Heart Aliments- Result of Genetics, Doping or over exercise?

[IndianCyclist]

Suddenly too many riders are getting heart problems Vansummeren , Rogers, Gesink, Nuyens, Albert etc. Are they due to genetic defects, over exercise or due to doping? Would doping (EPO specifically) actually prevent heart ailments by reducing the max effort required by the heart. Discuss.

 

[blackcat]

Re: Heart Aliments- Result of Genetics, Doping or over exerc

Suddenly too many riders are getting heart problems Vansummeren , Rogers, Roulston, Walker, Gesink, Nuyens, Albert etc. Are they due to genetic defects, over exercise or due to doping? Would doping (EPO specific
ally) actually prevent heart ailments by reducing the max effort required by the heart. Discuss.

added two antipodes, there are more. Seems like it could be a cluster, it also may not be statistically relevant.

 

[Dear Wiggo]

I am sure it's perfectly legit, and that these issues do in fact magically appear much later in life, despite still being young and focusing their entire life on being healthy and fit, surrounded by professional coaches, soigneurs and other paraphenalia all working together to keep them in optimal condition.

 

[LaFlorecita]

Rogers' condition was known for a long time FYI

 

[blackcat]

Re:

I am sure it's perfectly legit, and that these issues do in fact magically appear much later in life, despite still being young and focusing their entire life on being healthy and fit, surrounded by professional coaches, soigneurs and other paraphenalia all working together to keep them in optimal condition.

devils advocate tho DW, that gym training and hypertrophy can make the aorta larger, which will pose problems in later life. Or is it ventricle, I thought aorta, but I will prolly be wrong.

Now, what will muddy the waters, and this aint specificially relevant to cycling, tho it aint irrelevant, is the high correlation of roids to people hitting the gym for hypertrophy and aesthetics

 

[carolina]

a friend of mine had a heart attack 2 years ago, when he was only 23-24 years old. the cardiologist said he had a defect in his heart, but also said that it was something very common. he chose to have the surgery, although it was not necessary.

I think it's possible that these guys have had these issues for a long time, but it was never a problem for them or maybe they never had any reason to look for it.

look at gesink, he had an arrhythmia for several years, but only decided to correct it a couple years ago.

 

[JackRabbitSlims]

Re: Re:

I am sure it's perfectly legit, and that these issues do in fact magically appear much later in life, despite still being young and focusing their entire life on being healthy and fit, surrounded by professional coaches, soigneurs and other paraphenalia all working together to keep them in optimal condition.

devils advocate tho DW, that gym training and hypertrophy can make the aorta larger, which will pose problems in later life. Or is it ventricle, I thought aorta, but I will prolly be wrong.

Now, what will muddy the waters, and this aint specificially relevant to cycling, tho it aint irrelevant, is the high correlation of roids to people hitting the gym for hypertrophy and aesthetics

hypertrophy of the the Left Ventricle.

http://ehjcimaging.oxfordjournals.org/content/10/3/350

 

[WillemS]

Re: Heart Aliments- Result of Genetics, Doping or over exerc

Heart ailments are not that rare in young adults; I mean, most of us will never experience them, but they aren't exactly rare, either. I'm not surprised that some of the riders discover their arrhythmias and other heart diseases in their 20s.

Are some doping related? Possibly, I don't know. I would be surprised if they were all doping-related, because one would expect to find a number of cases in a group of this sizes given the overall incidence rate. Moreover, some that might never have been diagnosed in the general population, might be diagnosed in the population of pro cycling precisely because they are under regular medical scrutiny.

Is the observation of a cluster enough to detect a systematic increase? Not really, in a random sequence, clusters happen. (In fact, a very regular rhythm or pattern is probably not random.) Besides, without a careful analysis, we don't even know if the current occurring numbers are unusual.

So, to make a true inference, one would need to carefully analyse the data of the last decade or so to see whether or not a new trend seems to be happening, while controlling for trends in the general population. I would expect the incidence rate to be slightly above the general population incidence rate, as I expect the probability of detection/diagnosis to be higher in the pro cycling population, due to the higher incidence of medical checks in that population compared to the general population.

 

[Catwhoorg]

A lot of the time when you read about a hobby jogger dying in a race (Marathon/half very rare in a 5k), it frequently turns out to be some undiagnosed heart condition, frequently congenital.

