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Purpose: The aim of this study was to determine whether iron treatments improve the iron status and aerobic capacity of iron deficient non-anaemic endurance athletes.Method: A meta-analysis of studies that investigated the effects of iron treatment on serum ferritin (sFer), serum iron (sFe), transferrin saturation (Tsat), haemoglobin concentration ([Hb]) and (VO(2max)). Seventeen eligible studies were identified from online databases.Results: Analysis of pooled data indicated that iron treatments had a large effect on improving sFer (Hedges' g=1.088, 95% CI 0.914 to 1.263, p<0.001), sFe (Hedges' g=1.004, 95% CI 0.828 to 1.181, p<0.001) and Tsat (Hedges g=0.741, 95% CI 0.564 to 0.919, p<0.001) and a moderate effect on improving [Hb] (Hedges' g=0.695, 95% CI 0.533 to 0.836, p<0.001) and (VO(2max)) (Hedges' g=0.610, 95% CI 0.399 to 0.821, p<0.001). Regression analysis revealed a significant interaction between the effect of iron treatment on sFer and treatment duration, suggesting treatments that lasted beyond 80 days appear to have the least effect on sFer.Conclusions: These results indicate iron treatments improve the iron status and aerobic capacity of iron deficient non-anaemic endurance athletes. [ABSTRACT FROM AUTHOR]

Background: An increasing number of sporting bodies report unacceptably high levels of false-positive ECGs when undertaking pre-participation cardiac screening. To address this issue, modified ECG interpretation criteria have become available for use within athletes. Objective: This study assessed the accuracy of the new 2014 'Refined Criteria' against the 2013 Seattle Criteria and the 2010 European Society of Cardiology (ESC) recommendations in a cohort of Arabic, black and Caucasian athletes. Methods 2491 male athletes (1367 Arabic, 748 black and 376 Caucasian) undertook pre-participation screening including a 12-lead ECG, with further investigation(s) upon indication. Results: Ten athletes (0.4%) were identified with cardiac pathology; seven with hypertrophic cardiomyopathy (HCM; five black and two Arabic) and three Arabs with Wolff-Parkinson-White syndrome (WPW). All three ECG criteria were 100% sensitive identifying all cases of HCM and WPW. The 2014 Refined Criteria reduced (p<0.0001) the prevalence of an abnormal ECG to 5.3% vs 11.6% (Seattle Criteria) and 22.3% (2010 ESC recommendations). The 2014 Refined Criteria significantly (p<0.0001) improved specificity (94.0%) across all ethnicities compared with the Seattle Criteria (87.5%) and ESC recommendations (76.6%). Black athletes continue to present a higher prevalence (p<0.0001) of abnormal ECGs compared with Arabic and Caucasian athletes (10% vs 3.6% and 2.1%). Conclusions: The 2014 Refined Criteria for athlete ECG interpretation outperformed both the 2013 Seattle Criteria and the 2010 ESC recommendations by significantly reducing the number of false-positive ECGs in Arabic, black and Caucasian athletes while maintaining 100% sensitivity for serious cardiac pathologies. [ABSTRACT FROM AUTHOR]

AIMS: To examine the cardiac structure and function of Arabic athletes and to establish if the European Society of Cardiology (ESC) guidelines for the interpretation of an athlete's ECG are applicable to this ethnicity. METHODS: 600 high-level Arabic, 415 Black African, 160 Caucasian male athletes (exercising >=6h/week) and 201 Arabic controls presented for ECG and echocardiographic screening. RESULTS: 9 athletes (0.7%) were identified with a cardiac pathology associated with sudden cardiac death. Two Arabics (0.3%) and five Black Africans (1.2%) were diagnosed with hypertrophic cardiomyopathy; a prevalence four times greater in Black African compared to Arabic athletes. Arabic athletes had significantly greater (p<0.05) left ventricular (LV) end-diastolic diameters, maximal LV wall thicknesses and LV mass compared with controls; yet were significantly smaller than Black African and Caucasian athletes. The percentage of athletes demonstrating LV hypertrophy (>=12mm) was comparable between Arabic, Black African and Caucasian populations (0.5%, 0.5% and 0.6%, respectively). There was no difference in the frequency of an uncommon and training-unrelated ECG between Arabic and Caucasian. However, Black Africans demonstrated a significantly greater prevalence than Arabic and Caucasian athletes (20% vs 8.4% and 6.9%, p<0.001); specifically more right/left atrial enlargement and T wave inversion. CONCLUSIONS: Arabic athletes present significantly smaller cardiac dimensions than Black African and Caucasian athletes. There was no significant difference between the frequency of an uncommon and training-unrelated ECG between Arabic and Caucasian athletes. Therefore, the use of ESC guidelines for the interpretation of an athlete's ECG is clinically relevant and acceptable for use within Arabic athletes. [ABSTRACT FROM AUTHOR]

The authors emphasize the need for current and future governments in Great Britain to develop a comprehensive and thorough national policy for child-centred physical education provision. Topics covered include the pervasiveness of physical inactivity among school children in Great Britain, the decline of physical education in schools and lack of play facilities, and lack of child physical activity policy in schools as a case of child neglect.

