Aerobic Capacity in Adults with Congenital Heart Disease: More than VO2peak, a Follow-Up Study

Adults; Aerobic capacity; Congenital heart diseaseAdultos; Capacidad aeróbica; Cardiopatía congénitaAdults; Capacitat aeròbica; Cardiopatia congènitaTo control the development of people with congenital heart disease (CHD), it is important to follow their aerobic capacity (AC), especially when they exercise. This research aimed to study the progress of AC during a follow-up of adults with CHD. This is a longitudinal study which involved 127 adults with a mean age of 33.8 (11.1) years (57.5% female; 75 moderate CHD and 52 complex CHD) who had undergone two cardiopulmonary exercise tests (CEPT) in at least one year between the first and the second test. The AC and exercise performance (EP) (duration of exercise time, velocity and percentage of grade) were assessed using a ramp protocol over a treadmill. In a mean of 4.5 (2.0) years of follow-up, there was a significant decrease in AC. The VO2peak at baseline was 27.8 (27.7) mL/kg/min (82.9% (20.3%) predicted) versus 26.6 (7.8) mL/kg/min (79.3% (20.8%) predicted) at the end of follow-up. This decline was independent of the body weight increase. There was no significant difference in HRpeak and EP among periods. These results suggest a sign of favorable evolution of adults with CHD. More research is needed to study different factors that could contribute to AC reduction.This research was funded by SUR of DEC Generalitat de Catalunya and European Union, PhD grant number 2020FI_B2_00128. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

Long-term Follow-up of Early Repolarization Pattern in Elite Athletes

AbstractBackgroundEarly repolarization pattern (ERP) is considered a benign variant of the electrocardiogram (ECG), more frequent in athletes. However, prospective studies suggested that ERP is associated with an increased risk of sudden cardiac death (SCD). The purpose of this study is to determine the prevalence, clinical characteristics, and long-term outcome of ERP in elite athletes during professional activity and after retirement.Methods and ResultsA cohort of 299 white elite athletes recruited between 1960 and 1999 was retrospectively analyzed. Athletes were eligible if they had participated for at least 6 consecutive months in high competition and retired for a minimum of 5 years before inclusion. Clinical data and ECG were abstracted from the clinical records using a questionnaire, and outcomes after a mean follow-up of 24 years were registered. Among the 299 athletes, 66% were men with a mean age of 20 (SD 6.4) years. ERP was found in 31.4% of participants, and it was located in lateral ECG leads in 57.4% of cases, in inferior leads in 6.4%, and in both leads in the remaining 36.2%. After retirement, ERP still persisted in 53.4% of athletes. Predictive factors for the persistence were: left ventricular hypertrophy signs at the baseline ECG (odds ratio [OR] 4.35; 95% confidence interval [CI], 1.43-13.24; P = .010), sinus bradycardia after retirement (OR 2.56; 95% CI, 1.09-5.99; P = .031), and presence of ERP during the sportive career (OR 20.35; 95% CI, 8.54-48.51; P < .001). After a mean follow-up of 24 years, no episodes of SCD occurred.ConclusionsA third of elite athletes presented ERP, and this persisted in 53.4% of cases after retirement. After a long follow-up period, no difference in outcome of SCD was seen

Myocardial remodelling and tissue characterisation by cardiovascular magnetic resonance (CMR) in endurance athletes

Our purpose was to evaluate by cardiovascular magnetic resonance (CMR) the presence of diffuse as well as focal MF in a series of high-performance veteran endurance athletes. Thirty-four veteran healthy male endurance athletes, still being in regular training, with more than 10 years of training underwent a CMR. A cardiopulmonary exercise test was also performed to assess their maximal physical performance. The control group consisted in 12 non-trained normal individuals. We found an increase in both, right and left ventricular (LV) volumes in the athlete's group when compared with controls. There was no increase in indexed LV myocardial mass despite of a significantly increased maximal myocardial wall thickness in comparison to controls. Native T1 values and extracellular volume (ECV) were normal in all cases. We did not find differences in native T1 values and ECV between both groups. In three athletes (9%), non-ischaemic late gadolinium enhancement (LGE) was observed. We did not find a correlation between total training volume and presence of LGE or with the ECV value. Our results show that the majority of veteran endurance athletes present with myocardial remodelling without MF as a physiological adaptive phenomenon. In the only three athletes with focal MF, the LGE pattern observed suggests an intercurrent event not related with the remodelling phenomenon

Deuterium trapping in low coatings

2.00SIGLELD:9091.9F(CLM-R--223) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Predicting fecal sources in waters with diverse pollution loads using general and molecular host-specific indicators and applying machine learning methods

In this study we use a machine learning software (Ichnaea) to generate predictive models for water samples with different concentrations of fecal contamination (point source, moderate and low). We applied several MST methods (host-specific Bacteroides phages, mitochondrial DNA genetic markers, Bifidobacterium adolescentis and Bifidobacterium dentium markers, and bifidobacterial host-specific qPCR), and general indicators (Escherichia colt, enterococci and somatic coliphages) to evaluate the source of contamination in the samples. The results provided data to the Ichnaea software, that evaluated the performance of each method in the different scenarios and determined the source of the contamination. Almost all MST methods in this study determined correctly the origin of fecal contamination at point source and in moderate concentration samples. When the dilution of the fecal pollution increased (below 3 log(10) CPU E. coli/100 ml) some of these indicators (bifidobacterial host-specific qPCR, some mitochondrial markers or B. dentium marker) were not suitable because their concentrations decreased below the detection limit. Using the data from source point samples, the software Ichnaea produced models for waters with low levels of fecal pollution. These models included some MST methods, on the basis of their best performance, that were used to determine the source of pollution in this area. Regardless the methods selected, that could vary depending on the scenario, inductive machine learning methods are a promising tool in MST studies and may represent a leap forward in solving MST cases.Peer Reviewe

Myocardial remodelling and tissue characterisation by cardiovascular magnetic resonance (CMR) in endurance athletes

Our purpose was to evaluate by cardiovascular magnetic resonance (CMR) the presence of diffuse as well as focal MF in a series of high-performance veteran endurance athletes. Thirty-four veteran healthy male endurance athletes, still being in regular training, with more than 10 years of training underwent a CMR. A cardiopulmonary exercise test was also performed to assess their maximal physical performance. The control group consisted in 12 non-trained normal individuals. We found an increase in both, right and left ventricular (LV) volumes in the athlete's group when compared with controls. There was no increase in indexed LV myocardial mass despite of a significantly increased maximal myocardial wall thickness in comparison to controls. Native T1 values and extracellular volume (ECV) were normal in all cases. We did not find differences in native T1 values and ECV between both groups. In three athletes (9%), non-ischaemic late gadolinium enhancement (LGE) was observed. We did not find a correlation between total training volume and presence of LGE or with the ECV value. Our results show that the majority of veteran endurance athletes present with myocardial remodelling without MF as a physiological adaptive phenomenon. In the only three athletes with focal MF, the LGE pattern observed suggests an intercurrent event not related with the remodelling phenomenon

Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial.

UNLABELLED:Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. TRIAL REGISTRATION:ClinicalTrials.gov NCT01447537