Cardiac hypertrophy and diastolic function in physically well trained and in obese men.

OBJECTIVE: The aim of the present study was to compare cardiac hypertrophy and diastolic function in extremely obese male patients and physically active adult male subjects of similar age (means 43.0-43.4 y). DESIGN: Data of male patients referred to our hospital ward in order to reduce their body weight (BW) were compared with those of physically active and nonactive healthy males. SUBJECTS: The groups contained 21-24 male subjects, very active and moderately active subjects taking part in regular competitive or leisure time physical activity were in the two athletic groups, severely overweight patients constituted the obese group and healthy persons served as controls. MEASUREMENTS: Two-dimensionally guided M-mode and Doppler recordings. RESULTS: In comparison with the controls, obese patients had larger left atrial systolic and left ventricular (LV) diastolic internal diameters, LV diastolic wall thickness and muscle mass. Of the body size-related indices, only the left atrial systolic diameter index was significantly higher. LV systolic and diastolic functions were impaired as indicated by a decreased ejection fraction (EF), higher heart rate (HR), decreased E/A quotient and increased isovolumetric relaxation time. In the physically very active subjects, a thicker LV diastolic wall was seen without LV dilatation. Body size-related wall thickness and muscle mass were significantly higher than in the controls. EF and HR did not differ from those of the controls. CONCLUSION: The most useful help to distinguish between physiological and pathological left ventricular hypertrophy can be to investigate diastolic functions. The most salient difference appeared in diastolic function, because E/A quotient was higher in the very active subjects than in the controls and it was the lowest in the obese persons.

The effect of moderate weight loss on echocardiographic parameters in obese female patients.

Based on the data collected by KNOLL Hungary Ltd. in Hungary in 1999, 37% of the adult population is overweight while 23% is obese. Inappropriate diet containing excess calories and physical inactivity are responsible for these statistical values. In their former studies, the authors investigated the effects of different stages of obesity on the cardiovascular system, and have verified that even moderate obesity elicits pathological geometric and functional changes in the heart. In the present study, effect of a half-year-long life-style modification program on the morphologic and functional characteristics of the heart was investigated in twenty-one obese women. Life-style modification contained a diet with reduced energy uptake (1000-1300 Cal/day) and a regular physical training of minimum 3-4 hours weekly. By the end of the sixth month the weight loss was 5.1 kg (5.9%) on an average. There was a marked reduction in cardiac dimensions measured by echocardiography, with a very slight, non-significant decrease in left ventricular internal diameter, and a marked, significant reduction in the left ventricular wall thickness. Decrease of the left ventricular muscle mass exceeded the decrease of body weight. A marked elevation was found in the E/A quotient that reflected a definite improvement in diastolic function. Results indicate that physical training programs have a favourable effect on the echocardiographic parameters, therefore the process is reversible even without a pharmacological intervention.

[The combined effect of psychotherapy and fluoxetine on obesity]. / A pszichoterápia és a fluoxetin hatékonysága obesitasban.

Obesity as psychosomatic disease is a mass phenomenon. The number of obese males (BMI > 30) became doubled in the last ten years. In the etiology of obesity play an important role the reactive obesity. In the background of "yo-yo syndrome" often could be found depression, or other psychotic disorder. The low self-esteem, body dissatisfaction, tension, anxiety disorders is well-known in a slimming diet. Obese subjects (n = 29) who were admitted on their request with a view to losing weight were examined (Hamilton Depressive Scala, Hamilton Anxietas Scala, Eating Attitude Test) Physical Conditioning and internal Medicine Department of National Sports Medicine Institute, Budapest. Among obesities with mild and severe depression as treatment of somatic complications was used fluoxetine, in severe cases and depression with severe anxiety was associated with supportive or cognitive-behavioral treatment. The prevalence of binge eating disorders were at 57% and bulimia nervosa was at 3% in using population (n = 29). Decreasing of anxiety and grade of depression significantly correlated with body mass index (p < 0.023, F = 1.997, p < 0.034, F = 3.131). The treatment of fluoxetine significantly correlated with body mass index (T1: p < 0.023, T2: p < 0.03, T3: p < 0.004). The patients indicated their well being as fluoxetine reduced eating, satiety and lower binges.

[The role of physical activity in the prevention of certain internal diseases]. / Testedzés szerepe néhány belbetegség megelözésében.

During the last decades the physical activity drastically was reduced in daily life. Epidemiological and prospective studies suggest that regular physical activity has beneficial effects in prevention of non-insulin dependent diabetes mellitus, and has protective benefit in control of risk factors in coronary artery disease. It increases cardiovascular functional capacity, decreases myocardial oxygen demand and has a blood-pressure lowering effect. In the prevention of obesity together with a proper diet, regular training is the most important factor influencing life-style. Some studies indicate that exercise might promote protection against colon, breast and lung cancers. To maintain good health aerobic exercise with a moderate intensity on a regular basis is recommended.

The medical aspects of doping.

One of the crucial problems in the competitive sports of our days is the illicit use of drugs in increasing physical performance. The moral, professional, and legal responsibility of the physicians having a role in doping is quite explicit. Sports medicine can significantly contribute to the repression of doping; due to the diverging interests, however, it will not be able to solve it alone. The paper reviews the development and background of doping and, relying on the list issued by the International Olympic Committee, on banned drugs discusses the intended and adverse effects of the drug classes used for doping. Cases of doping detected at the Seoul Olympic Games are presented and a brief survey is given of the means that should be used for check-up.

Position of conditioning in Hungary.

The continuous increase of the international competition amongst the top-athletes on the one hand and the hypokinesia of the common man on the other, required a wide-ranging interpretation of the conditioning concept. As early as in the early sixties the necessity arose that besides the relatively small group of top-athletes there should also be conditioning exercise programs available for the total population. The task of sport medicine is the training of sport medical service for the evaluation of the participants both in the beginning and later. Producing the material background is the task of the state. We are now performing the summarizing of twenty years' observations and in this paradoxical way we did not approach the practice from the theory but we conclude from our practice to the theory. We elaborated the data of athletes, who were examined in different diseases, during the reconvalescence and a competition period. We studied the changing of conditional skills in six categories, working up the exercising programs in each category. This categorization is also an aid in the unified aspects of fitness programs of non-sporting people.