No evidence of adverse cardiac remodeling in former elite endurance athletes.

BACKGROUND: The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. METHODS AND RESULTS: We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42 amateur-level ('sub-elite') cyclists or runners, aged 40-70years] and 18 aged-matched controls. A subset of 15 subjects (5 controls, 3 sub-elite and 7 elite athletes) also underwent cardiac magnetic resonance imaging (cMRI). Elite and sub-elite athletes had greater echocardiography-determined left ventricular myocardial mass indexed to body surface area than controls (113±22, 115.2±23.1 and 94.8±21g/m(2), respectively, p=0.008 for group effect), with similar results for left (50.5±4.4, 48.2±4.3 and 46.4±5.2mm, p=0.008) and right (38.6±3.8, 41.1±5.5 and 34.7±4.3mm, p<0.001) ventricular end-diastolic diameter, and cMRI-determined left atrial volume indexed to body surface area (62.7±8.1, 56.4±16.0 and 39.0±14.1ml/m(2), p=0.026). Two athletes showed a non-coronary pattern of small, fibrotic left ventricular patches detected by late gadolinium enhancement. No group effect was noted for biomarkers. CONCLUSIONS: Regardless of their competition level at a younger age, veteran endurance athletes showed an overall healthy, non-pathological pattern of cardiac remodeling. Nonetheless, the physiopathology of the ventricular fibrotic patches detected warrants further investigation.

Physical fitness, weight, smoking, and exercise patterns in young adults.

INTRODUCTION: The health and physical fitness of adolescents and young adults are important not just to the individuals concerned, but also to society as a whole. Many studies from many different countries have dealt with the prevalence of overweight, the risk factors for it, and the morbidity it causes, but no more than a few have addressed the effects of unhealthy lifestyles on physical fitness. In this study, we show that young adults' physical performance depends on the number of risk factors they possess. We also compare the young adults' physical performance with that of adolescents aged 10 to 17. METHODS: We obtained cross-sectional data on the weight, smoking status, athletic activity, time to run 1 km, and ability to perform a chin-up on a horizontal bar of 8048 subjects aged 10 to 25. The young adults were divided into groups depending on the number of risk factors they possessed from the following list: overweight, smoking, and lack of exercise. RESULTS: 28.4% of the men and 35.4% of the women aged 18 to 25 had none of these risk factors and exhibited the best physical performance. The more risk factors were present, the worse physical performance became. The 24- and 25-year-olds performed at the same level as the 14- and 15-year-olds. DISCUSSION: Unhealthy lifestyles can impair physical fitness even before any chronic disease arises. Possession of even a single risk factor is associated with significantly worse performance. Unless comprehensive and effective interventions are introduced in school and at work, the further cementation and worsening of unhealthy lifestyles will be hard to stop.

Sporting activity, prevalence of overweight, and risk factors: cross-sectional study of more than 12 500 participants aged 16 to 25 years.

BACKGROUND: Recent studies show that habits detrimental to health are becoming established ever earlier in life. Because most of these investigations focus on adolescents up to the age of 18 years, it is largely unknown whether and to what extent negative behavioral modifications are intensified in young adults. METHODS: Within the cross-sectional study "Fit fürs Leben" (Fit for Life) 12 835 volunteers aged 16 to 25 years were anthropometrically investigated and interviewed about their lifestyle and habits (sporting activity, nutrition and health-related behavior). RESULTS: Data on anthropometric (BMI, waist circumference, body fat) and health-relevant (lack of exercise, smoking) characteristics as well as the frequency of cardiovascular risk factors show a clear increase in unhealthy attributes, particularly among those aged 20 to 25 years. Fifty percent of 25-year-old men are overweight, 60% smoke, and around one third do not participate in sport. Although only one quarter of women aged 16 to 25 years are overweight, women engage in sport much less frequently. Only one quarter of all study participants display none of the investigated cardiovascular risk factors. DISCUSSION: The health-detrimental tendencies increase considerably after the age of 20. Efficient cross-institutional prevention campaigns are urgently necessary to promote and continually support a health-conscious life-style.

[Cholesterol-crystal embolization after PTCA. Case report and review of the literature]. / Cholesterinkristallembolie-Syndrom nach PTCA. Fallbericht und Literaturübersicht.

HISTORY: A 62-year-old male patient with depression after coronary intervention (PTCA) 4 weeks earlier. THERAPY AND CLINICAL COURSE: The patient developed insufficiency of liver and kidney as well as painful toe lesions. Some more symptoms were observed such as recurrent pulmonary edema, arterial hypertension, hardly responding to medical therapy, and severe gastrointestinal symptoms. The variety of symptoms and the progress of the disease were similar to a generalized vasculitis. Renal biopsy yielded the diagnosis of cholesterol-crystal embolization (CCE). After short-term remission, the patient died following prolonged and severe progression of the disease. CONCLUSION: CCE is a rare disease with devastating outcome. Clinicians should be aware of the disease, especially with regard to an increasing number of coronary interventions in older patients.