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Background: Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs characterized by marked repolarization abnormalities. Methods: From a database of 12,550 trained athletes, we identified 81 with diffusely distributed and deeply inverted T waves (≥2 mm in at least three leads) who had no apparent cardiac disease and who had undergone serial clinical, ECG, and echocardiographic studies for a mean (±SD) of 9±7 years (range, 1 to 27). Comparisons were made with 229 matched control athletes with normal ECGs from the same database. Results: Of the 81 athletes with abnormal ECGs, 5 (6%) ultimately proved to have cardiomyopathies, including one who died suddenly at the age of 24 years from clinically undetected arrhythmogenic right ventricular cardiomyopathy. Of the 80 surviving athletes, clinical and phenotypic features of hypertrophic cardiomyopathy developed in 3 after 12±5 years (at the ages of 27, 32, and 50 years), including 1 who had an aborted cardiac arrest. The fifth athlete demonstrated dilated cardiomyopathy after 9 years of follow-up. In contrast, none of the 229 athletes with normal ECGs had a cardiac event or received a diagnosis of cardiomyopathy 9±3 years after initial evaluation (P=0.001). Conclusions: Markedly abnormal ECGs in young and apparently healthy athletes may represent the initial expression of underlying cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. Athletes with such ECG patterns merit continued clinical surveillance. N Engl J Med 2008;358:152-61. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess, using 3-dimensioanl echocardiography, the morphologic characteristics, determinants, and physiologic limits of left ventricular (LV) remodeling in 511 Olympic athletes (categorized in skill, power, mixed, and endurance sport disciplines) and 159 sedentary controls matched for age and gender. All subjects underwent 3-dimensional echocardiography for the assessment of LV volumes, ejection fraction, mass, remodeling index (LV mass/LV end-diastolic volume), and systolic dyssynchrony index (obtained by the dispersion of the time to minimum systolic volume in 16 segments). Athletes had higher LV end-diastolic volumes (157 ± 35 vs 111 ± 26 ml, p <0.001) and mass (156 ± 38 vs 111 ± 25 g, p <0.001) compared to controls. Body surface area and age had significant associations with LV end-diastolic volume (R2 = 0.49, p <0.001) and mass (R2 = 0.51, p <0.001). Covariance analysis showed that also gender and type of sport were significant determinants of LV remodeling; in particular, the highest impact on LV end-diastolic volume and mass was associated with male gender and endurance disciplines (p <0.001). Regardless of the type of sport, athletes had similar LV remodeling indexes to controls (1.00 ± 0.06 vs 1.01 ± 0.07 g/mL, p = 0.410). No differences were found between athletes and controls for the ejection fraction (62 ± 5% and 62 ± 5%, p = 0.746) and systolic dyssynchrony index (1.06 ± 0.40% and 1.37 ± 0.41%, p = 0.058). In conclusion, 3-dimensional echocardiographic morphologic and functional assessment of the left ventricle in Olympic athletes demonstrated a balanced adaptation of LV volume and mass, with preserved systolic function, regardless of specific disciplines participated. [ABSTRACT FROM AUTHOR]

The article presents a study on 32 male road cyclists which engage in amateur racing and regular training. It states that subjects were instructed in refraining from exercise during the last 2 days preceding the experimental trial consisted of maximal incremental exercise test on friction-loaded cycle ergometer. It mentions that the effect of training and aging status on ventilatory response during incremental exercise was investigated through comparing older and young well-trained cyclists.

The article focuses on the study conducted regarding the use of the recommendations given by the American College of Sports Medicine to the noncompetitive rock climbers for their aerobic fitness. The study has been administered to 13 rock climbers to determine if they fulfill the suggestions given to them in maintaining their good level of physical fitness. It indicates that these people are suitable to be typical aerobic activity.

Objectives: In the present study we assessed the distribution and clinical significance of left atrial (LA) size in the context of athlete''s heart and the differential diagnosis from structural heart disease, as well as the proclivity to supraventricular arrhythmias. Background: The prevalence, clinical significance, and long-term arrhythmic consequences of LA enlargement in competitive athletes are unresolved. Methods: We assessed LA dimension and the prevalence of supraventricular tachyarrhythmias in 1,777 competitive athletes (71% of whom were males), free of structural cardiovascular disease, that were participating in 38 different sports. Results: The LA dimension was 23 to 50 mm (mean, 37 ± 4 mm) in men and 20 to 46 mm (mean, 32 ± 4 mm) in women and was enlarged (i.e., transverse dimension ≥40 mm) in 347 athletes (20%), including 38 (2%) with marked dilation (≥45 mm). Of the 1,777 athletes, only 14 (0.8%) had documented, symptomatic episodes of either paroxysmal atrial fibrillation (n = 5; 0.3%) or supraventricular tachycardia (n = 9; 0.5%), which together occurred in a similar proportion in athletes with (0.9%) or without (0.8%; p = NS) LA enlargement. Multivariate regression analysis showed LA enlargement in athletes was largely explained by left ventricular cavity enlargement (R2 = 0.53) and participation in dynamic sports (such as cycling, rowing/canoeing) but minimally by body size. Conclusions: In a large population of highly trained athletes, enlarged LA dimension ≥40 mm was relatively common (20%), with the upper limits of 45 mm in women and 50 mm in men distinguishing physiologic cardiac remodeling (“athlete''s heart”) from pathologic cardiac conditions. Atrial fibrillation and other supraventricular tachyarrhythmias proved to be uncommon (prevalence &#60;1%) and similar to that in the general population, despite the frequency of LA enlargement. Left atrial remodeling in competitive athletes may be regarded as a physiologic adaptation to exercise conditioning, largely without adverse clinical consequences. [Copyright &y& Elsevier]