[Echocardiographic examination of cardiac structure and function in male athletes of static and dynamic disciplines]. / Porównanie wybranych parametrów echoakardiograficznych u sportowców poddanych róznym rodzajom treningu.

UNLABELLED: Practising a record-seeking sport may in consequence lead to morphological and functional changes in a heart muscle. The physiological changes which are result of heart's adaptation to a greater physical effort are called "sportsman's heart". AIM OF THE THESIS: The value of echocardiographic tests in detecting and designating frequency of occurrence of heart abnormalities in sportsmen. The comparison of echocardiographic, functional and morphological adaptation changes in a group of sportsmen of both static and dynamic disciplines. The safety of practising football and bodybuilding. The influence of length of time when the sport is practised on the quantity of echocardiographic parameters. MATERIAL AND METHODS: The material analysed in the doctor's thesis consists of a group of 40 men practising a static sport and a group of 40 men subjected to dynamic effort, as well as a control group of 30 men who do not practise any sport. In all the examined men the analysis comprises echocardiographic examination. The analysis deals with morphology and function of heart's structures: the left and the right ventricles, atrium and valves, on the basis of echocardiography The data is evaluated in each group of sportsmen (frequency of occurrence of heart abnormalities in sportsmen) and compared both between the record-seekers practising two kinds of training, and between the record-seekers and the control group. RESULTS: Adaptation changes of the left ventricle in the sportsmen practising static disciplines showed thickening of walls of the left ventricle with the lessening of its inner size, so called concentric hypertrophy. Thickness of walls of the left ventricle did not exceed 12 mm in diastole in 97% of the examined. In the dynamic group a slight growth in thickness of the walls with the delatation of the left ventricle's cavity was observed in relation to the sportsmen of the static group (p < 0.002). In both groups of sportsmen a significantly higher than in the control group mass index of the left ventricle was noted, (however, it did not exceed 130g/m2) and the size of the left atrium (p < 0.05) and of right ventricle (p < 0.05). CONCLUSIONS: The left ventricle's adaptation changes to static and dynamic effort differ. In the group of static effort there is noted a larger growth of walls' thickness with the smaller size of the left ventricle in comparison with the dynamic effort group. However, hypertrophy of the left ventricle walls occurs rarely and is usually small, more intense in the group subjected to static effort. Some parameters of the right ventricle's morphology differed significantly statistically in both groups of sportsmen. Nevertheless, physical effort causes changes in the right ventricle's morphology, irrespectively of the sort of the practised sport. Record-seeking football and bodybuilding turned out to be safe in the examined group. The length of time when the sport was practised does not affect the quantity of the monitored echocardiographic parameters.

[ECG and 24-hour ECG findings in athletes of static and dynamic disciplines]. / Badanie EKG oraz 24-godzinna rejestracja EKG metoda Holtera u sportowców poddanych róznym rodzajom treningu.

UNLABELLED: Endurance sports are associated with structural and functional changes in the myocardium. Physiologic changes representing cardiac adaptation to training are termed "athletic heart". THE AIM: We compared the incidence of arrhythmias and conduction abnormalities in athletes of static and dynamic sports using resting and 24 hour electrocardiography. We also studied the effect of physiologic left ventricular hypertrophy on the incidence of arrhythmias and conduction abnormalities in athletes, as well as of training duration on electrocardiographic parameters. MATERIAL AND METHODS: We enrolled 40 male athletes of static and 40 of dynamic sports, as well as 30 normally active males. A 12-lead resting ECG, 24 hour ECG, and echocardiography were done. RESULTS: The resting heart reate in athletes was significantly slower (p < 0.0001). No intervals longer than 3s, bundle branch or atrioventricular blocks were disclosed. The finding of left ventricular bypertrophy and training duration had no significant effect on the presence and number of supraventricular and ventricular arrhythmias or blocks. CONCLUSION: Resting ECG, echocardiography, and 24 hour ECG provide valuable cardiologic information in athletes. The heart rate was slower in all athletes and the PQ interval was longer as compared with controls. No serious arrhythmias or conduction abnormalities were noted. The duration of training and the presence of myocardial hypertrophy had no effect on electrocardiographic parameters.

[Diagnostic and prognostic value of stress echo-pacing in patients with implanted AAI pace-maker]. / Wartosc diagnostyczna i prognostyczna echokardiografii obciqzeniowej z zastosowaniem stymulacji AAI ze stymulatora serca.

UNLABELLED: The aim of this study was to assess the utility, safety and prognostic value of echocardiographic stress test (EST) in non-invasive diagnosis of ischemic heart disease in patients (pts) with implanted pacemaker, with and without left ventricle hypertrophy. MATERIAL AND METHODS: EST was performed in 40 patients (mean age 60+/-10 years, from 43 to 78) with pacemaker. Using external programming system heart rate was accelerated by 10 beats in every 3 minute till reaching maximal heart rate. The examination was conducted only in patients with physiological stimulation of right atrium by AAI mode. Angiographically significant coronary artery stenosis size was accepted as over 50% artery diameter. Mean duration time of performed examination was 13+/-4 min. RESULTS: No adverse events were observed. The quality of stress echo visualization was good in every case. Heart rate at rest and at maximal stimulation were respectively 68+/-8 and 132+/-13 per minute (p<0.0001) and systolic blood pressure pressure 140+/-13 and 142+/-13 mmHg (ns). In 10 (25%) pts the result was positive, in 24 (60%) negative, and in 6 (15%) - non-diagnostic. Non-diagnostic result of the test was due to pacemaker limitation (1 pts), and achieving Wenckebach point (5 pts). Test specificity was 95%, sensitivity 69%, accuracy - 85%. Significant occlusion in coronary angiography were observed in 40% pts (including 1-vessel disease - 12,5%). In left ventricle hypertrophy group (n=19), the EST accuracy was 87% (without significant difference with non-hypertrophy group). In the group with beta blockers therapy (n=16) the observed accuracy was 93%. The follow-up time was 963+/-497 days. The prognostic value of positive EST result for cardiac events was 80%, and for negative - 100%. None of the pts with negative stress echo result suffered any cardiac event. CONCLUSIONS: EST is a safe, short lasting examination with good quality of echo visualization. This method seems to be of important value in diagnosing the ischaemic heart disease in pts with pacemaker, also with left ventricle hypertrophy and obligatory beta blockers medication.