Absence of cardiac damage induced by long-term intensive endurance exercise training: A cardiac magnetic resonance and exercise echocardiography analysis in masters athletes

Objectives: It is under debate whether the long-term practice of intensive endurance exercise induces chronic cardiac damage such as myocardial fibrosis and ventricle contractile dysfunction. Multimodality analysis was performed to evaluate myocardial damage induced by long term intensive endurance training in master athletes. Methods: Thirty-three asymptomatic endurance master athletes (47 ± 6 year-old, 9,6 ± 1,7 h training/week for 26 ± 6 years), were compared to 18 sedentary controls (49 ± 7 year-old). They underwent a CMR protocol including 4 chambers morphological and late gadolinium-enhancement (LGE) analysis, left (LV) and right ventricular (RV) T1 mapping and calculation of cardiac extracellular volume (ECV). A maximal exercise echocardiography with left and right ventricular longitudinal global strain (LGS) analysis was performed. Cardiac biomarkers of fibrosis (high sensitive cardiac Troponin T, N-Terminal pro brain natriuretic peptide, N-terminal propeptide of procollagen type I and N-terminal propeptide of procollagen type III) were analysed. Results: Athletes had larger left and right atrial volume, LV and RV end diastolic volume and increased LV and RV mass compared to controls. LGE was not found in athletes. Native T1 values of LV and RV were not significantly different in athletes compared with controls. ECV was normal in both groups (21,5%± 1,6% [18.3 – 23%] in athletes, 22%± 2,2% [18.5 – 27%] in controls). LV and RV peak exercise LGS values were higher in athletes. Cardiac biomarkers levels were normal. Conclusion: Despite significant physiological cardiac remodelling, consistent with previous descriptions of athlete's heart, there was no evidence of myocardial fibrosis or exercise left or right ventricular dysfunction or cardiac fibrosis in endurance athletes. Our results are not supporting the hypothesis of deleterious cardiac effects induced by long term and intensive endurance exercise training

279 Woman and marathon: impact on the heart?

During the 2008 “Marathon du Medoc”, 67 healthy voluntary female runners (47±7 years) had clinical, ECG and biological evaluation before the race, at the arrival (T2) and 3 hours after (T3). Mean NT-pro-BNP value significantly increased from 31 to 117 ng/L at T2 and was at 126 ng/l at T3. Nineteen (28%) had values >150 ng/l without clinical or ECG signs. CTnIc increased transiently (ranging from 0.20 to 1,64 ng/l) in 4 racers and decrease after. One had an initial inflammatory syndrome and finished exhausted. 3 another runners had moderate and transient creatinine increase. None had ECG abnormality. Marathon has no heart impact in woman who respects advice of regular training, correct hydratation and running without fever

Significance of the Identification in the Horn of Africa of an Exceptionally Deep Branching <em>Mycobacterium tuberculosis</em> Clade

<div><p>Molecular and phylogeographic studies have led to the definition within the <em>Mycobacterium tuberculosis</em> complex (MTBC) of a number of geotypes and ecotypes showing a preferential geographic location or host preference. The MTBC is thought to have emerged in Africa, most likely the Horn of Africa, and to have spread worldwide with human migrations. Under this assumption, there is a possibility that unknown deep branching lineages are present in this region. We genotyped by spoligotyping and multiple locus variable number of tandem repeats (VNTR) analysis (MLVA) 435 MTBC isolates recovered from patients. Four hundred and eleven isolates were collected in the Republic of Djibouti over a 12 year period, with the other 24 isolates originating from neighbouring countries. All major <em>M. tuberculosis</em> lineages were identified, with only two <em>M. africanum</em> and one <em>M. bovis</em> isolates. Upon comparison with typing data of worldwide origin we observed that several isolates showed clustering characteristics compatible with new deep branching. Whole genome sequencing (WGS) of seven isolates and comparison with available WGS data from 38 genomes distributed in the different lineages confirms the identification of ancestral nodes for several clades and most importantly of one new lineage, here referred to as lineage 7. Investigation of specific deletions confirms the novelty of this lineage, and analysis of its precise phylogenetic position indicates that the other three superlineages constituting the MTBC emerged independently but within a relatively short timeframe from the Horn of Africa. The availability of such strains compared to the predominant lineages and sharing very ancient ancestry will open new avenues for identifying some of the genetic factors responsible for the success of the modern lineages. Additional deep branching lineages may be readily and efficiently identified by large-scale MLVA screening of isolates from sub-Saharan African countries followed by WGS analysis of a few selected isolates.</p> </div

Minimum spanning tree based upon whole genome SNP analysis.

<p>The tree is based upon 13382 SNPs. The tree size is 13463, i.e. it contains approximately 0.6% of homoplasia. The length of each branch expressed in SNP numbers is indicated. The red star marks the approximate branching point of the <i>M. canettii</i> lineage according to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone.0052841-Namouchi1" target="_blank">[19]</a>. The two blue stars indicate the positions of newly defined ancestral nodes within the two Africanum lineages 5 and 6.</p

Minimum spanning tree representation of the clustering of 435 isolates from the Horn of Africa.

<p>The color code reflects the main MLVA clusters. Lineages (1 to 6) and some sublineages (CDC1551, H37Rv, …) are indicated. The size of the circles reflects the number of isolates with an identical genotype. Branches longer than 10 are not drawn. The main outlier candidates are arrowed (red arrows: isolates selected for sequencing).</p

Genetic distances within an outbreak.

<p>Investigation of 32 <i>M. tuberculosis</i> outbreak isolates sampled in 2005–2008 and 3 historical isolates sampled in 1995–2001 from the investigation by <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone.0052841-Gardy1" target="_blank">[52]</a>. The sequence reads were analysed together with the other genomes using the same SNP selection rules. The three historical samples collected a few years earlier in the same region are numbered in blue. Twenty-two outbreak samples corresponding to the central node show an identical genotype. Nine samples numbered in red are one to four SNPs away from the central node in a star like pattern. MT0001 the most likely index case belongs to the central node. Each branch length (number of SNPs) is indicated in black, logarithmic scaling is used. The proportion of the different mutations detected among historical and outbreak isolates is shown using the same color code as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone-0052841-g007" target="_blank">Figure 7</a>.</p