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

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May 26, 2010
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fmk_RoI said:
King Boonen said:
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.
 
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.
 
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.
 
Re: Cardiac Anomalies - is something going on or is this nor

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.
 
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?
 
Apr 3, 2016
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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.
 
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Oude Geuze said:
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
 
Apr 3, 2016
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Merckx index said:
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.
 
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. :)
 
Aug 9, 2017
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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.
 
Apr 20, 2016
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Re: Cardiac Anomalies - is something going on or is this nor

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
 
Jul 24, 2009
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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.
 
Aug 12, 2015
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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.
 
Jul 24, 2009
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I would have thought the high you get from alcohol would at least partially be related to the lowering of adrenaline. At least in people who drink to alleviate stress. Alcohol makes me feel relaxed. Caffeine makes me feel agitated and anxious. Caffeine and alcohol effect me in completely opposite ways. Haven't there been studies suggesting that a moderated consumption of alcohol is good for the heart?
 
Dec 18, 2013
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Generally its accepted that anything that causes vaso dilation and/or lowering of the blood pressure is good for the heart...obviously you can go too far and cause episodes of fainting etc but pretty much all heart conditions are medicated with drugs to slow the rate, reduce the force of the pump and lower BP...stimulants do the opposite and in large doses or with chronic use will put too much pre load on the heart, raise BP, make someone a stroke risk and reduce elasticity of the blood vessels.
 
Aug 12, 2015
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I'm not really interested in studies or doctors as they usually concentrate on specific separated parts and the body doesn't work like that. Holistic stuff has much more to it.
High blood pressure is caused by too much salt in the blood attached to a lot of water. Why is that salt cannot leave the blood and enter the cells? Now that can have a myriad of causes which I won't enumerate here.
Caffeine and alcohol are diuretics due to their toxic nature. However, if the person is dehydrated (has adrenal fatigue) then the kidneys cannot help so alcohol must be removed by the liver which slows down other metabolic functions as the toxin removal is first priority of the body at this point. So this results in a fake calming effect.
This is why younger people get the adrenaline boost because they're not as dehydrated as ones over thirty.
 
Jul 24, 2009
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Re: Re:

fmk_RoI said:
bebellion2 said:
I'm not really interested in studies or doctors as they usually concentrate on specific separated parts and the body doesn't work like that.
And the ghost of Michael Gove sighed contentedly...
Are you one of those people who prescribes meditation to cure AIDS?
 
Re: Re:

sars1981 said:
fmk_RoI said:
bebellion2 said:
I'm not really interested in studies or doctors as they usually concentrate on specific separated parts and the body doesn't work like that.
And the ghost of Michael Gove sighed contentedly...
Are you one of those people who prescribes meditation to cure AIDS?
That's an acrobatic leap of logic worthy of sniper. Chapeau for saying something beyond stupid.
 
Jul 24, 2009
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Re: Re:

fmk_RoI said:
sars1981 said:
fmk_RoI said:
bebellion2 said:
I'm not really interested in studies or doctors as they usually concentrate on specific separated parts and the body doesn't work like that.
And the ghost of Michael Gove sighed contentedly...
Are you one of those people who prescribes meditation to cure AIDS?
That's an acrobatic leap of logic worthy of sniper. Chapeau for saying something beyond stupid.
I was referring to B. But Chapeau to me for not knowing what chapeau means.
 
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