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

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Re: Re:

26 Jun 2017 14:45

fmk_RoI wrote:
Huapango wrote:Please include Charlie Craig to this list.
Absolutely not. Now you're just being silly.


It wasn't meant to be silly. Although not an elite professional, one could argue he was an elite junior. http://www.c-r-y.org.uk/charlie-craig/
Huapango
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26 Jun 2017 15:38

Arrhythmia definitely increases with age. I remember a review saying it affected I think 1-2% of American adults over 60, with the % increasing with age. This is entirely to be expected for what is basically a degenerative disease.

Keep in mind, though, that this is not a circulatory problem. To make an analogy with physical systems, it's not the plumbing, it's the wiring. Arrhythmias, at least the most common kinds, result from electrical impulses that cause heart contractions beginning or continuing at places they normally don't. I mention this because it's not obvious that the enormous stress placed on the circulatory system by pros training and racing would put one at increased risk for this problem. I'm not saying this isn't possible, but there's no particular reason why it should, and no evidence for it that I'm aware of.
Merckx index
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26 Jun 2017 17:49

I have a benign arrhythmia. Dehydration, caffeine, stress, and some other factors can make it flare up. Seems like the kind of thing that would generally be exacerbated by cycling. No idea if that is a complete explanation for these instances, and no idea if there is any increase over time in the number of issues with arrhythmias in the pro cycling population.

Not sure how that would ever be determined given the often shady nature of "medical" professional practice in cycling. Truth in medical records not exactly being at a premium in this sport...
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Re:

26 Jun 2017 18:07

Merckx index wrote:Arrhythmia definitely increases with age. I remember a review saying it affected I think 1-2% of American adults over 60, with the % increasing with age. This is entirely to be expected for what is basically a degenerative disease.

Keep in mind, though, that this is not a circulatory problem. To make an analogy with physical systems, it's not the plumbing, it's the wiring. Arrhythmias, at least the most common kinds, result from electrical impulses that cause heart contractions beginning or continuing at places they normally don't. I mention this because it's not obvious that the enormous stress placed on the circulatory system by pros training and racing would put one at increased risk for this problem. I'm not saying this isn't possible, but there's no particular reason why it should, and no evidence for it that I'm aware of.
While I did read the Haywire Heart book, excuse if much didn't actually register. But one of the issues here is a build up of scar tissue that effectively blocks the electrical pulses, correct? And the causes of that scar tissue are many and various, yes?

You mentioned a genetic connection, in an earlier comment. I have seen in several places people saying don't look to elite athlete's hearts because the genes that get them to the top could also be a factor there. (This is likely to be said in response to pointing out the (good) mortality statistics and the like for ex cyclists.)
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26 Jun 2017 18:24

Two athletes I am involved with have heart conditions. I know of one other nearby and one friend who is an ex-endurance athlete. two of them have conditions associated with their lives as athletes (bradycardia and arhythmia) the other two from genetic disease that they were unaware of until things went badly awry. None take PEDs, legal or otherwise. "Athlete's heart" issues are not uncommon.
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Re: Re:

26 Jun 2017 19:12

fmk_RoI wrote:
King Boonen wrote:If we are going to assume that the drugs used in professional sport, and in particular cycling, cause heart conditions, and that drug use is rife, we have to expect a much higher incidence of heart conditions, but there is no evidence for that.
That is something I think that needs to be considered. If we say that doping causes this problem, why does the real problem appear to be so small?

(If we're not careful here, we'll prove there is no doping and have to close the Clinic down.)




Bit of a leap to assume that Doctors ( team or otherwise) who give riders PEDs of varying doses for alleged conditions or no conditions just purely to enhance performance give a fig about arrhythmia's. I guess it would have to be a pretty serious arrhythmia before an athlete or Doc is going to say stop and rest or retire, never mind team owners wanting to pay athletes to sit out any time......

