic heart and a dilated cardiomyopathy.

Altered Circulating MicroRNA Profiles After Endurance Training: A Cohort Study of Ultramarathon Runners.

BACKGROUND: Despite the positive effects of endurance training on the cardiovascular (CV) system, excessive exercise induces not only physiological adaptations but also adverse changes in CV system, including the heart. We aimed to evaluate the selected miRNAs expression based on bioinformatic analysis and their changes before and after an ultramarathon run. MATERIALS AND METHODS: Cardiac tissue-specific targets were identified with the Tissue 2.0 database. Gene-gene interaction data were retrieved from the STRING app for Cytoscape. Twenty-three endurance athletes were recruited to the study. Athletes ran to completion (100 km) or exhaustion (52-91 km, median 74 km). All participants completed pre- and post-run testing. miRNAs expressions were measured both before and after the race. RESULTS: Enrichment analysis of the signaling pathways associated with the genes targeted by miRNAs selected for qRT-PCR validation (miR-1-3p, miR-126, miR-223, miR-125a-5p, miR-106a-5p, and miR-15a/b). All selected miRNAs showed overlap in regulation in pathways associated with cancer, IL-2 signaling, TGF-ß signaling as well as BDNF signaling pathway. Analysis of metabolites revealed significant regulation of magnesium and guanosine triphosphate across analyzed miRNA targets. MiR-1-3p, miR-125a-5p, miR-126, and miR-223 expressions were measured in 23 experienced endurance athletes, before and after an ultramarathon wherein athletes ran to completion (100 km) or exhaustion (52-91 km, median 74 km). The expressions of miR-125a-5p, miR-126, and miR-223 were significantly increased after the race (p = 0.007, p = 0.001, p = 0.014, respectively). MiR-1-3p expression post-run showed a negative correlation with the post-run levels of high-sensitivity C-reactive protein (hs-CRP) (r = -0.632, p = 0.003). Higher miR-1-3p expression was found in runners, who finished the race under 10 h compared to runners who finished over 10 h (p = 0.001). Post-run miR-125a-5p expression showed a negative correlation with the peak lactate during the run (r = -0.576, p = 0.019). CONCLUSION: Extreme physical activity, as exemplified by an ultramarathon, is associated with changes in circulating miRNAs' expression related to inflammation, fibrosis, and cardiac muscle function. In particular, the negative correlations between miR-125a-5p and lactate concentrations, and miR-1-3p and hs-CRP, support their role in specific exercise-induced adaptation. Further studies are essential to validate the long-term effect of these observations.

Football spectatorship and selected acute cardiovascular events: lack of a population-scale association in Poland.

BACKGROUND: The status of football spectatorship-induced emotional stress as a risk factor for acute cardiovascular events remains a matter of dispute.              Aims: This study aimed to investigate the relationship between football spectatorship and the incidenceof selected acute cardiovascular events in the Polish male population. METHODS: Events that occurred in male patients aged 35 years and older in Poland during 3 tournaments(2012 and 2016 European Championships and 2018 World Cup) were retrospectively analyzed based onhospital admission codes (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD­10]) obtained from the Polish National Health Fund (Narodowy Fundusz Zdrowia). The followingprimary diagnoses were of interest: acute myocardial infarction (AMI; I21), sudden cardiac arrest (I46),sudden arrhythmias (I47-I49). The corresponding dates in the years before and after the tournamentsconstituted the reference periods. RESULTS: A total of 255 383 patients were included in this study. There were no significant differences in the incidence of events between the combined exposure and reference periods: relative risk [RR] = 1.05 (95% CI, 0.97-1.14; P = 0.2) for AMI, RR = 1.08 (95% CI, 0.87-1.35;P = 0.47) for sudden cardiac arrest, and RR = 1.02 (95% CI, 0.98-1.06; P = 0.32) for sudden arrhythmias. Individual tournament analyses revealeda higher incidence of AMI (RR = 1.2; 95% CI, 1.12-1.3; P <0.001) during the World Cup. However, day ­by ­­day analysis for the World Cup did not show a higher incidence of AMI on match versus match­free days. CONCLUSIONS: Emotional stress evoked by football spectatorship is insufficiently potent to precipitatea population­scale increase in the incidence of selected acute cardiovascular events.