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

[djpbaltimore]

Yeah, there are probably genetic factors that are a part of the equation too. But the environmental influences of ultra endurance sport may lead to development of heart issues in those that are already genetically susceptible. It is an interesting area of research, but it can't be easily conveyed in a bite size message of 'exercise good' or 'exercise bad' as the media would prefer.

 

[Cannibal72]

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.

Great post.

 

[Libertine Seguros]

The rider who died in the Middle East race a few years ago was Friederik Nolf, he rode for Topsport Vlaanderen. This was apparently to do with a congenital heart defect but as noted, no autopsy etc. so people have always asked questions.

Remember, nobody has formally confirmed the connection between doping and the deaths in the late 80s and early 90s usually presumed due to early EPO pioneering, such as Johannes Draaijer and Joachim Halupczok; their deaths were also very different from one another. There's also the young Portuguese Bruno Neves, who had a heart attack and died on the bike during the Clásica Amarante in I believe 2008 (shortly before his LA-MSS team were raided by the police, and from that nine riders got suspensions of some kind and the team doctor was banned); the race has been renamed the Memorial Bruno Neves accordingly.

I think it's a little from column A and a little from column B and is too complex a situation (which will also differ from athlete to athlete) to simply answer as what comes from which column will vary from case to case. Congenital heart defects or naturally occurring problems are both more likely to be picked up in sportspeople than the general populace due to more regular health checks, and more likely to be exacerbated due to the workload placed upon the heart to compete in sport at the elite level; doping is a way that this can be exacerbated, either directly through the effects of the doping itself, or indirectly in the effect on the athlete's physiology.

 

[djpbaltimore]

Your last paragraph reminded me of Ryan Shay. He was an American marathon champion that died during the US Olympic trials in 2007. His autopsy showed a congenitally enlarged heart, but that condition was probably only lethal because of the load he was placing on his heart by running at the highest level.

 

[Dear Wiggo]

Re: Re:

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

Athletes spend their careers focusing on performance, not health.

You can't perform unhealthy. Or recover. Or train hard.

Pretty sure that not only does performance depend on health, but that my point stands.

 

[IndianCyclist]

Re:

Your last paragraph reminded me of Ryan Shay. He was an American marathon champion that died during the US Olympic trials in 2007. His autopsy showed a congenitally enlarged heart, but that condition was probably only lethal because of the load he was placing on his heart by running at the highest level.

Most athletes that compete are going at anaerobic or VO2 max levels towards the end of the race 1hr- last 10 minutes. Is it possible that the this is cause for problems rather that slower pace prevalent in much of the road races at the first half of most of the cycling races? Also the stress related to competing vs training without any pressure should be one of the factors IMO

 

[Archibald]

I have a congenital heart defect (hole between the upper atriums) - only discovered last year, but has been there since birth. Previous ECGs did not detect or show it. Pure luck and circumstance revealed it.
I was also told that this defect is in about 20% of the population with the majority not knowing about it... so its highly likely other posters here will have it too and not know...

I'd take a punt that there's other pro-riders with heart issues that haven't yet been discovered - PEDs may affect/exacerbate them, but I highly doubt they'd be a cause to the heart issues in question.

 

[veganrob]

Re:

I have a congenital heart defect (hole between the upper atriums) - only discovered last year, but has been there since birth. Previous ECGs did not detect or show it. Pure luck and circumstance revealed it.
I was also told that this defect is in about 20% of the population with the majority not knowing about it... so its highly likely other posters here will have it too and not know...

I'd take a punt that there's other pro-riders with heart issues that haven't yet been discovered - PEDs may affect/exacerbate them, but I highly doubt they'd be a cause to the heart issues in question.

Same here. Bicuspid aorta at birth. Never affected me or so I thought. Raced bikes for many years. then last year at 60 yrs I have a problem. I still ride at high level and trail run but won't push it too hard. I'll need surgery in a few years when the procedure is perfected.

 

[Marmot]

I recall hearing Will Walker speaking on a radio show a couple of years ago about his problems (and near death experience) with tachycardia.

If I remember correctly, he attributed his problems to a combination of three things: (i) Rabobank throwing him in to big races when he was not sufficiently mature (I think he specifically mentioned the Vuelta as an example), (ii) his own approach to training which was, in short, to just work harder/longer (he also said Rabobank didn't really supervise his training or try to rein him in), and (iii) the high levels of doping among the pro peloton (again, I think he mentioned the Vuelta specifically).

