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Background: Structural and functional arterial adaptations with regard to the type and level of training in young athletes are understudied. Our research aimed at evaluating them in two types of exercise (dynamic and static) and two levels of engagement (high and recreational)., Methods: A total of 76 volunteers formed five groups. Group A included 17 high-level dynamic sports athletes 30·9 ± 6·4 years old, group B 14 recreational ones aged 28·7 ± 6·2 years, group C 15 high-level static sports athletes 26·4 ± 3·9 years old and group D 16 recreational ones, aged 25·8 ± 4·8 years. Fourteen sedentary men 30 ± 3·8 years old formed control group E. Structural indices of left cardiac chambers and thoracic aorta were echographically obtained, as well as common carotid intima-media thickness (cIMT). Furthermore, applanation tonometry was conducted, at rest and during a handgrip strength test, for the acquisition of central arterial pressure parameters, carotid-femoral pulse wave velocity (cfPWV) and total arterial compliance (C τ )., Results: No significant differences in structural arterial markers were observed. However, group A obtained the highest handgrip central systolic pressure values (13·1% compared to group D, P<0·05). Resting cfPWV was lower in group B by 13·8% (P<0·05) than C and by 16·7% (P<0·01) than E, whereas C τ was higher in group Β by 33·3% than C (P<0·05) and by 40·9% than E (P<0·01)., Conclusion: Functional arterial exercise-induced adaptations become apparent at an early age, without being in conjunction with structural ones. Recreational dynamic exercise results in the most favourable arterial characteristics., (© 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

The present study examined the autonomic cardiac modulation of veteran athletes by the use of traditional and modern methods of heart rate variability (HRV) analysis. Twenty-nine healthy male master soccer players were divided into two groups; group A consisted of fourteen participants (age 48.9±5.8 years), who were engaged to regular aerobic exercise and group B of fifteen sedentary ones (age 50.8±5.7 years). Sixteen age-matched non-athletes formed control group C. All participants underwent ambulatory 24-h continuous electrocardiogram monitoring for the calculation of time and frequency domain HRV indices. Additionally, Poincaré analysis SD1 and SD2 as well as multiresolution wavelet analysis σwav(16) and σwav(32) markers were calculated. Time-domain indices were significantly increased in group A compared to groups B and C. Group A presented greater values of SD1 (by 43%, p<0.01 and 34.4%, p<0.05 than groups B and C respectively) and SD2 (by 26% compared to B and by 34.1% to C, p<0.05). Index σwav(16) was higher in group A than in B and C by 35.6% (p<0.01) and 23.5% (p<0.05) respectively and so did σwav(32) by 22% (p<0.05) and 24% (p<0.05). Strong correlations were reported among indices. In conclusion, physically active master athletes attain better cardiac autonomic activity than sedentary counterparts, as proved by the application of Poincaré and multiresolution wavelet analyses, which can be useful research tools of cardiac autonomic modulation in sports cardiology., (Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.)

Left ventricular hypertrophy (LVH) with intraventricular septum thickness (IVST) between 1.2 and 1.5 cm in athletes represents a "gray zone" between physiologic adaptation and mild hypertrophic cardiomyopathy (HCM). Various echo and laboratory parameters have been reported till now in the literature to discriminate the "gray zone" entities. Aim of this study was to assess the efficacy of these "classic" parameters in differentiating physiologic LVH in athletes from mild HCM in a highly selected population. Nine highly trained athletes with IVST (1.28 ± 0.07 cm), 9 patients with mild HCM (1.38 ± 0.11 cm), and 26 athletes without LVH (1.06 ± 0.09 cm; P < 0.0005) underwent echocardiographic study, cardiopulmonary treadmill exercise stress test, and brain natriuretic peptide (BNP) measurement before and after exercise. Among all parameters tested, 7 were found to significantly differ between "gray zone" groups. After bootstrapping analysis, it was found that athletes with left ventricular end-diastolic diameter <4.74 cm, mitral deceleration time >200 ms, isovolumic relaxation time >94 ms, tricuspid E/A < 1.63, septum Em < 9.5 cm/sec, relative wall thickness >0.445, and a BNP value at rest >9.84 pg/mL had a greater possibility for having underlying cardiomyopathy. A 10-point score based on these parameters showed accuracy (area under the curve = 0.958 [95%CI: 0.738-1.0; P = 0.00005, standard error = 0.0342]) for revealing HCM in a gray zone athletic population. Differentiation of adaptive LVH versus HCM in a gray zone population could be facilitated by recognition of certain features referring to LV dimensions, diastolic function, and BNP., (© 2012, Wiley Periodicals, Inc.)

