Cardiac adaptation to endurance exercise training: Differential impact of swimming and running.

Objectives: High-intensity training has been associated with bi-ventricular and bi-atrial remodelling and a potentially increased risk of arrhythmias. Most of the evidence is based on endurance disciplines mainly involving the lower part of the body, while few data is available on upper body disciplines. The purpose of this study was to compare chronic cardiac remodelling induced by running and swimming as well as the acute response of ventricular and atrial performance after an upper-body and a lower-body endurance race. Methods: Standard and speckle tracking echocardiographic assessment of left ventricle, right ventricle and both atria was performed at baseline and immediately after a 9.5 km open-water swimming race in 26 healthy men and before and after a 35 km-trail-running race in 21 male runners. Results: No significant differences were observed in baseline ventricular dimensions. However, both right ventricular and atrial systolic deformation were greater in runners. This group also showed slightly larger atrial volumes as compared to swimmers. After the race, right ventricular dilatation was observed in both groups, but only runners showed a decrease in right ventricular deformation and a decrease in atrial volumes and deformation. Significant increases in atrial deformation without reduction in atrial volumes were observed only in swimmers after the race. Conclusions: Right ventricular and atrial remodelling is different depending on the endurance training discipline. Long-distance running races induce a greater impairment in right ventricular performance and atrial function compared to endurance swimming competitions.

Macronutrient and mineral intake effects on racing time and cardiovascular health in non-elite marathon runners.

OBJECTIVE: The aim of this study was to analyze the intake of specific macronutrients and minerals that could influence cardiovascular health in recreational marathon runners. METHODS: We grouped 37 male runners into two groups according to their 50th percentile race time (3.39 h) and divided them into fast (group 1 [G1]: 3.18 ± 0.18 h) and slow runners (group 2 [G2]: 3.84 ± 0.42 h). Anthropometric parameters, macronutrients, and mineral records were collected before the race. Minerals (sodium ion, potassium ion, and magnesium ion), lipid profile (triacylglycerols, low-density lipoprotein, high-density lipoprotein, and cholesterol), muscle damage (creatine kinase), inflammation (C-reactive protein), and cardiovascular health (high-sensitivity troponin T, ST2, and N-terminal proB-type natriuretic peptide) were analyzed in blood 24 h before, immediately after, and 48 h postrace. RESULTS: Weight (G1: 74.70 ± 7.76 kg, G2: 79.58 ± 6.72 kg; P < 0.05) and body mass index (G1: 23.01 ± 1.81 kg/m2, G2: 25.30 ± 2.02 kg/m2; P < 0.01) differed significantly between the groups. Moreover, G1 consumed significantly more (P < 0.01) mono- and polyunsaturated fatty acids than G2, and presented significantly higher iron, potassium, and magnesium intake. Regarding blood lipid profile, G2 presented significantly higher triacylglycerol values and lower levels of high-density lipoprotein (P < 0.01). The high-sensitivity troponin T marker of cardiac myocyte stress or injury was significantly higher (P < 0.05) in G2, reaching values >250 ng/L, and 81% of the runners (30 of 37) presented higher postrace values. CONCLUSIONS: Marathon runners consuming adequate amounts of unsaturated fat, iron, potassium, and magnesium, performed better and presented better cardiovascular health.

Aortic root remodelling in competitive athletes.

BACKGROUND: Controversy remains about the cut-off limits for detecting aortic dilatation in athletes, particularly in large-sized individuals. The allometric scaling model has been used to obtain size-independent measurements in cardiovascular structures in the general population. AIM: The purpose of this study was to validate the use of allometric scaling in the measurement of the aortic root for competitive athletes and to offer reference values. METHODS: This was a cross-sectional study that analyses the dimensions of aortic root found in the echocardiogram performed as part of pre-participation sports screening in competitive athletes between 2012-2015. Beta exponents were calculated for height and body surface area in the whole cohort. In order to establish whether a common exponent could be used in both genders the following model was assessed y = axb*exp(c*sex). If a common exponent could not be applied then sex-specific beta exponents were calculated. RESULTS: Two thousand and eighty-three athletes (64% men) were included, from a broad spectrum of 44 different sports disciplines, including basketball, volleyball and handball. The mean age was 18.2 ± 5.1 years (range 12-35 years) and all athletes were Caucasian, with a training load of 12.5 ± 5.4 h per week. Indexed aortic root dimension showed a correlation with ratiometric scaling by body surface area (r: -0.419) and generated size independence values with a very light correlation with height (r: -0.084); and with the allometric scaling by body surface area (r: -0.063) and height (r: -0.070). The absolute value of aortic root was higher in men than in women (p < 0.001). These differences were maintained with allometric scaling. CONCLUSION: Size-independent aortic root dimension values are provided using allometric scaling by body surface area and height in a large cohort of competitive athletes. Aortic root values were larger in men than in women, both in absolute values and after allometric scaling. The use of these indexed aortic reference ranges can be useful for the early detection of aortic pathologies.