This is the third in a series of case studies on an individual with normal coronaries who sustained an idiopathic acute myocardial infarction . Bilateral pulmonary emboli almost 2 years post-myocardial infarction (MI) revealed coagulopathy as the cause. The original MI resulted in 16% myocardial scar tissue. An increasing number of patients are surviving MI, hence the burden for healthcare often shifts to heart failure. Accumulating evidence suggests high-intensity aerobic interval exercise (AHIT) is efficacious in improving cardiac function in health and disease. However, its impact on MI scar has never been assessed. Accordingly, the 50-year-old subject of this case study undertook 60 weeks of regular AHIT. Successive cardiac MRI results demonstrate, for the first time, a decrease in MI scar with exercise and, alongside mounting evidence of high efficacy and low risk, suggests AHIT may be increasingly important in future prevention and reversing of disease and or amelioration of symptoms. [ABSTRACT FROM AUTHOR]

The article explores several issues facing sports cardiology in the U.S. and Europe. According to the authors, electrocardiography (ECG) can add to screening costs but there is a need to address whether adding ECG to preparticipation screening of athletes leads to more harm than good. Information on methods used in the U.S. and Great Britain for assessing cardiovascular risk is provided. The authors argue that a higher level of justification is needed for mandating screening for a population.

Aim Differentiating physiological cardiac hypertrophy from pathology is challenging when the athlete presents with extreme anthropometry. While upper normal limits exist for maximal left ventricular (LV) wall thickness (14 mm) and LV internal diameter in diastole (LVIDd, 65 mm), it is unknown if these limits are applicable to athletes with a body surface area (BSA) >2.3 m². Purpose To investigate cardiac structure in professional male athletes with a BSA>2.3 m², and to assess the validity of established upper normal limits for physiological cardiac hypertrophy. Methods 836 asymptomatic athletes without a family history of sudden death underwent ECG and echocardiographic screening. Athletes were grouped according to BSA (Group 1, BSA>2.3 m², n=100; Group 2, 2-2.29 m², n=244; Group 3, <1.99 m², n=492). Results There was strong linear relationship between BSA and LV dimensions; yet no athlete with a normal ECG presented a maximal wall thickness and LVIDd greater than 13 and 65 mm, respectively. In Group 3 athletes, Black African ethnicity was associated with larger cardiac dimensions than either Caucasian or West Asian ethnicity. Three athletes were diagnosed with a cardiomyopathy (0.4% prevalence); with two athletes presenting a maximal wall thickness >13 mm, but in combination with an abnormal ECG suspicious of an inherited cardiac disease. Conclusion Regardless of extreme anthropometry, established upper limits for physiological cardiac hypertrophy of 14 mm for maximal wall thickness and 65 mm for LVIDd are clinically appropriate for all athletes. However , the abnormal ECG is key to diagnosis and guides follow-up, particularly when cardiac dimensions are within accepted limits. [ABSTRACT FROM AUTHOR]

The pervasive public health message is that moderate amounts of endurance exercise help maintain optimal health and reduce cardiovascular risk. While not enough people meet national physical activity guidelines, there are some at the opposite end of the activity spectrum who far exceed the recommended 'dose' of exercise. The cardiovascular health consequences of single and/or multiple (lifelong) 'doses' of high-volume endurance exercise are currently being debated. Recent commentaries, case reports and case series data have posed the question whether you can 'overdose on exercise', and that is the focus of this brief review. [ABSTRACT FROM AUTHOR]

Background: The differentiation between physiological cardiac enlargement and cardiomyopathy is crucial, considering that most young non-traumatic deaths in sport are due to cardiomyopathy. Currently, there are few data relating to cardiac dimensions in junior elite tennis players. The aim of this study was to define the upper limits of left ventricular dimensions in a large cohort of national adolescent tennis players. Methods: Between 1996 and 2003, 259 adolescent tennis players (152 males), mean (SD) age 14.8 (1.4) years (range 13–19) and 86 healthy age, gender and body surface matched sedentary controls underwent 12-lead ECG and 2D-transthoracic echocardiography. Results: Inter-ventricular septal end diastolic dimension (IVSd), left ventricular end diastolic dimension (LYEDd) and left ventricular end diastolic posterior wall dimension (LVPWd) in tennis players were significantly higher than in controls (8.9 mm vs 8.3 mm p<0.001, 48.9 mm vs 47.9 mm p<0.05 and 9 mm vs 8.3 mm p<0.001 respectively), however in absolute terms, the difference did not exceed 7%. None of the tennis players had a wall thickness exceeding 12 mm or a left ventricular cavity size exceeding 60 mm. Conclusions: Tennis players exhibit modest increases in cardiac dimensions, which do not resemble those seen in individuals with cardiomyopathy affecting the left ventricle. [ABSTRACT FROM AUTHOR]

The author ponders on whether life-long exercise damages the heart. He cites a study which found a higher prevalence of subclinical cardiac disease in veteran athletes which may increase the risk of an exercise-associated cardiac event. He concludes that excessive life-long exercise may be damaging to the heart, but still considers the benefits of regular exercise upon long-term cardiovascular health in the re

This study reports the cardiac structure and function of a lifelong male endurance athlete, who has run over 148 000 miles, who presented with symptoms of chest discomfort, dyspnoea and loss of competitive running performance. Importantly, the athlete documented several periods of regular intensive endurance activity while suffering with flu-like symptoms. Cardiovascular MRI demonstrated a pattern of late gadolinium enhancement, which indicated myocardial scarring as a result of previous myocarditis. [ABSTRACT FROM AUTHOR]