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Cardiac Anomalies - is something going on or is this normal?

The Clinic is the only place on Cyclingnews where you can discuss doping-related issues. Ask questions, discuss positives or improvements to procedures.

Moderators: Eshnar, King Boonen, Red Rick, Pricey_sky

12 Jan 2018 11:33

Mod hat on:

Ok, this has gone way off topic. If you want to discuss practices within healthcare and the pharmaceutical industry you're welcome to make a thread in the Cafe where this kind of discussion belongs, but lets stop it here. I'll even move the posts across if you want?

Cheers,

KB.
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User avatar King Boonen
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Re:

12 Jan 2018 20:46

King Boonen wrote:Mod hat on:

Ok, this has gone way off topic. If you want to discuss practices within healthcare and the pharmaceutical industry you're welcome to make a thread in the Cafe where this kind of discussion belongs, but lets stop it here. I'll even move the posts across if you want?

Cheers,

KB.
I certainly wouldn't mind, given who the OP of this thread is. (Reliably his/her replies will be rude in some fashion, can we have some kind of a calculable % as to when the replies will actually not be rude?)

Okay, I know, off to serve some hard time in the sin bin I go. Apologies to the mods ahead of time.

EDIT: If (and this is just a suggestion) we should have such a thread in the Cafe it would be with the understanding that there won't be any discussion of PEDs, otherwise things might get a bit iffy between the Cafe and the Clinic affairs.
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14 Jan 2018 21:23

@nomad

The key word here was «Health». Performance wise you need increased intensitet as you age in order to improve, it’s just probably not good for you.
«Sky helped for the GC, so did BMC - a lot of teams tried but one rider isn't enough. Not against De Gendt. He's like 10 riders.»
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29 Jan 2018 11:35

Not WT level, but CCC Sprandi-Polkowice's Paweł Cieślik (31) - he's only ever been a conti or pro-conti rider - has been sidelined with a hole in his heart (ASD / PFO). (Polish article.)
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Re:

01 Feb 2018 21:55

fmk_RoI wrote:Not WT level, but CCC Sprandi-Polkowice's Paweł Cieślik (31) - he's only ever been a conti or pro-conti rider - has been sidelined with a hole in his heart (ASD / PFO). (Polish article.)
Due to my lack of speaking/reading the Polish language - is the hole understood to be congenital? Or, is it believed to have been cause by PEDs? Please translate.

Btw., seeing as my dad is going through all these heart tests right now - they are all extremely expensive. (Especially the nuclear ones.) So this may be why no such tests are performed on athletes who are young and are deemed to be to healthy enough to perform.
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Re: Re:

02 Feb 2018 16:36

Tricycle Rider wrote:
fmk_RoI wrote:Not WT level, but CCC Sprandi-Polkowice's Paweł Cieślik (31) - he's only ever been a conti or pro-conti rider - has been sidelined with a hole in his heart (ASD / PFO). (Polish article.)
Due to my lack of speaking/reading the Polish language - is the hole understood to be congenital? Or, is it believed to have been cause by PEDs? Please translate.
1) It doesn't say - but there's probably a clue in it being a PFO

2) What doctor on earth would state that the cause was PEDs?

3) I have translated the key points of the article
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Re: Re:

04 Feb 2018 03:05

fmk_RoI wrote:
Tricycle Rider wrote:
fmk_RoI wrote:Not WT level, but CCC Sprandi-Polkowice's Paweł Cieślik (31) - he's only ever been a conti or pro-conti rider - has been sidelined with a hole in his heart (ASD / PFO). (Polish article.)
Due to my lack of speaking/reading the Polish language - is the hole understood to be congenital? Or, is it believed to have been cause by PEDs? Please translate.
1) It doesn't say - but there's probably a clue in it being a PFO

2) What doctor on earth would state that the cause was PEDs?

3) I have translated the key points of the article
You presumed too much and translated very little.