Conclusions of the Grupo Avilés Working Group Meeting of 2018 / Conclusiones de la Reunión de Trabajo del Grupo Avilés 2018

No disponible

Affected pathways and transcriptional regulators in gene expression response to an ultra-marathon trail: Global and independent activity approaches.

Gene expression (GE) analyses on blood samples from marathon and half-marathon runners have reported significant impacts on the immune and inflammatory systems. An ultra-marathon trail (UMT) represents a greater effort due to its more testing conditions. For the first time, we report the genome-wide GE profiling in a group of 16 runners participating in an 82 km UMT competition. We quantified their differential GE profile before and after the race using HuGene2.0st microarrays (Affymetrix Inc., California, US). The results obtained were decomposed by means of an independent component analysis (ICA) targeting independent expression modes. We observed significant differences in the expression levels of 5,084 protein coding genes resulting in an overrepresentation of 14% of the human biological pathways from the Kyoto Encyclopedia of Genes and Genomes database. These were mainly clustered on terms related with protein synthesis repression, altered immune system and infectious diseases related mechanisms. In a second analysis, 27 out of the 196 transcriptional regulators (TRs) included in the Open Regulatory Annotation database were overrepresented. Among these TRs, we identified transcription factors from the hypoxia-inducible factors (HIF) family EPAS1 (p< 0.01) and HIF1A (p<0.001), and others jointly described in the gluconeogenesis program such as HNF4 (p< 0.001), EGR1 (p<0.001), CEBPA (p< 0.001) and a highly specific TR, YY1 (p<0.01). The five independent components, obtained from ICA, further revealed a down-regulation of 10 genes distributed in the complex I, III and V from the electron transport chain. This mitochondrial activity reduction is compatible with HIF-1 system activation. The vascular endothelial growth factor (VEGF) pathway, known to be regulated by HIF, also emerged (p<0.05). Additionally, and related to the brain rewarding circuit, the endocannabinoid signalling pathway was overrepresented (p<0.05).

Bioelectrical impedance vector analysis (BIVA) for measuring the hydration status in young elite synchronized swimmers.

PURPOSE: The assessment of body hydration is a complex process, and no measurement is valid for all situations. Bioelectrical impedance vector analysis (BIVA) has emerged as a relatively novel technique for assessing hydration status in sports. We applied BIVA a) to determine hydration changes evoked by an intense synchronized swimming (SS) training session; b) to characterize the sample of young elite swimmers in relation with a nonathletic reference population; and c) to generate its 50%, 75% and 95% percentiles of the bioelectrical variables. METHODS: Forty-nine elite SS female swimmers of two age categories, comen (Co: 13.9 ± 0.9 years, n = 34) and junior (Jr: 16.3 ± 0.6 years, n = 15), performed a long, high intensity training session. Body mass (BM) and bioelectrical variables (R, resistance; Xc, reactance; PA, phase angle; and Z, impedance module) were assessed pre- and post-training. BIVA was used to characterize 1) the distribution pattern of the bioelectrical vector (BIA vector) for both age groups, and 2) pre- to post-training BIA vector migration. Bioelectrical variables were also correlated with BM change values. RESULTS: Most swimmers were mostly located outside the 75% and some beyond the 95% percentile of the bioelectrical tolerance ellipses of the general population. The BIA vector showed statistically significant differences in both Co (T2 = 134.7, p = 0.0001) and Jr (T2 = 126.2, p < 0.001). Both groups were also bioelectrically different (T2 = 17.6, p < 0.001). After the training session, a decrease in BM (p = 0.0001) and an increase in BIA variables (p = 0.01) was observed. BIVA also showed a significant pre-post vector migration both in Co (T2 = 82.1; p < 0.001) and Jr (T2 = 41.8; p < 0.001). No correlations were observed between BM changes and bioelectrical variables. CONCLUSIONS: BIVA showed specific bioelectrical characteristics in young elite SS athletes. Considering the decrease in BM and the migration of the BIA vector, we conclude that the homeostatic hydration status of these young elite female swimmers was affected by the execution of intense training sessions. From a methodological perspective, BIVA appears to be sensitive enough to detect subtle hydration changes, but further research is needed to ensure its validity and reliability. Moreover, these findings highlight the importance of ensuring adequate fluid intake during training in young SS athletes.

