Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities

OBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertrophy in athletes of various sport modalities remains unknown. METHODS: Five electrocardiogram criteria used to detect left ventricular hypertrophy were tested in 180 male athletes grouped according to their sport modality: 67% low-static and high-dynamic components and 33% high-static and high-dynamic components of exercise. The following echocardiogram parameters are the gold standard for diagnosing left ventricular hypertrophy: left ventricular mass index ≥134 g.m-2, relative wall thickness ≥0.42 mm, left ventricular diastolic diameter index ≥32 mm.m-2, septum wall thickness ≥13 mm, and posterior wall thickness ≥13 mm. Results for the various criteria were compared using the kappa coefficient. Significance was established at p<0.05. RESULTS: Fifty athletes (28%) presented with left ventricular hypertrophy according to electrocardiogram findings, with the following sensitivities and specificities, respectively: 38-53% and 79-83% (Perugia), 22-40% and 89-91% (Cornell), 24-29% and 90% (Romhilt-Estes), 68-87% and 20-23% (Sokolow-Lyon), and 0% and 99% (Gubner). The Perugia and Cornell criteria had higher negative predictive values for the low-static and high-dynamic subgroup. Kappa coefficients were higher for Romhilt-Estes, Cornell and Perugia criteria than for Sokolow-Lyon and Gubner criteria. CONCLUSION: All five evaluated criteria are inadequate for detecting left ventricular hypertrophy, but the Perugia, Cornell and Romhilt-Estes criteria are useful for excluding its presence. The Perugia and Cornell criteria were more effective at excluding left ventricular hypertrophy in athletes involved in a sport modality with low-static and high-dynamic component predominance.

Physical Training and Cardioprotection / 中国运动医学杂志

Experimental, clinical and epidemiologic studies have provided strong evidence that physical training has beneficial effects on cardiovascular health. Numerous investigations have demonstrated that exercise increases coronary blood flow and myocardial perfusion. Importantly, training also can stimulate angiogenesis and accelerate collateral vessel growth in animal models with coronary artery occlusion. Cardiac adaptation such as increased vascularity or capillary density has been evidenced after regular endurance exercises. More recently, several studies indicate that physical training induces high levels of myocardial heat shock protein and antioxidant protein expression, which may play an important role in myocardial protection against ischemia-reperfusion injury.

The effect of running training on regional cardiac myosin isozyme composition in rats / 体力科学

We examined the effect of running training on regional cardiac myosin isozyme composition in rats. Male Sprague-Dawley strain rats (4 weeks old) were used, and divided into two groups: sedentary control (C) and trained (T) groups. The T group was trained by treadmill running (40 m/min, 1h/day, 5 days/week, for 12 weeks) . At 16 weeks old, their hearts were excised. The left ventricle was separated into the subendocardium (Endo) and subepicardium (Epi) by dissecting the ventricle at the mid-wall. The ventricular myosin isozymes were examined by electrophoresis on pyrophosphate gel under non-dissociating conditions. The results showed the following: 1) The relative heart weight of the T group was significantly higher than the C group. 2) Left ventricular myosin isozyme composition showed a region-specific distribution in the C rats, and the proportion of V3 myosin or β-myosin heavy chain in the Endo was significantly higher than that of the Epi. However, the training had no effect on the cardiac myosin isozyme in either portion. 3) The activity of citrate synthase did not show transmural gradient in the ventricle of C animals. Training had no effect on the activities of either portion. 4) The activity of lactate dehydrogenase (LDH) showed transmural gradient in the ventricle of C rats. Training-induced changes in the activity of LDH were found in both portions, therefore, training abolished the transmural gradient in the activity of LDH, suggesting a corresponding redistribution of the myocardial work load.<BR>These results indicate that running training might induce the redistribution of the myocardial work load, whereas the stimulation apparently has no effect on the regional distribution of cardiac myosin isozyme composition.