The aim of the present study was to evaluate cardiac autonomic function by pupillometry in male athletes. Fifteen elite endurance- (END) and eleven power-trained (POWER) athletes and fifteen sedentary individuals (CONTROL) were studied. All subjects underwent three pupillometric measurements: at rest, peak exercise testing and recovery phase. The pupillometric indices studied were: baseline pupil radius (R1), minimum pupil radius (R2), maximum constriction velocity (VC(max)), maximum constriction acceleration (AC(max)), amplitude (AMP, R1-R2), constriction ratio (AMP%). During exercise, RR intervals were obtained for each subject with a Polar S810i for time and frequency domain heart rate variability (HRV) analysis. The following parameters of HRV were measured: standard deviation of all NN intervals (SDNN), the mean square successive differences (rMSSD), percent of NN intervals differing >50 ms from the preceding NN (pNN50), low (LF)- and high (HF)- frequency components of the autoregressive power spectrum of the NN intervals and their ratio (LF/HF). At rest and recovery, END showed significantly increased VC(max) and AC(max) compared to POWER and CONTROL. AMP% was significantly greater in END at rest, peak exercise and recovery compared to POWER and CONTROL. END and POWER had significantly greater AMP at rest and recovery compared to CONTROL. Moreover, all HRV indices were significantly increased in END compared to POWER and CONTROL. However, POWER showed significantly increased rMSSD and LF compared to CONTROL. HRV parameters were significantly correlated with pupillometric parameters during exercise. Our results indicated that any kind of exercise training and mainly endurance one affects autonomic regulation of pupillary light reflex.

Objectives: Cardiac autonomic neuropathy (CAN) as a result of diabetic autonomic neuropathy is positively related to a poor prognosis in diabetic patients. The measurement of heart rate variability )HRV( is a remarkable index of cardiac autonomic dysfunction. The aim of this study was to examine the effects of long-term exercise training on HRV in type 2 diabetic patients with definite CAN. Methods: Seventeen type 2 diabetic patients with definite CAN (group A: 56.2 years (SD 5.8)) and 15 without CAN (group B: 55.8 years (SD 5.6)) participated in the study. All patients followed an aerobic exercise training programme three times a week for 6 months; the intensity of the session was 70% to 85% of heart rate reserve. At the beginning and end of the study all subjects underwent graded maximal exercise testing with spiroergometry for the evaluation of their aerobic capacity (V02PEAK). Moreover, time and frequency domain indices of HRV were obtained from 24 h ambulatory continuous ECG Holter recordings. Results: At baseline, all measurements of HRV indices were significantly reduced in group A compared with group B (p<0.05). Moreover, group A reached a significantly lower V02PEAK by 14.8% compared with group B (p<0.05). Following the exercise training programme, the SD of all normal-to-normal AR intervals in the entire recording (SDNN) was increased by 18.8% (p<0.05( and 13.8% (p<0.05), the square root of the average of sum of squares of difference between adjacent filtered AR intervals (rMSSd( was increased by 35% (p<0.05) and 15.2% (p<0.05), and the percentage of differences between adjacent filtered AR intervals which was greater than 50 ms for the entire analysis (pNN50( was increased by 400% (p<0.05() and 67.9% (p<0.05( in groups A and B, respectively. Regarding the frequency domain indices, only the high frequency power (HF) was found to be significantly increased in group A. At the end of the exercise training programme, SDNN, rMSSd and low frequency power (LF) were significantly lower (24.3% (p<0.05), 20.3% (p<0.05) and 40% (p<0.05L respectively) in group A compared with group B. Also, V02PEAK increased by 17.8% (p<0.05) in group A and by 11% (p<0.05) in group B. Furthermore, the exercise training programme had significant effects on blood lipid and glucose levels and glycosylated haemoglobin )HbA1c( in both groups. Conclusions: The results indicate that 6-month aerobic exercise training improves the cardiac autonomic nervous system function in type 2 diabetic patients. However, more favourable effects are found in type 2 diabetic patients with definite CAN. [ABSTRACT FROM AUTHOR]

Summary The purpose of this study was to assess the heart rate variability triangular index (HRVI) in elite track and field athletes. Sixty healthy males (mean aged 22·1 ± 3·5 years) -15 long distance runners (group A), 15 speed runners (Group B), 15 throwers (Group C) and 15 non-trained subjects (Group D) were submitted to spiroergometric test, m-mode echocardiography and 24-h ambulatory ECG monitoring. The HRVI, mean heart rate, mean interval between two consecutive R waves of the QRS complexes (R–R interval) and standard deviation of the R–R (SDRR) were assessed through time domain method on computed 24-h Holter recordings. The HRVI and the SDRR were 62·2 ± 9·6 and 220 ± 40 ms correspondingly in group A, 52·7 ± 6·0 and 210 ± 40 ms in B, 44·5 ± 5·3 and 180 ± 40 ms in C, 39·3 ± 6·4 and 180 ± 30 ms in D. The HRVI and the mean R–R were found to differ statistically between groups A, B and C versus D (P <0·05). However, the higher value in HRVI was found in group A. Maximal oxygen consumption (V O2max ) was 62·0 ± 4·4 ml kg-1 min-1 in group A, 52·7 ± 6·0 in group B, 44·6 ± 5·3 in C and 41·6 ± 6·0 in D. The higher value in V O2max was also found in group A. The left ventricular mass index (LVMI) and end-diastolic volume index (EDVI) were 136 g m-2 and 83 ml m-2 correspondingly in group A, 136 and 79 in B, 124 and 56 in C and 88 and 55 in group D. The HRVI was found to have a significant relationship with V O2max and EDVI only in group A. On the other hand, no significant relationships were found between HRVI and LVMI in all groups. It is concluded, that the enhanced HRVI in athletes is affected by exercise training pattern. Moreover, HRVI depends on the level of V O2max in endurance-trained, but is independent from the extent of myocardial hypertrophy in all types of training. [ABSTRACT FROM AUTHOR]