Contraindicaciones cardiológicas para la práctica deportiva / Cardiological contraindications in sports

La muerte súbita en el deporte está causada en la mayoría de ocasiones por enfermedades cardiacas. El objetivo del cribado pre-participativo es poder identificar a los individuos que requieran un tratamiento específico para continuar el deporte o el cese de la práctica deportiva. La evidencia científica actual se basa en recomendaciones de expertos que en algunos casos son controvertidas y en ocasiones poco prácticas. Esta revisión tiene como objetivo dar un enfoque actualizado y pragmático de las recomendaciones en los deportistas con cardiopatía

In most cases, sudden death in sports is caused by heart disease. The aim of preparticipation screening is to identify individuals who require specific treatment to continue the sport or stop practicing it. Current scientific evidence is based on expert recommendations that in some cases are controversial and sometimes impractical. This review aims to present an updated and pragmatic approach to the recommendations in athletes with heart disease

Acute, Exercise Dose-Dependent Impairment in Atrial Performance During an Endurance Race: 2D Ultrasound Speckle-Tracking Strain Analysis.

OBJECTIVES: This study sought to understand and characterize the acute atrial response to endurance exercise and the influence of the amount of exercise performed. BACKGROUND: Endurance exercise seems to be recognized as a risk factor for developing atrial arrhythmia. Atrial geometrical and functional remodeling may be the underlying substrate. METHODS: Echocardiography was performed in 55 healthy adults at baseline and after a 3-stage trail race: a short race (S) (14 km), n = 17; a medium race (M) (35 km), n = 21; and a long race (L) (56 km), n = 17. Analysis consisted of standard, speckle-tracking assessment of both the left ventricle (LV) and right ventricle (RV) and both the left atrium (LA) and the right atrium (RA): a-wave strain (Sa) and strain rate (Ra) as a surrogate for atrial contractile function and s-wave strain (St) and strain rate (SR) as reservoir function. RESULTS: After the race, RA reservoir function decreased in group M (Δ% SRs: -12.5) and further in group L (Δ% SRs: -15.4), with no changes in group S. RA contractile function decreased in group L (Δ% SRa: -9.3), showed no changes in group M (Δ% SRa: +0.7), and increased in group S (Δ% SRa: +14.8). A similar trend was documented in LA reservoir and contractile function but with less pronounced changes. The decrease in RA reservoir after the race correlated with the decrease in RV global longitudinal strain (GLS) (Δ% RVGLS vs. RASt and RASRs: +0.44; p < 0.05 and +0.41, respectively; p < 0.05). CONCLUSIONS: During a trail-running race, an acute exercise-dose dependent impairment in atrial function was observed, mostly in the RA, which was related to RV systolic dysfunction. The impact on atrial function of long-term endurance training might lead to atrial remodeling, favoring arrhythmia development.

Inter-individual variability in right ventricle adaptation after an endurance race.