In reference to the doping, he clearly was not suggesting that he had been doping, but rather that the speeds were absurdly high, and just hanging on was brutal. His response was to push himself even more, and the workload took its toll on his heart.

If we take this at face value, the health problems attributable to doping can be seen as both direct and indirect.

 

[blackcat]

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.

did not Brioche la Boulangerie's Fabrice Salanson's family put the kibosh on an autopsy... or something like that

 

[sniper]

"to put the kibosh on sth."
nice, hadn't heard that one before. Must be of Yiddish/Hebrew origin(?)
Is that a common expression down under?

 

[Maxiton]

Re:

"to put the kibosh on sth."
nice, hadn't heard that one before. Must be of Yiddish/Hebrew origin(?)
Is that a common expression down under?

"Kibosh" is a quite common word in English, though maybe a bit less common today than in decades past. Sometimes people pronounce it kai·bosh (emphasis on the first syllable) for added irony. You'll find more info about the word on this page than you might want, but you still won't find its exact origin. And here is the wiki on it. Kibosh is used in less formal speech, and is possibly more common among men than women.

I thought blackcat was in Germany. (?)

 

[blackcat]

Re: Re:

"to put the kibosh on sth."
nice, hadn't heard that one before. Must be of Yiddish/Hebrew origin(?)
Is that a common expression down under?

"Kibosh" is a quite common word in English, though maybe a bit less common today than in decades past. Sometimes people pronounce it kai·bosh (emphasis on the first syllable) for added irony. You'll find more info about the word on this page than you might want, but you still won't find its exact origin. And here is the wiki on it. Kibosh is used in less formal speech, and is possibly more common among men than women.

I thought blackcat was in Germany. (?)

i am everywhere, and anywhere, i tend to hang with the parakeets. They are my homies

 

[sniper]

Re: Re:

"to put the kibosh on sth."
nice, hadn't heard that one before. Must be of Yiddish/Hebrew origin(?)
Is that a common expression down under?

"Kibosh" is a quite common word in English, though maybe a bit less common today than in decades past. Sometimes people pronounce it kai·bosh (emphasis on the first syllable) for added irony. You'll find more info about the word on this page than you might want, but you still won't find its exact origin. And here is the wiki on it. Kibosh is used in less formal speech, and is possibly more common among men than women.

I thought blackcat was in Germany. (?)

cheers!
i guess i associated it sound-wise with kibbutz, and hence with yiddish or hebrew.
the link you provided addresses it all.
There are so many words in Dutch that are Yiddish/Hebrew-derived without most people knowing.

blackcat? he's down with the clinic, and he flies neatly below the radar, hence i thought "down - below" -> down under.

 

[Maxiton]

Re:

The rider who died in the Middle East race a few years ago was Friederik Nolf, he rode for Topsport Vlaanderen. This was apparently to do with a congenital heart defect but as noted, no autopsy etc. so people have always asked questions.
<snip>

Thanks for that, Libertine. That's the rider I meant.

did not Brioche la Boulangerie's Fabrice Salanson's family put the kibosh on an autopsy... or something like that

Maybe it's a cultural thing, but refusing an autopsy for a suddenly dead child under these circumstances raises all kinds of red flags for me. If it were my child who died in pro cycling, I'd want the most comprehensive autopsy I could get. Sure, it won't get you your kid back, but it might point to complicity, if there is any, in his death, and give you some peace of mind if no complicity is indicated.

 

[Maxiton]

Re: Re:

i am everywhere, and anywhere, i tend to hanf with the parakeets. They are my homies

I am large, I contain multitudes. Or in this case parakeets.

Ain't nobody here but us parakeets.

 

[Maxiton]

Re: Re:

i guess i associated it sound-wise with kibbutz, and hence with yiddish or hebrew.
the link you provided addresses it all.
There are so many words in Dutch that are Yiddish/Hebrew-derived without most people knowing.

Interesting. Likewise with English, particularly American English. A lot of American idioms and informal syntax are straight from Yiddish. In the case of kibosh (which I always assumed originated in New York, where the Yiddish influence is particularly pronounced), Yiddish seems like a good guess, but if so it would be by way of UK in the early 19th century.

