Medical support of children’s sports: Topical problems

The paper discusses the most topical issues of medical support of children and adolescents engaged in physical exercises and sports. Much attention is paid to different views on the etiology, pathogenesis, diagnosis, and principles of therapy of pathological transformation of the heart in child athletes. The problem of sudden cardiac death in sports and the possibility of a relationship between connective tissue dysplasia and its development are touched upon. Electrocardiographic and morphological criteria for cardiac maladaptation in athletes are discussed. The problem of early and accessible diagnosis and Russia’s tactics for the diagnosis of health changes in athletes and approaches to their prevention and treatment are covered. Different ways to prevent the pathological transformation of the cardiovascular system in athletes and sudden cardiac death as its extreme manifestation are discussed

Hypertension in child athletes

The paper reviews literature data on the prevalence and causes of hypertension in athletes. It considers different points of view on the impact of regular physical activities on blood pressure levels. It also describes available diagnostic approaches to identifying and treating higher blood pressure in children and adolescents going in for sports. The authors give the results of their observations identifying hypertension and its risk factors in young athletes. They show it necessary to apply an integrated approach to diagnosing this condition in sports, by making 24-hour blood pressure monitoring, echocardiography, and exercise testing. Standards for a normal blood pressure response to graduated exercise have been developed in 12 -16-year-old athletes. Based on their own findings and Russian and foreign experience, the authors present an original algorithm for following up young athletes with hypertension

The correlation of blood pressure changes and cardiac morpho- functional restructuring in young athletes

A steady increase in the number of young sportsmen predetermines the relevance of studying the nature and severity of cardiovascular system remodeling in young athletes, including the development of arterial hypertension (AH) and left ventricular myocardial hypertrophy (LVHM).Objective. To study the prevalence and nature of arterial hypertension (AH) and its associations with signs of cardiovascular remodeling in young athletes taking into account pathogenetic relationship and genetic determination.Characteristics of children and methods. The study included 80 young athletes (including 42 boys, average age 14,5±1,54 years), divided into 4 groups depending on the kind of sports (1 – cyclic, 2 – game, 3 – complex coordination, 4 – power). We used the following research methods: “office” (i.e. during visit to the doctor) measurement of blood pressure, electrocardiography, echocardiography, color Doppler scanning of the neck vessels, daily monitoring of blood pressure, bicycle ergometry, genetic testing using the original panel with 448 markers.Results. An increase in blood pressure at rest was detected in 2,5% of children engaged in power sports, an insufficient decrease at night – in 16,3% of children, and an excessive reaction of blood pressure to dosed physical activity – in 25% of children. These changes correlated with signs of sports remodeling, in particular with the formation of left ventricular myocardial hypertrophy, which was diagnosed in 7–12,5% of athletes. According to the results of genetic testing, pronounced polymorphism in the NO synthase gene at three loci (rs10918594, rs12143842, rs16847548) was associated with a reorganization of the cardiovascular system in 45% of athletes.Conclusion. Violation of the circadian profile of blood pressure and excessive reaction to physical activity demonstrate 7,5–25% of young athletes, especially those involved in complex coordination and power sports. These changes were associated with the severity of sports remodeling and determined by a genetic predisposition