BACKGROUND: Right ventricle (RV) dysfunction has been described in athletes after endurance races. We aimed to understand and characterize the RV response to endurance exercise, the impact of individual variability and the effects of the amount of exercise. METHODS AND RESULTS: Echocardiography was performed in 55 healthy adults at baseline and after a three-stage trail race: short (14 km; n = 17); medium (35 km; n = 21); and long (56 km; n = 17). Standard and speckle tracking echocardiographic assessment of the RV was performed with global and separate analysis of the RV basal (inflow) and apical regions. Although no change was observed in the short distance runners, the RV systolic deformation decreased significantly (p < 0.05) after both the medium length and long races (Δ% RV global strain -7.6 ± 20.1 and -8.7 ± 21.8, respectively) with significant RV dilatation (Δ% RV volume +10.6 ± 9.9 and +15.3 ± 12.8, respectively). The RV basal segment made a major contribution to stroke volume during exercise, showing larger increases in size and strain compared with the apex. Various patterns of RV adaptation to exercise, ranging from increases in both RV segmental strains and sizes to an insufficient increase in size and a decrease in strain, were identified; this individual variability was not correlated with prior training. CONCLUSION: An acute RV impairment was demonstrated after a trail-running race and was related to the amount of exercise. A high inter-individual variability was observed. Differences in RV adaptation patterns were independent of prior training, suggesting the influence was due to other individual factors.

Sarcomere Disruptions of Slow Fiber Resulting From Mountain Ultramarathon.

OBJECTIVE: To investigate changes after a mountain ultramarathon (MUM) in the serum concentration of fast (FM) and slow (SM) myosin isoforms, which are fiber-type-specific sarcomere proteins. The changes were compared against creatine kinase (CK), a widely used fiber-sarcolemma-damage biomarker, and cardiac troponin I (cTnI), a widely used cardiac biomarker. METHODS: Observational comparison of response in a single group of 8 endurance-trained amateur athletes. Time-related changes in serum levels of CK, cTnI, SM, and FM from competitors were analyzed before, 1 h after the MUM, and 24 and 48 h after the start of the MUM by 1-way ANOVA for repeated measures or Friedman and Wilcoxon tests. Pearson correlation coefficient was employed to examine associations between variables. RESULTS: While SM was significantly (P = .009) increased in serum 24 h after the beginning of the MUM, FM and cTnI did not change significantly. Serum CK activity peak was observed 1 h after the MUM (P = .002). Moreover, serum peaks of CK and SM were highly correlated (r = .884, P = .004). CONCLUSIONS: Since there is evidence of muscle damage after prolonged mountain running, the increase in SM serum concentration after a MUM could be indirect evidence of slow- (type I) fiber-specific sarcomere disruptions.

The therapeutic lamp: treating small-animal phobias.

We all have an irrational fear or two. Some of us get scared by an unexpected visit from a spider in our house; others get nervous when they look down from a high building. Fear is an evolutionary and adaptive function that can promote self-preservation and help us deal with the feared object or situation. However, when this state becomes excessive, it might develop into psychological disorders such as phobias, producing high anxiety and affecting everyday life. The Therapeutic Lamp is an interactive projection-based augmented-reality system for treating small-animal phobias. It aims to increase patient-therapist communication, promote more natural interaction, and improve the patient's engagement in the therapy.

Ergometría y cambio climático / Ergometry and climate change

Introducción y objetivosEn la corta historia de la ergometría moderna (50 años aprox.) se han producido notables cambios en la atmósfera que respiramos a nivel de grandes, medianas y pequeñas partículas; también a nivel de la composición gaseosa, con aumentos del gas carbónico (CO2) en torno al 125%. Esta situación se agrava dentro de los edificios, que es donde se ubican los laboratorios de fisiología del esfuerzo.El objeto del presente estudio fue comprobar cómo afectan estos cambios atmosféricos a los humanos durante el esfuerzo.MétodosSe realizó estudio comparativo mediante dos pruebas cicloergométricas, apareadas, en 13 sujetos (12♂+1♀). Una se hizo en la situación habitual del laboratorio (indoor) y la réplica se hizo en el mismo laboratorio, dentro de una burbuja con un sitema de filtrado de grandes, medianas y pequeñas partículas, tomando el aire del exterior del laboratorio, (aire libre, outdoor). Los parámetros que se controlaron fueron: la potencia máxima conseguida en el cicloergómetro y expresada en vatios (W), los parámetros ergoespirométricos (VO2max, VCO2max, VEmax), los parámetros cardiológicos: ritmo cardíaco por minuto y los niveles de ácido 2-hidroxipropanoico (La++) y la glicemia en sangre capilar arterializada.ResultadosNo se modificaron estadísticamente los parámetros ergoespirométricos, cardíacos, así como los relativos a la potencia alcanzada en el cicloergómetro, cuando comparamos las dos situaciones estudiadas. Sin embargo, los sujetos mostraron un mayor nivel de lactato arterial capilarizado (+117%) a los 3minutos de finalizar la prueba en situación indoor (7,55±1,81 vs 6,44±1,76mMol/dl; p<0,016; n=13).Idéntico comportamiento observamos en los niveles de glucosa en sangre capilar, que mostraron un incremento del 112% en la situación habitual (indoor) en comparación con los de la burbuja de aire purificado y exterior (glicemia: 90,0±12,2mg/dl vs 82,15±6,94mg/dl; p>0,054 no significativo; n=13)(AU)