Odd that this thread came up, as it almost a year since a friend stopped to perform CPR on a fellow runner in a race until the emergency services got there. (The runner thankfully recovered and survived, most likely thanks to a portable defibrillator)

 

[Maxiton]

We know doping goes on in sports, particularly cycling. We know some doping may cause heart problems, although to what extent we really have no idea. We know some cyclists, virtually all of them young, have died of, or been impaired by, heart ailments. It seems reasonable therefore to think there may be some correspondence between heart problems and use of certain performance enhancing drugs. The only way to verify this common sense inference, though, is to have a statistically valid study. Anyone? UCI? WADA?

 

[Hawkwood]

Re: Re:

I am sure it's perfectly legit, and that these issues do in fact magically appear much later in life, despite still being young and focusing their entire life on being healthy and fit, surrounded by professional coaches, soigneurs and other paraphenalia all working together to keep them in optimal condition.

devils advocate tho DW, that gym training and hypertrophy can make the aorta larger, which will pose problems in later life. Or is it ventricle, I thought aorta, but I will prolly be wrong.

Now, what will muddy the waters, and this aint specificially relevant to cycling, tho it aint irrelevant, is the high correlation of roids to people hitting the gym for hypertrophy and aesthetics

I know a heart specialist who has a research interest in cardiac risks from endurance training, I think he said something about enlarged aortas or ventricles, likewise I can't remember which.

 

[sniper]

i posted a link to a German article not long ago interviewing a German medical professor who spoke about a range of new PEDs on the market.
If I recall correctly, he also spoke of heart problems some of these PEDs could cause.
Unfortunately I don't know where I posted the link.

 

[sniper]

Re:

We know doping goes on in sports, particularly cycling. We know some doping may cause heart problems, although to what extent we really have no idea. We know some cyclists, virtually all of them young, have died of, or been impaired by, heart ailments. It seems reasonable therefore to think there may be some correspondence between heart problems and use of certain performance enhancing drugs. The only way to verify this common sense inference, though, is to have a statistically valid study. Anyone? UCI? WADA?

good post.
and good thread topic.
there should be much more focus on this kind of stuff.
Cf. what was discussed in the pseudo-science thread: sports scientists of all sorts are publishing disposable trash on a daily basis, meanwhile there is no real research done on how doping influences performances, let alone on how it influences health.
Understandable, because writing about that, that's no way for a sports scientist to get on the payroll of pros and proteams, now is it.

I wonder/doubt if ever there is any serious autopsy done whenever a professional athlete dies of heart failure.

 

[armchairclimber]

Two of the most talented athletes I know are now suffering from heart conditions relating to their heightened fitness (endurance trained) and, in particular, low resting heart rate.
One, in his forties, suffers arrhythmia (AF). The other, mid twenties, suffers bradycardia. Both have had to give up sport and both face the prospect of living with a pacemaker.
Both are clean.

It's a known problem for highly trained endurance runners. Thickening of the heart muscle wall is, I believe, usually the problem.

 

[Maxiton]

Re: Re:

We know doping goes on in sports, particularly cycling. We know some doping may cause heart problems, although to what extent we really have no idea. We know some cyclists, virtually all of them young, have died of, or been impaired by, heart ailments. It seems reasonable therefore to think there may be some correspondence between heart problems and use of certain performance enhancing drugs. The only way to verify this common sense inference, though, is to have a statistically valid study. Anyone? UCI? WADA?

good post.
and good thread topic.
there should be much more focus on this kind of stuff.
Cf. what was discussed in the pseudo-science thread: sports scientists of all sorts are publishing disposable trash on a daily basis, meanwhile there is no real research done on how doping influences performances, let alone on how it influences health.
Understandable, because writing about that, that's no way for a sports scientist to get on the payroll of pros and proteams, now is it.

I wonder/doubt if ever there is any serious autopsy done whenever a professional athlete dies of heart failure.

Yeah, who was that young neo-pro (?) who died a few years ago in the Tour of Oman, I think it was, of a suspected heart attack, and after team management talked with his parents, the parents decided not to ask for an autopsy? Anybody know who I mean?

Oh, and speaking of heart problems I think we need to add Kim Kirchen to the list.

Maybe we should try to compile a list of a competitive cyclists (or maybe only pros) who've died or been sidelined by heart-related problems.

 

[Maxiton]

Re:

Two of the most talented athletes I know are now suffering from heart conditions relating to their heightened fitness (endurance trained) and, in particular, low heart rate.
One, in his forties, suffers arrhythmia. The other, mid twenties, suffers bradycardia. Both have had to give up sport and both face the prospect of living with a pacemaker.
Both are clean.

That's interesting, too. Sad, but interesting. There must be some studies on fitness/endurance training and heart problems.

