Cardiopulmonary capacity and muscle strength in transgender women on long-term gender-affirming hormone therapy: a cross-sectional study.

OBJECTIVE: For transgender women (TW) on oestrogen therapy, the effects of prior exposure to testosterone during puberty on their performance, mainly cardiopulmonary capacity (CPC), while exerting physical effort are unknown. Our objective was to evaluate CPC and muscle strength in TW undergoing long-term gender-affirming hormone therapy. METHODS: A cross-sectional study was carried out with 15 TW (34.2±5.2 years old), 13 cisgender men (CM) and 14 cisgender women (CW). The TW received hormone therapy for 14.4±3.5 years. Bioimpedance, the hand grip test and cardiopulmonary exercise testing on a treadmill with an incremental effort were performed. RESULTS: The mean VO2peak (L/min) was 2606±416.9 in TW, 2167±408.8 in CW and 3358±436.3 in CM (TW vs CW, p<0.05; TW vs CM, p<0.0001; CW vs CM, p<0.0001). The O2 pulse in TW was between that in CW and CM (TW vs CW, p<0.05, TW vs CM, p<0.0001). There was a high correlation between VO2peak and fat-free mass/height2 among TW (r=0.7388; p<0.01), which was not observed in the other groups. The mean strength (kg) was 35.3±5.4 in TW, 29.7±3.6 in CW and 48.4±6.7 in CM (TW vs CW, p<0.05; TW vs CM, p<0.0001). CONCLUSION: CPC in non-athlete TW showed an intermediate pattern between that in CW and CM. The mean strength and VO2 peak in non-athlete TW while performing physical exertion were higher than those in non-athlete CW and lower than those in CM.

Abnormal neurovascular control in anabolic androgenic steroids users.

PURPOSE: Previous studies showed that anabolic androgenic steroids (AAS) increase vascular resistance and blood pressure (BP) in humans. In this study, we tested the hypotheses 1) that AAS users would have increased muscle sympathetic nerve activity (MSNA) and reduced forearm blood flow (FBF) compared with AAS nonusers and 2) that there would be an association between MSNA and 24-h BP. METHODS: Twelve AAS users aged 31 +/- 2 yr (means +/- SE) and nine age-matched AAS nonusers aged 29 +/- 2 yr participated in the study. All individuals were involved in strength training for at least 2 yr. AAS was determined by urine test (chromatography-mass spectrometry). MSNA was directly measured by microneurography technique. FBF was measured by venous occlusion plethysmography. BP monitoring consisted of measures of BP for 24 h. RESULTS: MSNA was significantly higher in AAS users than that in AAS nonusers (29 +/- 3 vs 20 +/- 1 bursts per minute, P = 0.01). FBF (1.92 +/- 0.17 vs 2.77 +/- 0.24 mL x min(-1) x 100 mL(-1), P = 0.01) and forearm vascular conductance (2.01 +/- 0.17 vs 2.86 +/- 0.31 U, P = 0.02) were significantly lower in AAS users than that in AAS nonusers. Systolic (131 +/- 4 vs 120 +/- 3 mm Hg, P = 0.001), diastolic (74 +/- 4 vs 68 +/- 3 mm Hg, P = 0.02), and mean BP (93 +/- 4 vs 86 +/- 3 mm Hg, P = 0.005) and heart rate (74 +/- 3 vs 68 +/- 3 bpm, P = 0.02) were significantly higher in AAS users when compared with AAS nonusers. Further analysis showed that there was a significant correlation between MSNA and 24-h mean BP (r = 0.75, P = 0.002). CONCLUSIONS: AAS increases MSNA and reduces muscle blood flow in young individuals. In addition, the increase in BP levels in AAS users is associated with augmented sympathetic outflow. These findings suggest that AAS increases the susceptibility for cardiovascular disease in humans.

Miocardiopatias: atividades físicas e esportes / Cardiomyopathies: exercise and sports

Jovens tem sido, atualmente, considerados como uma parte especial da sociedade. Entretanto morte cardíaca súbita pode ocorrer mesmo na ausência de sintomas prévios, e esse fato tem impacto emocional e social considerável na opinião pública. Nos Estados Unidos, a cardiomiopatia hipertrofica apresenta-se como a causa mais comum de morte súbita entre atletas. Diversas doenças cardiovasculares presentes em atletas podem determinar a morte súbita, entre as quais destacam-se a miocardiopatia dilatada, a displasia arritmogênica no ventriculo direito, a miocardite viral, a endomiocardiofibrose e a doença arterial coronariana. As diretrizes para qualificar ou não os atletas capazes de participar de treinamento intensivo e atividades competitivas são fundamentais, porque essas condições aumentam o risco de morte súbita em atletas nos quais a condição cardíaca apresenta risco que poderá determinar o afastamento definitivo ou temporário desses atletas para competições. Nos pacientes com insuficiência cardíaca estável, treinamento com exercício de intensidade leve a moderada e duração prolongada não apresentou sinais de deteriorização dos volumes e da função ventrícular esquerda, tendo apresentado redução significativa da atividade simpática, mostrando-se seguro e efetivo, com melhora da tolerância ao exercício e da qualidade de vida. A forma indeterminada da doença de chagas claramente,apresenta-se como uma condição benigna com favorável prognóstico ao longo do tempo. A presença de taquicardia ventricular no teste de esforço está associada com elevada incidência de morte súbita em pacientes portadores de cardiopatia da doença de chagas em sua forma crônica e com arritmia ventricular presente...