So, why bother posting this in your very own thread in the Clinic if it's got very little to do with PEDs? (Just pretend I'm slow, like most of the posters here judging by your replies.)
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Re: Re:

04 Feb 2018 10:30

Tricycle Rider wrote:So, why bother posting this in your very own thread in the Clinic if it's got very little to do with PEDs? (Just pretend I'm slow, like most of the posters here judging by your replies.)
If for just one minute you could stop trying to be rude AF and score petty points, you might have noticed that PEDs are not being presumed to cause any of the incidents listed. In point of fact, the whole purpose here is to ask if some aren't just too quick off the mark in blaming PEDs for everything, from crashes to heart conditions.
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Re: Cardiac Anomalies - is something going on or is this nor

09 Mar 2018 02:55

On holiday drinking expresso in the lobby bar. I watched the beginning of two European games from the UK and France respectively. Before each game a minute's silence for Davide Astori. The silence in Manchester is particularly impressive. What went wrong with Astori? The club admitted he was constantly "monitored" by medical staff. Is this true? Are players' vital organs being constantly monitored? The bit I believe is that he sees a doctor regularly but it is not to monitor his heart.
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Re: Cardiac Anomalies - is something going on or is this nor

21 Mar 2018 15:05

fmk_RoI wrote:Over the last couple of years elite professional cycling has seen a number of riders sidelined either temporarily or permanently with cardiac conditions.

2017: Ramūnas Navardauskas (29, arrhythmia); Lars Boom (31, arrhythmia)

2016: Gianni Meersman (31, arrhythmia); Johan Vansummeren (35, arrhythmia); Michael Rogers (36, arrhythmia)

2015: Will Walker (28, arrhythmia); Romain Zingle (28, inflammation)

2014: Niels Albert (28, arrhythmia); Robert Gesink (27, arrhythmia); Olivier Kaisen (30, arrhythmia); Klaas Lodewyck (26, arrhythmia)

2012: Haimar Zubeldia (35, arrhythmia)

2011: Mario Aerts (36, arrhythmia)

2010: Nicolas Vogondy (32, arrhythmia); Kim Kirchen (31, cardiac arrest)

2009: Nicolas Portal (29, arrhythmia)

And then there's the deaths. Last year Gijs Verdick (21) suffered a heart attack during a U23 race in Poland and died a week later. Earlier in the year Roubaix-Lille Métropole's Daan Myngheer (22) suffered a heart attack during the Critérium International and died in hospital two days later. In 2012 Rob Goris (30) of pro-conti squad Accent Jobs-Willems Veranda suffered a heart attack during a visit to the Tour de France.

The number of cardiac cases listed above doesn't necessarily suggest that there is a problem that cycling is failing to confront. Cyclists have always had heart problems: look at Franco Bitossi, look at Eddy Merckx. Cyclists, often times they suffer the same problems as everyone else (even though anti-doping rules deny them the same treatments as everyone else, but that's a story for another day). And the numbers above aren't particularly high when you consider the size of the professional peloton (which, at WorldTour level alone, is more than 500 riders). But, given the myth of the EPO deaths, you tend to notice these things, they tend to stick in the mind, and you want some sort of explanation, preferably one that doesn't just say nothing to see here, move along, one that actually explains to you what is actually at play here.

So, what the hell is going on, something or nothing?

nb: I'll edit the above list if additional names are suggested, but only within a reasonable time period (the last ten years) and only for elite-level cyclists.


is rthere any research on riders going back to the 60s/70s? im sure there were plenty of cases back then also; to know if there is an increased incidence of it today, we would need this info
53*11
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Re: Cardiac Anomalies - is something going on or is this nor

27 Mar 2018 20:55

Maybe Add 2009 - Steve Larsen, died while running?

fmk_RoI wrote:Over the last couple of years elite professional cycling has seen a number of riders sidelined either temporarily or permanently with cardiac conditions.

2017: Ramūnas Navardauskas (29, arrhythmia); Lars Boom (31, arrhythmia)

2016: Gianni Meersman (31, arrhythmia); Johan Vansummeren (35, arrhythmia); Michael Rogers (36, arrhythmia)

2015: Will Walker (28, arrhythmia); Romain Zingle (28, inflammation)

2014: Niels Albert (28, arrhythmia); Robert Gesink (27, arrhythmia); Olivier Kaisen (30, arrhythmia); Klaas Lodewyck (26, arrhythmia)

2012: Haimar Zubeldia (35, arrhythmia)

2011: Mario Aerts (36, arrhythmia)

2010: Nicolas Vogondy (32, arrhythmia); Kim Kirchen (31, cardiac arrest)

2009: Nicolas Portal (29, arrhythmia)

And then there's the deaths. Last year Gijs Verdick (21) suffered a heart attack during a U23 race in Poland and died a week later. Earlier in the year Roubaix-Lille Métropole's Daan Myngheer (22) suffered a heart attack during the Critérium International and died in hospital two days later. In 2012 Rob Goris (30) of pro-conti squad Accent Jobs-Willems Veranda suffered a heart attack during a visit to the Tour de France.