DiscusiónLos analizadores de gases para estudio metabólico fueron capaces de calibrarse en diferentes atmósferas y determinar correctamente las capacidades y potenciales de estos sujetos, a pesar de los cambios atmosféricos. Las adaptaciones metabólicas fueron suficientes para compensar las diferencias atmosféricas comparadas y permitieron un nivel similar de prestaciones físicas expresadas en la prueba de esfuerzo y también en el comportamiento cardíaco expresado durante la misma atendiendo a los niveles de contaminación en un laboratorio cercano a Barcelona (NE spam).ConclusionesLos sujetos fueron capaces de adaptarse a los cambios atmosféricos debidos a la progresiva contaminación. No mostraron diferencias en las dos situaciones planteadas en el análisis metabólico de gases en esfuerzo, y tampoco hubo cambios en el comportamiento cardíaco. No se modificó la potencia máxima obtenida en el laboratorio. Pero metabólicamente se pagó un precio por la contaminación atmosférica, como muestra la mayor mobilización de glucosa en la sangre capilar y también en la mayor producción de lactato capilar en las condiciones del estudio(AU)

Introduction and objectivesIn the short history of ergonomics (approximately 50 years) there have been notable changes in the atmosphere that we breathe, such as large, medium and small particles, as well as the gas composition, with increases in carbon dioxide (CO2) of about 125%. This situation becomes worse within the buildings where the physiology exercise laboratories are located.The objective of this study was to determine how these atmospheric changes affect humans during exercise.MethodsA comparative study was conducted by means of 2 paired ergometric bicycle tests on 13 subjects (12 males and 1 female). One was carried out in the normal laboratory situation (indoor), and the repeat was done in the same laboratory, with a bubble with a system that filtered large, medium and small particles, breathing the air outside the laboratory (outdoor). The parameters that were controlled were: the maximum power achieved on the ergometric bicycle expressed in watts (W), the ergospirometer parameters (VO2max, VCO2max, VEmax), cardiological parameters: heart beats per minute and 2-hydroxypropanoic acid (La++) levels and arterialised capillary blood glucose.ResultsThe ergospirometer and cardiac parameters, or those associated with the power achieved on the ergometric bicycle did not change statistically, when we compared the two situations studied. However, the subjects did have higher levels of arterialised capillary lactate (+117%) 3min after finishing the indoor situation test (7.55±1.81 vs 6.44±1.76mMol/dl, P<0.016; n=13).We observed identical behaviour in the capillary blood glucose levels, which showed an increase of 112% in the usual situation (indoor) compared to those in the purified (outdoor) air bubble (blood glucose: 90.0±12.2mg/dl vs 82.15±6.94mg/dl; P>0.054 (not significant, n=13)(AU)

ConclusionsThe subjects were able to adapt to the atmospheric changes owing to the gradual contamination. No differences were seen in the two situations established in the metabolic gas analyses under effort, and neither were there any changes in cardiac behaviour. The maximum potential obtained in the laboratory did not change. But, metabolically, a price was paid for atmospheric contamination, as shown by the higher mobilisation of glucose in capillary blood, and also in the higher production of capillary lactate under the conditions of the study(AU)

Valoración nutricional de los hábitos alimentarios en jóvenes esgrimistas de competición / No disponible

