[Effect of intensive training on salivary level of cortisol, testosterone, alpha-amylase and mood of elite adolescent wrestlers]

Increasing the intensity of training is one of the factors that improve the athletic performance. Evaluation of psychological and biochemical factors is believed to be beneficial for evaluating the effectiveness of training schedule. Previous studies have shown that there are various responses to the training intensity due to the level of athlete's fitness and the kind of training. This study was done to investigate the effect of intensive training on salivary level of cortisol, testosterone, alpha-amylase and mood of elite adolescent wrestlers. This quasi-experimental study was performed on fifteen adolescent wrestlers of Iranian national team during 2009. The subjects were under extension training for three weeks. The saliva samples were taken prior, first, second and third weeks of training to determine cortisol, testosterone and alpha-amylase level of salivary samples. Also, the Brahms questionnaire was used to assess the mood profile before and after the training. Data were analyzed using SPSS-14, ANOVA and student t-tests. There was no significant differences of salivary cortisol [7.69 +/- 0.75, 8.1 +/- 0.93 ng/ml], testosterone [82.3 +/- 0.89, 64.2 +/- 1.7 ng/ml], alpha-amylase [98.81 +/- 1.35, 84.2 +/- 1.5 U/ml] level and mood [16.4 +/- 3.28, 20.08 +/- 2.91] of subjects prier and after training. This study indicated that the intensive training do not alter salivary hormons level and mood of elite adolescent wrestlers

Lower-loop reentrant atrial flutter

The mechanism of typical atrial flutter [AFL] has been well established. The isthmus between the tricuspid annulus and Eustachian ridge has been recognized as a critical part for maintaining the typical AFL circuit and the target site for ablation. However, a subtype of AFL, as double-wave reentry [lower loop reentry], has been described. This arrhythmia is due to the presence of 2 activation wavefronts rotating simultaneously. In this case report, we presented a case of counter-clockwise AFL with such activation circuit

effect of weight reduction on ultrasonographic findings of non alcoholic fatty liver

Non-alcoholic fatty liver [NAFL] includes a spectrum of diseases ranging from simple hepatic steatosis to nonalcoholic steatohepatitis [NASH] and cirrhosis. NAFL is typically seen in association with obesity, diabetes and hypertriglyceridaemia. In order to seek the role of diet therapy in treatment of NAFL, we compared the ultrasonographic findings of patients with fatty liver disease before and after standard diet therapy. Twenty-three overweight or obese subjects with incidental fatty liver discovered during ultrasonography were included. Subjects underwent 3 months of diet therapy, and anthropometric data including weight, height, BMI, waist circumference, and hip circumference were measured. Ultrasonographic findings were graded from 0 to 3. Changes in ultrasonographic findings and anthropometric data were studied. After three months of dieting, the ultrasonographic grade of all patients decreased by one or two grades. Fifteen patients decreased one grade while 8 others decreased by 2 grades. We observed a significant correlation between the decrease in ultrasonographic grade and the decrease in weight and BMI. Our study indicates that standard diet therapy could be used as an effective treatment for NAFL patients

Frequency of syncope in patients with accessory atrioventricular connection

Syncope in patients with Wolff-Parkinson-White [WPW] syndrome is related to rapid reciprocating tachycardia or rapid ventricular response over the accessory pathway during atrial fibrillation [AF]. The aim of this retrospective study is to evaluate the frequency of syncope in patients with WPW syndrome. We reviewed the records of 150 consecutive patients with WPW syndrome. There were 20 patients [13.3%] who reported at least one episode of syncope and 130 patients [86.7%] without such a history. Syncope is relatively frequent in patients with WPW. Patient with WPW syndrome who has experienced this symptom should be thoroughly evaluated