The number of cardiac cases listed above doesn't necessarily suggest that there is a problem that cycling is failing to confront. Cyclists have always had heart problems: look at Franco Bitossi, look at Eddy Merckx. Cyclists, often times they suffer the same problems as everyone else (even though anti-doping rules deny them the same treatments as everyone else, but that's a story for another day). And the numbers above aren't particularly high when you consider the size of the professional peloton (which, at WorldTour level alone, is more than 500 riders). But, given the myth of the EPO deaths, you tend to notice these things, they tend to stick in the mind, and you want some sort of explanation, preferably one that doesn't just say nothing to see here, move along, one that actually explains to you what is actually at play here.

So, what the hell is going on, something or nothing?

nb: I'll edit the above list if additional names are suggested, but only within a reasonable time period (the last ten years) and only for elite-level cyclists.
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Re: Cardiac Anomalies - is something going on or is this nor

27 Mar 2018 21:02

Add Glen Winkle Maybe, and definitely read his story: http://www.afathletes.info/AFIB/Glen_Winkel.html


fmk_RoI wrote:Over the last couple of years elite professional cycling has seen a number of riders sidelined either temporarily or permanently with cardiac conditions.

2017: Ramūnas Navardauskas (29, arrhythmia); Lars Boom (31, arrhythmia)

2016: Gianni Meersman (31, arrhythmia); Johan Vansummeren (35, arrhythmia); Michael Rogers (36, arrhythmia)

2015: Will Walker (28, arrhythmia); Romain Zingle (28, inflammation)

2014: Niels Albert (28, arrhythmia); Robert Gesink (27, arrhythmia); Olivier Kaisen (30, arrhythmia); Klaas Lodewyck (26, arrhythmia)

2012: Haimar Zubeldia (35, arrhythmia)

2011: Mario Aerts (36, arrhythmia)

2010: Nicolas Vogondy (32, arrhythmia); Kim Kirchen (31, cardiac arrest)

2009: Nicolas Portal (29, arrhythmia)

And then there's the deaths. Last year Gijs Verdick (21) suffered a heart attack during a U23 race in Poland and died a week later. Earlier in the year Roubaix-Lille Métropole's Daan Myngheer (22) suffered a heart attack during the Critérium International and died in hospital two days later. In 2012 Rob Goris (30) of pro-conti squad Accent Jobs-Willems Veranda suffered a heart attack during a visit to the Tour de France.

The number of cardiac cases listed above doesn't necessarily suggest that there is a problem that cycling is failing to confront. Cyclists have always had heart problems: look at Franco Bitossi, look at Eddy Merckx. Cyclists, often times they suffer the same problems as everyone else (even though anti-doping rules deny them the same treatments as everyone else, but that's a story for another day). And the numbers above aren't particularly high when you consider the size of the professional peloton (which, at WorldTour level alone, is more than 500 riders). But, given the myth of the EPO deaths, you tend to notice these things, they tend to stick in the mind, and you want some sort of explanation, preferably one that doesn't just say nothing to see here, move along, one that actually explains to you what is actually at play here.

So, what the hell is going on, something or nothing?

nb: I'll edit the above list if additional names are suggested, but only within a reasonable time period (the last ten years) and only for elite-level cyclists.
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29 Mar 2018 20:57

The element of the equation that I think is being overlooked is how many of these people had a thorough heart health evaluation before they became competitive cyclists? Because if you don't know that, then you can't tell whether the sport is causing the condition or merely exacerbating a previously existing one.

Almost all endurance athletes have an abnormal heart. You could say, after a fashion, that it is normal for them to have an abnormal heart. It's called athletic heart syndrome. The same symptoms would be diagnosed pathological if the patient's athletic background wasn't known.

Basically, if you have engaged in endurance sport enough that it significantly lowered your resting heart rate (an indication of an increase in stroke volume), you probably have athletic heart syndrome (Miguel Indu-train allegedly had an RHR of 28). The "enlarged heart" that the Pharmstrong fanbois always used to crow about, as if it was a personal gift to him from the cycling gods, was nothing more than this.