 

[armchairclimber]

Just edited my post. It's not uncommon.

 

[Maxiton]

Re:

Just edited my post. It's not uncommon.

I'm going to look for some data. I have heard of heart conditions that came about from endurance training, but I didn't think it was common.

Anyway, sorting out what's training-related and what's PED-related sounds like a tall order. For us, I mean.

 

[Hawkwood]

Re: Re:

Two of the most talented athletes I know are now suffering from heart conditions relating to their heightened fitness (endurance trained) and, in particular, low heart rate.
One, in his forties, suffers arrhythmia. The other, mid twenties, suffers bradycardia. Both have had to give up sport and both face the prospect of living with a pacemaker.
Both are clean.

That's interesting, too. Sad, but interesting. There must be some studies on fitness/endurance training and heart problems.

There are studies, here's one dating back to 2006, haven't read it and can't comment how good it is: http://circ.ahajournals.org/content/114/15/1633.full
I do remember reading bits and pieces years ago, perhaps in the 1990s, about links between endurance training and heart problems.

 

[More Strides than Rides]

Re:

focusing their entire life on being healthy and fit...

Athletes spend their careers focusing on performance, not health. An athlete's definition of healthy means "able to perform without pain or impairment". A medical doctor's definition of healthy is more along the "staying alive, longer" sense. Athletes spend their lives focusing on performance, not well-being or life-expectancy.

Every few months there is a click-bait article about how exercise is bad for you. Something like more than 5 hours per week on endurance exercise leads to lower life expectancy, or something. Those articles are bad media and bad science, but based on real observations: people who exercise do get problems, and they can be related to the stress put on the body during exercise.

This is an answerable question, but I don't think there is enough data to give a good answer, right now.

 

[Hawkwood]

Re: Re:

We know doping goes on in sports, particularly cycling. We know some doping may cause heart problems, although to what extent we really have no idea. We know some cyclists, virtually all of them young, have died of, or been impaired by, heart ailments. It seems reasonable therefore to think there may be some correspondence between heart problems and use of certain performance enhancing drugs. The only way to verify this common sense inference, though, is to have a statistically valid study. Anyone? UCI? WADA?

good post.
and good thread topic.
there should be much more focus on this kind of stuff.
Cf. what was discussed in the pseudo-science thread: sports scientists of all sorts are publishing disposable trash on a daily basis, meanwhile there is no real research done on how doping influences performances, let alone on how it influences health.
Understandable, because writing about that, that's no way for a sports scientist to get on the payroll of pros and proteams, now is it.

I wonder/doubt if ever there is any serious autopsy done whenever a professional athlete dies of heart failure.

Yeah, who was that young neo-pro (?) who died a few years ago in the Tour of Oman, I think it was, of a suspected heart attack, and after team management talked with his parents, the parents decided not to ask for an autopsy? Anybody know who I mean?

Oh, and speaking of heart problems I think we need to add Kim Kirchen to the list.

Maybe we should try to compile a list of a competitive cyclists (or maybe only pros) who've died or been sidelined by heart-related problems.

Marc Demeyer, dead of a heart attack at the age of 31, think it was on a training ride. I always thought he looked really classy on a bike. I think I might have Freddy Maertens' book it's possible he commented on Demeyer's death.

 

[armchairclimber]

One study of AF in endurance athletes. http://www.kardrehab.insel.ch/fileadmin/kardiorehab/kardiorehab_user/Bilder/1_F_European_Journal_of_Preventive_Cardiology-2013-Wilhelm-2047487313476414.pdf

 

[armchairclimber]

This article is more about bradycardia. https://www.sciencenews.org/blog/scicurious/slow-heartbeat-athletes-not-so-funny

 

[djpbaltimore]

Interesting papers ACC. Here is a review about the adaptations of the heart due to endurance exercises published in a sports science journal. AICAR has actually been used for a long time in the clinic to stimulate ATP synthesis from an ischemic heart.

http://bjsm.bmj.com/content/46/Suppl_1/i29.long

 

[armchairclimber]

That's dense stuff... but something very pertinent in there struck me. There's a difference between the physical "damage" done to, say middle and long distance runners (up to 10k specialists) and that done to "ultra" runners (and, I guess, elite road cyclists). Sustained acidosis, exposure to stress hormones, oxidative stress, impact damage to red blood cells etc etc. Aside from the adaptations that the heart must need to make, there's a cocktail of other stuff that the cardiovascular system has to endure on stages/races that last for 4/5/6 hours must be immense.