The peloton could be full of guys with mild 'health conditions' due to the PEDs but most of them are not going to stop racing because of it.
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27 Jun 2017 09:55

2015:
Romain Zingle
Klaas Lodewyck
Max Gulickx (Cyclocross espoir)
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27 Jun 2017 23:35

My dad (a very athletic person who's never taken any PEDs) has had arrhythmia his entire life, when he's perfectly relaxed he actually skips a beat. It'll go three beats and then a pause. When he's stressed or active his heartbeat is regular.

He actually had a heart attack last week, his first one, but he's 75 now and is not in the habit of seeing a doctor regularly. Thankfully he's had only a couple of stents put in instead of a bypass like the doctors initially thought, but he's going to have to be much more diligent about having regular check-ups from now on.

Anyhoo, with elite athletes heart conditions are just probably detected more frequently because they get tested so much. And if PEDs are a cause of their heart problems, well, that actually wouldn't surprise me, either.
User avatar Tricycle Rider
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28 Jun 2017 00:25

Btw., I think it's extremely terrifying when one of your buds, your teammates, your neighbors (or whatever else you may be) are not able to visit you when your heart is being worked on in the ICU.

But at the same time, as my dad's daughter - I do understand.
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22 Dec 2017 18:07

Time to add a new one to the list: Lars Boom
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Re: Cardiac Anomalies - is something going on or is this nor

23 Dec 2017 13:14

Among 46 'high-level' European endurance athletes diagnosed with cardiac arrhythmia, eighty percent were cyclists. Nine athletes died, and all of the ones who died were cyclists

80% of the patients = cyclists
100% of the deaths = cyclists

So there has got to be some specific correlation between cycling and the ventricular arrhythmia, especially the fatal cases where a normally benign heart symptom went out of control. And the authors conclude that the pursuit of elite endurance sports is causative - either causes the symptoms in the first place or makes it progressively worse

Probably there is a lot of research out there related to the subject of prevalence of heart anomalies in athletics

High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification.
Heidbüchel H1, Hoogsteen J, Fagard R, Vanhees L, Ector H, Willems R, Van Lierde J.

Electrocardiographic abnormalities and premature ventricular contractions are common in athletes and are generally benign. However, the specific outcome of high-level endurance athletes with frequent and complex ventricular arrhythmias is unclear. Also, information on the predictive accuracy of different investigations in this subgroup is unknown.
RESULTS:
We report on 46 high-level endurance athletes with ventricular arrhythmias (45 male; median age 31 years) followed-up for a median of 4.7 years. Eighty percent were cyclists. Hypertrophic cardiomyopathy or coronary abnormalities were present in < or =5%. Eighty percent of the arrhythmias had a left bundle branch morphology. Right ventricular (RV) arrhythmogenic involvement (based on a combination of multiple criteria) was manifest in 59% of the athletes, and suggestive in another 30%. Eighteen athletes developed a major arrhythmic event (sudden death in nine, all cyclists).

Complex ventricular arrhythmias do not necessarily represent a benign finding in endurance athletes. An electrophysiological study is indicated for risk evaluation, both by defining inducibility and identifying the arrhythmogenic mechanism. Endurance athletes with arrhythmias have a high prevalence of right ventricular structural and/or arrhythmic involvement. Endurance sports seems to be related to the development and/or progression of the underlying arrhythmogenic substrate.
ClassicomanoLuigi
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23 Dec 2017 13:44

Beginnings of a prospective study which seeks to properly answer several questions about athleticism vs. cardiac problems

https://www.baker.edu.au/research/laboratories/sports-cardiology/pro-at-heart/contribution

Notably they mention they want to study whether cardiovascular factors can be identified which are predictive of future talent.
Obviously there must be some factors beneficial to becoming pro cyclists in the first place, but what exactly are those innate characteristics?
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23 Dec 2017 14:11