And there also are other abnormalities commonly seen in attendance to athlete's heart, such as right bundle branch block. A cardiologist once told me that RBBB was endemic among performance athletes, affecting as much as 80% of them.

As I understand it, these are not necessarily pathological conditions (that is, indicative of heart disease), but they still are abnormalities, the very existence of which can complicate the matter of diagnosing heart health. And perhaps athlete's heart and RBBB and all the others also predispose cyclists to further pathological abnormalities, in the same manner as cycling predisposes them to exercise-induced asthma (but that takes me completely out of my depth and is entirely conjectural).

But it all starts from my opening question. How do you know there wasn't anything wrong with their heart before they took up cycling?
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Re: Cardiac Anomalies - is something going on or is this nor

30 Mar 2018 10:57

53*11 wrote:is rthere any research on riders going back to the 60s/70s? im sure there were plenty of cases back then also; to know if there is an increased incidence of it today, we would need this info
Please read the OP
fmk_RoI wrote:Cyclists have always had heart problems: look at Franco Bitossi, look at Eddy Merckx.
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Re: Cardiac Anomalies - is something going on or is this nor

30 Mar 2018 11:01

cdort wrote:Maybe Add 2009 - Steve Larsen, died while running?

cdort wrote:Add Glen Winkle
Please read the OP
fmk_RoI wrote:nb: I'll edit the above list if additional names are suggested, but only within a reasonable time period (the last ten years) and only for elite-level cyclists.
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Re: Cardiac Anomalies - is something going on or is this nor

09 Apr 2018 09:46

fmk_RoI wrote:
53*11 wrote:is rthere any research on riders going back to the 60s/70s? im sure there were plenty of cases back then also; to know if there is an increased incidence of it today, we would need this info
Please read the OP
fmk_RoI wrote:Cyclists have always had heart problems: look at Franco Bitossi, look at Eddy Merckx.


thanks , i meant peer reviewed scientific papers dude
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09 Apr 2018 09:47

Very sad
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Re: Cardiac Anomalies - is something going on or is this nor

09 Apr 2018 16:27

I did a quick search of PubMed using the terms "cardiac arrhythmia endurance athletes". The earliest article that turned up was from 1985.

I suspect that the lack of attention to this issue prior to that date reflects the fact that 1) such cardiac anomalies are, thankfully, still relatively uncommon, even in highly trained individuals, 2) mass participation in endurance sports is a relatively new phenomenon, and 3) the technology for recording ECG during daily life has gotten progressively more accessible.
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10 Apr 2018 11:09

from an AFP story, which asks "Can 'unseen' heart conditions, which have claimed the lives of many athletes over many different sports, ever be fully detectable?":
"According to the current rules of the UCI, teams are obliged to carry out the physical and cardiological examination and monitoring (of their riders)," said French doctor Francais Armand Megret, a member of the UCI's medical commission.

Jacky Maillot, a doctor with the Groupama-FDJ team, underlined that point: "In accordance with the UCI rules, every year we must put our riders through the most gruelling heart stress tests in order to obtain a medical certificate that has no contraindications (that would prevent riders from competing). The top-level riders also undergo a heart echography once every two years."

Despite a battery of tests, some heart defects simply cannot be detected, according to the experts.

"These tests are never 100%," Kris Van der Mieren, a member of the medical commission for the Belgian cycling federation, told AFP.

"Even the world's best cardiologist, carrying out all the available tests — a heart ultrasound, an electrocardiogram — would be unable to detect certain anomalies.

"The only thing we can do is make sure every rider is monitored very closely."
Megret, from the UCI's medical commission, suggests one change that should be considered:
For Dr Megret, there is one improvement that can be made: transferring any final decision to an external, independent expert.

"When a heart defect or anomaly is detected, it is the team doctor who makes the decision. But I believe an independent expert should determine which tests are carried out and who makes the decisions," he added.

"Our objective is to detect the risks involved, which tests must be done to detect them, and once the defect is found, which preventative and protective measures can be taken and how they can be integrated into the regulations so they can be applied," he added.
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10 Apr 2018 12:59

Yet another argument for making all doctors independent and assigned yearly from a pool.
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