Effect of acute smoking on diastolic function

Smoking is a known risk factor of atherosclerosis, endothelial dysfunction, athermanous plaque rupture, unstable coronary syndrome and sudden cardiac death. The present study comprised 40 randomly selected healthy male hospital staff without a history of hypertension or cardiac or pulmonary disease. Participants were divided into two groups. The first group included 20 professional smokers [at least 5 pack/year till the time of study] and the second group consisted of 20 nonprofessional smokers defined as 0.5 pack/ year or less till the time of study. Participants were instructed not to smoke for 6 hours before the study. Patients underwent echocardiography before smoking. The participants were then asked to smoke a whole cigarette. After smoking, echocardiography was repeated within 7 to 15 minutes. Echocardiographic indices of diastolic function [E wave, A wave, Ea, E/A ratio and deceleration time] were measured before and after smoking. There was no statistically significant difference in the baseline measures in both groups before smoking and also there was no significant difference between measures in the two groups after smoking. The analysis of the pooled data from two groups showed that, smoking resulted in significant increase of heart rate [P<0.001]. A wave, E wave, Ea, E/A ratio and deceleration time changed significantly after smoking [P<0.001, P=0.027, P=0.011, P<0.001 and P<0.001 respectively]. Smoking of only a cigarette in both professional and nonprofessional smokers resulted in the same significant diastolic dysfunction

Prediction of coronary artery disease by B-mode sonography

Although coronary angiography is gold standard for diagnosis of coronary artery disease, it is nevertheless an invasive and potentially hazardous procedure. The aim of this study was to investigate the predictive value of carotid and femoral artery Intima-Media Thickness [IMT] for detection of coronary artery disease. The present study comprised 100 consecutive patients referred for coronary angiography due to symptoms of ischemic heart disease. Ultrasound assessment of common carotid and common femoral artery were performed with an ultrasound device equipped with a high-resolution transducer. IMT was measured in the common carotid and common femoral artery [10 mm proximal to the deep femoral artery origin]. There were 25 cases in each of single [S], double [D] and triple [T] vessel disease and 25 in significant left main diseases groups of patients. In regard to common carotid artery IMT was 0.78 mm in S, 0.84 mm in D, 0.97 mm in T and 1.05 mm in left main disease groups. There was a significant correlation between IMT measured in the carotid artery and severity of coronary artery disease [P = 0.0001]. With respect to common femoral artery IMT was 0.66 mm in S group, 0.73 mm in D group, 0.84 mm in T groups and 0.85 mm in patients with left main disease.. There is a significant correlation between IMT [measured in the common femoral artery] and severity of coronary artery disease [P = 0.0001]. Our results indicated that early atherosclerosis in both carotid and femoral arteries were highly predictive of coronary involvement and IMT being associated with the number of coronary vessels disorder

Effect of professional exercises on brain natriuretic peptide

Brain natriuretic peptide [BNP] reflects myocardial wall stress. BNP activities are similar to those of atrial natriuretic peptide, including diuresis, natriuresis, hypotension and smooth muscle relaxation as well as ability to inhibit the rennin aldosterone system. It is mainly produced and released into the circulation by the ventricle in response to increased ventricular wall pressure or stretching. Therefore, BNP can be served as a marker of left ventricular dysfunction. The aim of this study was to investigate effect of various professional exercises on plasma BNP levels. We enrolled 20 consecutive healthy professional athletic males from different sporting disciplines including 5 football players, 5 volleyball players, 5 bodybuilders and 5 water- polo players. Plasma BNP samples were taken immediately before and 1 hour after exercise. Plasma BNP level was significantly increased after exercise [30.01 +/- 23.46 vs. 16.72 +/- 10.86 pg/ml; P= 0.042]. The highest increase in BNP level was found among volleyball players [mean values: 19.12 to 43.38 pg/ml; 126.3% increase after volleyball] compared to other exercises. Exercise can increase plasma BNP levels, particularly among volleyball players

Contractility Dispersion in long QT syndrome

Previous studies, using M mode echocardiography, provided unexpected evidence of a mechanical alteration in patients with long QT syndrome. The aim of this study was to evaluate entire left ventricular [LV] wall motion characteristics in patients with long QT syndrome using tissue Doppler imaging. We enrolled 17 patients with congenital long QT syndrome [11 female and 6 male, aged 21 to 45 years. 10 subjects without cardiac disease were also selected as control group. Two-dimensional tissue Doppler imaging [TDI] recording of the LV was obtained from the basal and mid-segments from apical four-chamber, two-chamber, and long-axis views. 'Myocaridal Contraction Duration' [MCD] was defined as the time from start of R wave on ECG to end of S wave on TDI. MCD was measured in the six LV wall positions: septal, anteroseptal, lateral, inferior, posterior and anterior positions. LV contractility dispersion was significantly greater in long QT syndrome patients compared to control group [0.051 +/- 0.011 vs. 0.016 +/- 0.06; P<0.001]. Our study evaluated left ventricular dispersion of contractility duration in patients with long QT syndrome. This mechanical dispersion may be a reflection of the inhomogeneity of repolarisation in the long QT syndrome