Endurance exercise is essentially a state of cardiac volume overload. The adaptive response is increased myocardial thickness and increased ventricular volume which results in greater cardiac output measured in liters per minute or minute volume. A normal human can perhaps sustain 25litres per minute, a top athlete 50litres like indurain. The cardiac muscle is also conducting the electrical impulse or depolarization wave from the sinus node, and a great change in muscle volume and distance which the signal needs to travel increases the risk of aberration, especially the atrial chambers can develope ancillary depolarization nodes which produce chaos and fibrillation/flutters. PEDs would probably contribute to the likelihood of this occurring either by increasing training overload possible or by decreasing threshold stimulus need for depolarization by sympaticomimetics (beta agonist fx). But I think the list is relatively short and to be expected from a sport with thousands of professional athletes. The cardiac arrest and death was almost certainly congenital anomaly or familial hypercholesterolomi or something similar.
«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.»
Oude Geuze
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Re:

23 Dec 2017 14:45

Oude Geuze wrote:a great change in muscle volume and distance which the signal needs to travel increases the risk of aberration, especially the atrial chambers can develop ancillary depolarization nodes which produce chaos and fibrillation/flutters. PEDs would probably contribute to the likelihood of this occurring either by increasing training overload possible
Makes sense, on both counts
or by decreasing threshold stimulus need for depolarization by sympaticomimetics (beta agonist fx).
The doping with asthma medications seems kind of unsafe for this reason, and there was some speculation in the Froome/salbutamol threads as to how this level of β-agonist abuse is tolerable without severe side effects?
But I think the list is relatively short and to be expected from a sport with thousands of professional athletes.
True observation, when it comes right down to the numbers, between all the contributions to the list, there still were not a lot more to be found than prevalence in the general population. Maybe at the very top of world-level cyclists the athletes are somewhat self-selected in that they don't make it there in the first place if they are prone to these anomalies
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Re:

23 Dec 2017 21:02

Merckx index wrote:Arrhythmia definitely increases with age. I remember a review saying it affected I think 1-2% of American adults over 60, with the % increasing with age. This is entirely to be expected for what is basically a degenerative disease.

Keep in mind, though, that this is not a circulatory problem. To make an analogy with physical systems, it's not the plumbing, it's the wiring. Arrhythmias, at least the most common kinds, result from electrical impulses that cause heart contractions beginning or continuing at places they normally don't. I mention this because it's not obvious that the enormous stress placed on the circulatory system by pros training and racing would put one at increased risk for this problem. I'm not saying this isn't possible, but there's no particular reason why it should, and no evidence for it that I'm aware of.


I would agree in principle, but it’s important to mention that circulation can cause problems with “wiring” so to speak. An infarction kills the myocardial cells and leaves an area of fibrous connective tissue which will have a different potential than healthy cells, this may cause aberrant depolarization and ventricular arrhythmia and even fibrillation and death and is a common problem in heart attacks (why defibrillators work, resets entire muscle to same potential again).
The heart is unique amongst organs in that it supplies itself with blood from outside and in, but it only gets blood during diastolic (relaxing) phase as the pressure gradient is zero or negative while it’s contracting. Thus it’s susceptible to endocardium (innermost layer of the heart) infractions when the walls get too thick. So training may in fact cause, in the predisposed, conduction disease secondary to vascular pathology.
«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.»
Oude Geuze
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24 Dec 2017 20:50

May sort of understand what you guys are talking about, but here's the latest on my dad's heart situation.

By saying he was a very active athlete I don't mean he just worked out in the gym once in a while, I mean he had actually completed 15 cross-country ski marathons, even at the Master's level. Some of those races in miserable conditions were as long as 80km (hello Sweden!), most of them were about 50km, or so.

During his heart attack (and probably even earlier because he's never been known to admit to having some pain) he had sustained some heart damage, unlike other organs the heart will not come back from that. Once the heart tissue is dead it's dead. That is according to his cardiologist, so next step is to have a defibrillator implanted because dad is more at risk for sudden cardiac death.

He's on a bunch of meds right now, the defibrillator implant will do nothing more for him than keep him alive in case his heart goes dead and needs a jolt.