 

[Maxiton]

Re:

Those who take male hormones take longer for their heart rates to slow down after exercise and also have reduced flow of blood to their heart muscles (Int J Sports Med, 2013 Oct;34(10):931-5). Taking male hormones also causes the left ventricle, the main pumping chamber of the heart, to enlarge disproportionately, compared to the rest of the heart. This increases chances for irregular heart beats and sudden death (Heart, May 2004;90(5):473–475).

http://www.drmirkin.com/fitness/dangers-of-anabolic-steroids.html

Good post.

 

[arvc40]

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.

Hi. I was an Elite UK rider. Raced around Europe. Number 1 ranked U23 rider at the time. I was diagnosed with ARVC age 21. Arrhythmogenic Right Ventricular Cardiomyopathy. Went from fit as a fiddle to no longer being able to walk upstairs. Condition thought to be Genetic. Lots of cases of ARVC in Endurance Athletes 20-35. Certainly not self inflicted.

 

[arvc40]

Having spent the last 18 years talking to various cardiologists and surgeons I don't hold out much hope for you lot coming up with the answer to riders heart problems.

 

[arvc40]

Re: Re:

Those who take male hormones take longer for their heart rates to slow down after exercise and also have reduced flow of blood to their heart muscles (Int J Sports Med, 2013 Oct;34(10):931-5). Taking male hormones also causes the left ventricle, the main pumping chamber of the heart, to enlarge disproportionately, compared to the rest of the heart. This increases chances for irregular heart beats and sudden death (Heart, May 2004;90(5):473–475).

http://www.drmirkin.com/fitness/dangers-of-anabolic-steroids.html

Good post.

This happens to people without taking PEDS.

 

[jyl]

The incidence of congenital heart defects is not that low. Around 8 per 1,000 live births. Most of these don't require treatment, many are undiagnosed. But professional endurance athletes stress their hearts (and the rest of their bodies) to an incredible degree. Their physical condition is also more carefully monitored than for the average person. Small issues, that would never be noticed for average people, be noticed and then symptomatic for these athletes. That's in addition to the negative effects that extreme exercise can have, already mentioned in previous posts.

 

[therhodeo]

My son has a fairly complex congenital heart defect and I can say this, they're much much more common than people realize and oftentimes the people who have them don't know.

 

[More Strides than Rides]

Re:

The incidence of congenital heart defects is not that low. Around 8 per 1,000 live births. Most of these don't require treatment, many are undiagnosed. But professional endurance athletes stress their hearts (and the rest of their bodies) to an incredible degree. Their physical condition is also more carefully monitored than for the average person. Small issues, that would never be noticed for average people, be noticed and then symptomatic for these athletes. That's in addition to the negative effects that extreme exercise can have, already mentioned in previous posts.

What are the symptoms then? Fatigue? Heavy breathing? High heart rate, or low heart rate? Difficulty catching their breath. Which is why to say that...

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

Athletes spend their careers focusing on performance, not health.

You can't perform unhealthy. Or recover. Or train hard.

Pretty sure that not only does performance depend on health, but that my point stands.

... is true, but it is not really getting at reality. Athletes are monitored to perform better, not to be healthier. So an athlete complaining of fatigue isn't sent to get an ultrasound of their heart, or EKG, or whatever.

You may not be able to win, but an athlete can certainly go through their training and racing with full effort while unhealthy. To suggest that these conditions can only be tied to doping because athletes/doctors would have noticed natural issues ignores the propensity of issues, and the likely scenario that would play out. Those symptoms, fatigue, shortness of breath, dizziness after a hard effort... are all likely to be met with a "toughen up" or "get some rest." or "Lets change the training". And athletes can power through it. Ryan Shay got through his whole training, and the first 10k of the marathon in the lead pack before collapsing. Gesink competed every season before his surgery (doping caused or not, it is an example of powering through with an unhealthy body).

 

[Dear Wiggo]

To clarify: yes, it might be congenital.

To say doping has no bearing or impact is to be blind to the reality of pro cycling. Doping allows over exercising, no question. These guys would probably have never seen any issues if they were normally aspirated.

Check the timeline of Mick "teflon clen" Rogers:

3 x WC TT
mediocre-ish
Sky's captains lose weight and gain TT power and Mick follows suit, losing weight to 16-y-o levels and best power ever.
Mick leaves sky and gets done for Clen