Echocardiographic features of cardiac fatigue

Little information is available regarding the effects of strenuous exercise on cardiac function. We evaluated the effect of severe prolong exercise on ventricular performance. Army rangers were invited to participate in this study. All patients underwent transthoracic echocardiography using tissue Doppler imaging. A total of 45 consecutive male rangers who completed ranger training program were included in this study. Peak systolic myocardial velocity [S] decreased significantly after training [12.46 +/- 0.54 vs. 9.93 +/- 0.45 cm/s; P< 0.001]. In the right ventricle, tissue Doppler measures of systolic and early diastolic function decreased significantly after training. In conclusion, strenuous prolonged exercise may result in depressed left ventricular contractile function

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa

Mitral- aortic intervalvular fibrosa pseudoaneurysm a rare complication of aortic valve replacement, that was diagnosed in a 55 years-old 2 years after operation

Aortic distensibility in beta-Thalassemia major

Any unfavorable effect of beta-Thalassemia major on aortic distensibility will contribute to the adverse effects of beta-Thalassemia major on the cardiovascular system. To evaluated aortic distensibility in patients with beta-Thalassemia major. The study comprised eighty [46 males] consecutive beta-Thalassemia major patients and 80 control subjects matched for age and gender were selected. Aortic distensibility was approximately two-fold lower in patients compared with control subjects [aortic distensibility: 1.4 +/- 0.8 vs 3.6 +/- 1.2, cm[2] dyn[-1] 10[-6], P = 0.01]. Beta-Thalassemia major causes significant decrease in aortic distensibility

Collateral circulation in normal coronary arteries

A 64-year-old woman referred with a 4-month history of intractable chest pain. Coronary angiography was performed and showed normal left coronary arteries. Posterior descending coronary artery was filled via distal left circumflex artery. The right coronary artery injection showed prompt filling of the distal circumflex through prominent collaterals. There was no evidence of proximal obstructive disease or spasm. We present a case in which a large collateral artery was seen in angiographically normal coronary arteries

incidence of late stent thrombosis after successful cypher stent implantation

Stent thrombosis is a rare but devastating complication of coronary stent implantation. Coronary stent deployment is associated with a low incidence of acute and sub-acute thrombosis. However, late stent thrombosis has been recognized clinically. The aim of this prospective study was to evaluate the incidence of late stent thrombosis in patients receiving sirolimus-eluting stents. One hundred patients [132 lesions] who underwent implantation of sirolimus eluting stents were selected. All patients were pre-medicated with 325 mg of aspirin, which was continued indefinitely. Anti-thrombotic regimens, including intravenous heparin and a loading dose of clopidogrel [300 mg] were given in the catheterization laboratory and clopidogrel 75 mg/day was continued for at least 6 months. In patients allergic to clopidogrel, ticlopidine at a dose of 250 mg twice daily was prescribed as a substitute. Late stent thrombosis was defined as myocardial infarction characterized by anginal symptoms with ST-elevation on the electrocardiogram and creatine kinase-MB elevation > 3 times the upper limit of normal with angiographic documentation of partial or total stent occlusion more than 30 days after sirolimus eluting stent implantation [while the stented segment was the culprit lesion]. Complete 2 year follow-up was available for all patients. Between 30 days to 2 years after sirolimus-eluting stent implantation, 2 patients [2%] experienced late stent thrombosis at a mean time of 420 days [range 360 to 480]. This study reports a very late stent thrombosis after 20 months of sirolimus eluting stent implantation and 15 months after cessation of clopidogrel treatment, despite continued aspirin administration. This study also implies the possible need for long term antiplatelet therapy among patients receiving sirolimus eluting stents