Anyhoo, sorry to have interrupted, this was just an anecdotal kind of thing. Please proceed as you were. :)
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04 Jan 2018 07:18

Hartthijs de Vries, on Rabo continental for 2015-2016 and SEG 2017, signed with Roompot in 2018 retires immediately because of his heart.

I do remember that Peter Winnen wrote in one of his books about a heart testing, where there was only 1 rider on the team confirmed to not have any cardiac problems. That rider was never named, but because it is then told that this rider got addicted to amphetamines after his career it's not that hard to believe that he is talking about Johan van der Velde. As they were on the same team, that must have been 1986 or so.
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Re: Cardiac Anomalies - is something going on or is this nor

04 Jan 2018 13:37

I can't speak for elite endurance athletes as I wouldn't have any idea why so many, particularly young athletes, are having heart problems. Could be medical drug-induced as the drugs these days have so many side-effects and many of safety studies are industry-funded (as well as buried studies in lot of cases). And IMO, with the FDA a subsidiary of Big Pharma and a promoter of destructive drugs, anything is possible (I lost a family member a few years ago to drug-induced organ failure).

My take is intense endurance exercise is beneficial for the cardiovascular system and improves stroke volume & lowers RHR. And from a new study it's clear that high-intensity interval training (HIIT) at >90% VO2max has a much more positive influence on gene transcripts & improved cardio-metobolic rate than less intense, lower VO2max type excercise. And in this study a greater number of genes were influenced with the older middle-aged test group than the younger bucks - which is good for us old cats!

As an avid runner in my late 50s I've been doing HIIT for over 30 yrs. Though I do lower mileage now and cross train more on a bike due to age-related chronic injuries, about half of my training is HIIT related. I haven't had any cardiovascular problems and even had a treadmill test a few years ago. RHR is very low for my age.


https://mobile.nytimes.com/2017/03/23/well/move/the-best-exercise-for-aging-muscles.html?mc=aud_dev&mcid=keywee&mccr=domdesk&kwp_0=619189&kwp_4=2200908&kwp_1=919655&referer=http://www.letsrun.com/forum/flat_read.php?thread=8581110

https://www.ncbi.nlm.nih.gov/pubmed/28273480
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07 Jan 2018 16:06

An iron man out here died of 'athletes heart' recently. This article includes a doctor's insight.

http://www.goldcoastbulletin.com.au/lifestyle/why-did-fit-former-ironman-dean-mercers-heart-fail/news-story/d8b3debc78b34de1d3cbc5264a987f10

I think I have an arrhythmia.It usually happens when my pulse rate is low, and I get a big thud in my chest all of a sudden. But it's happened during exercise too, and it's quite disconcerting. I know caffeine and stress promote it. I asked the hospital about it and that did an ECG and said my heart is great. It annoys me because it makes me self-conscious and anxious doing high intensity exercise. Very much negates the endorphin high that i seek out in exercise.
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07 Jan 2018 19:22

Caffeine and alcohol are toxic to the body, that's why people get high from them as the adrenals are trying to remove the substance through the kidneys, which results in a temporary adrenaline boost. On the long term this leads to chronic dehydration and adrenal fatigue, which might or might not be apparent to the user as it's usually a very slow, gradual decline in the quality of life ever since the first childhood dose of a hot cocoa drink. Later in life this can lead to many side effects like panic attacks or arrhythmias, as when the sodium/potassium ratio in cells gets out of balance muscle activity is immediately affected.

"Athlete's heart" is another condition which relates to (as in 'chronic stress') but not entirely caused by this. A carbohydrate-based diet induces a general 'high' which gives immediate energy that the person wants to spend right away. When this is coupled with exercise that burns mostly carbs, the effect is multiplied and the heart muscles get weakened over the years due to this overusage. In general a low carb diet is preferable (not Atkins), exercise has to be long distance+low intensity (fat burning zone) with the occasional bursts of high intensitiy intervals. This type of diet high in saturated fats also protects one from high cholesterol.
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