Introducción y objetivos: Si bien las necesidades nutricionalesy el perfil somático del esgrimista de élite han sidodescritos, no sucede así en jóvenes esgrimistas. El objetivodel presente estudio fue doble: describir el perfil cineantropométricode un grupo de jóvenes esgrimistas de competicióny valorar sus hábitos alimentarios.Métodos: El presente estudio, de carácter observacional ydescriptivo, agrupa las variables analizadas en dos valoraciones:a) valoración nutricional (registro de 24 h): energíatotal, hidratos de carbono, proteínas, lípidos, fibra, colesterol,contenido en agua de la dieta, vitaminas y minerales; b)valoración cineantropométrica: talla, peso, somatotipo ycomposición corporal.Resultados: El 26,3% del grupo se situó por encima de losvalores recomendados de ingesta energética, mientras queel 57,9% lo hizo por debajo. El consumo de hidratos de carbonofue inferior a los valores recomendados, mientras quela ingesta de proteínas y lípidos fue superior. El 89,5 y el63,2% del grupo se situó por debajo de las recomendacionesde grasas monoinsaturadas y poliinsaturadas, respectivamente.El 89,5% registró valores de grasas saturadas porencima de la ingesta recomendada. El consumo de fibra fuedeficitario en el 52,6% de los casos. El consumo de colesterolfue en cambio superior (73,7%). Se registraron valoresde vitaminas acordes con las recomendaciones, no siendoasí en el caso de algunos minerales. Ambos sexos conformangrupos notablemente heterogéneos a nivel somático.Conclusiones: La mayoría de los jóvenes esgrimistas analizadosposeen hábitos alimentarios no adecuados para mantenerun estado de vida saludable ni para la práctica deportiva.Resulta necesario corregir dichos hábitos basándose enuna correcta educación y seguimiento nutricional. Más aún silo que se pretende es optimizar su rendimiento deportivo.La valoración cineantropométrica ratifica estos resultados

Introduction and objectives: Although the nutritional requirements and somatic profile of the elite fencer havebeen described, this information is lacking in young fencers.The aim of the present study was two-fold: firstly, to describethe kinanthropometric profile of a group of youngcompetitive fencers and, secondly, to assess their nutritionalhabits.Methodology: The present observational, descriptivestudy classified the variables analyzed into two categories:a) nutritional assessment (24 h recording): total energy,carbohydrates, proteins, lipids, fiber, cholesterol, dietarywater content, vitamins and minerals; b) kinanthropometricassessment: height, weight, somatotype, and body composition.Results: Total energy intake was above recommended levelsin 26.3% of the group and below these levels in 57.9%.Carbohydrate intake was lower than recommended, whereasprotein and lipid intake was higher. Intake of monounsaturatedand polyunsaturated fats was below recommendedlevels in 89.5% and 63.2% of young fencers,respectively. Saturated fat intake was higher than recommendedintake in 89.5% of the fencers. Fiber consumptionwas deficient in 52.6% of the fencers. In contrast, cholesterolintake was higher than recommended consumption in73.7%. Vitamin intake was in line with recommended levelsbut intake of some minerals was deficient. Both sexes wereremarkably heterogeneous in somatic profile.Conclusions: Nutritional habits in most of the young fencersanalyzed were unsuitable both to maintain a state ofhealth and to practice sport. These habits should be correctedthrough proper education and nutritional follow-upwith further interventions to optimize sports performance.The kinanthropometric assessment confirms these results

Deshidratación osmótica de manzana (Grany Smith) con diferentes soluciones osmóticas / Osmotic dehydration of apple (Grany Smith) with diferents osmotic solutions

Se estudio el proceso de deshidratación osmótica de anillos de manzana sometidos a 40º,50º y 60ºC y a la acción de dos agentes osmóticos (sacarosa e hidrolizados de maíz) idénticos en grados Brix actividad de agua y viscosidad pero diferentes en su composición (contenido de polisacáridos). Los parámetros de pérdida de peso, contenido de agua, ganancia de sólidos y grados Brix; indicaron diferencias entre los medios estudiados, se perdió más agua y se ganaron menos sólidos con los hidrolizados de maíz en comparación con la sacarosa. Los polisacáridos que permanecen en los jarabes de maíz influyen en el proceso, limitando la entrada de solutos y facilitando la salida de agua