Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise.

INTRODUCTION AND OBJECTIVES: The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise. METHODS: A total of 105 asymptomatic male veteran athletes (48±5.6 years old) were studied. A high coronary atherosclerotic burden was defined as one of the following characteristics in coronary computed tomography angiography: calcium score >100, >75th percentile, obstructive plaques, involving left main, three-vessels or two-vessels including proximal anterior descending artery, segment involvement score >5 or CT-adapted Leaman score ≥5. CV risk was stratified by SCORE2 and volume of exercise by metabolic equivalent task score. RESULTS: Most athletes (n=88) were engaged in endurance sports for 17.1±9.8 years, with a median exercise volume of 66 [IQR 44-103] metabolic equivalent of tasks/hour/week. The mean Systematic Coronary Risk Evaluation 2 was 2.8±1.5%; 76.9% of athletes had a low-moderate risk and none a very high risk. High coronary atherosclerotic burden was present in 25.7% athletes. Athletes with high cardiovascular risk and high exercise volume (above the median) showed significantly high coronary atherosclerotic burden compared to those with low-moderate risk and high volume (50.0% vs. 15.6%; p=0.017). Among athletes with low to moderate risk, a high volume of exercise tended to be protective, while in those with low volume, there was similar rate of high coronary atherosclerotic burden, regardless of CV risk. CONCLUSIONS: A combination of higher volume of exercise and high cardiovascular risk revealed the worst association with coronary atherosclerosis in veteran athletes. The relationship between these variables is controversial, but integrating exercise characteristics and risk assessment into preparticipation evaluation is essential.

Coronary atherosclerotic burden in veteran male recreational athletes with low to intermediate cardiovascular risk.

INTRODUCTION: Although there is evidence that a significant proportion of veteran athletes have coronary atherosclerotic disease (CAD), its prevalence in recreational athletes with low to intermediate cardiovascular (CV) risk is not established. This study aimed to characterize the coronary atherosclerotic burden in veteran male recreational athletes with low to intermediate CV risk. METHODS: Asymptomatic male athletes aged ≥40 years with low to intermediate risk, who exercised >4 hours/week for >5 years, underwent cardiac computed tomography (CT) for coronary artery calcium (CAC) scoring and CT angiography. High coronary atherosclerotic burden was defined as at least one of the following: CAC score >100; CAC score ≥75th percentile; obstructive CAD; disease involving the left main, three vessels or two vessels including the proximal left anterior descending artery; segment involvement score >5; or CT Leaman score ≥5. Athletes were categorized by tertiles of exercise volume, calculated by metabolic equivalent of task (MET) scores. RESULTS: A total of 105 athletes were included, all with SCORE <4%, mainly engaged in high-dynamic sports. Median exercise volume was 66 (44-103) METs/hour/week, with 8±5 hours training/week and 17±10 years of exercise. A high coronary atherosclerotic burden was present in 27 (25.7%) athletes. Ten (9.5%) athletes had CAC score >100, 13 (12.4%) had CAC score ≥75th percentile and six (5.7%) had obstructive lesions. The extent and severity of coronary plaques did not differ according to exercise volume. CONCLUSIONS: The prevalence of subclinical CAD detected by cardiac CT in veteran male recreational athletes with low to intermediate CV risk was high. Up to a quarter of our cohort had a high coronary atherosclerotic burden.

La participación de los atletas veteranos en deportes competitivos: ¿El ideal de envejecimiento activo? / The participation of Master athletes in competitive sports: An ideal of active aging? / A participação de atletas veteranos em esportes competitivos: O ideal do envelhecimento ativo?

En los últimos años se ha asistido a un aumento de la participación en disciplinas deportivas competitivas durante la vejez. El objetivo de este artículo es reflexionar si los atletas veteranos mayores pueden considerarse un ideal de envejecimiento activo. Para ello, se exploran tanto los factores determinantes como el impacto de la práctica de deportes competitivos entre atletas mayores. Finalmente se ofrece una visión crítica que resalta la problematicidad de la entronización de este colectivo como ejemplo de "buen envejecer".

In the last few years, participation in competitive sports in later life has considerably increased. The purpose of this article is to reflect if older Master athletes can be considered an ideal model of active aging. In order to this, the determinants and impacts of the competitive sports participation for older athletes are explored. Finally, this article offers a critical view that highlights the problem of considering this group as an ideal example of "well aging".

Nos últimos anos, houve um aumento da participação em disciplinas esportivas competitivas durante a velhice. O objetivo deste artigo é refletir se atletas veteranos mais velhos podem ser considerados um ideal de envelhecimento ativo. Para isso, são explorados os fatores determinantes e o impacto de praticar esportes competitivos entre os atletas maisvelhos. Por fim, é oferecida uma visão crítica que destaca a natureza problemática da entronização desse grupo como um exemplo de "bom envelhecimento".

Coronary artery disease in athletes: An adverse effect of intense exercise?

Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed. However, the methodology for screening veteran athletes is not consensual, and several markers of CAD, in addition to clinical CV risk factors, could improve risk stratification in this population. In the present paper we review the published data on CAD in athletes, focusing on the relationship between the dose of exercise and CAD, as well as the implications for pre-participation screening of veteran athletes.

Competências psicológicas em atletas veteranos / Psychological skills of veteran athletes

Ao iniciarmos nosso trabalho com atletas veteranos, constatamos que a maioria dos estudos centrados nessa população focou-se na avaliação dos componentes fisiológicos ligados ao rendimento e a sua relação com o envelhecimento. Em relação à psicologia do desporto, poucos são os estudos realizados sobre o uso das competências psicológicas em veteranos, existindo, assim, uma lacuna e a necessidade de mais estudos a fim de auxiliar no entendimento das competências psicológicas utilizadas pelos atletas veteranos. Nesse sentido, nosso ponto de vista vem demonstrar que os atletas veteranos utilizam um conjunto de competências psicológicas com o objectivo de melhorar o rendimento desportivo e/ ou superar as dificuldades que surgem durante as competições. Além disso, estudar tais competências psicológicas em veteranos pode nos fornecer informações relevantes em relação aos processos cognitivos em idosos, uma vez que, sendo esta uma população especial, a literatura descreve uma série de alterações cognitivas que podem ocorrer em virtude do processo de envelhecimento.

At the beginning of the study of veteran athletes, most investigations involving this population have focused on the physiological aspects of performance and their relationship with the aging process. With respect to sport psychology, there are few studies on the use of psychological skills by veteran athletes. In view of this gap, further studies are needed to increase the understanding of psychological skills used by veteran athletes. In this respect, our point of view shows that veteran athletes use a set of psychological skills to enhance their competitive performance and to overcome obstacles during the competition. In addition, the study of these psychological skills provides relevant information regarding the cognitive processes that occur in older adults, since a series of cognitive changes have been reported to occur as a result of the aging process.