cardiology – Seite 2 – SEMS-journal

exercise physiology sports and youth preparticipation sports medicine cardiology performance

Cardiopulmonary exercise testing in children and adolescents

In cardiopulmonary exercise testing with children and adolescents, age specific protocols are used together with tools adjustable to their body dimension and development. Assessing weight, height und pubertal stage is a prerequisite for the interpretation of every test. Indications for exercise testing are airway symptoms and findings limited performance, chronic diseases, planning of trainings and scientific studies. The more tests are standardized and used on a large scale, the more normal values are available to compare individual results. However, the interindividual variability of measured values is high, depending as much from the developmental stage of the individual as from protocols, tools and the performing laboratory.

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Cardiopulmonary Exercise Testing in Sports Cardiology

Leisure-time and elite athletes often seek sports medical advice for inadequate exertional dyspnea and loss of performance. The work-up has to rule-out underlying cardiac pathologies that are associated with sudden cardiac death, although commonly the symptoms are training- and not disease-related. Cardiopulmonary exercise testing (CPET) helps to differentiate between cardiac and pulmonary causes and guides further diagnostic and therapy. This article illustrates the potential of CPET in three clinical cases.

sports medicine cardiology preparticipation

Sudden cardiac death in athletes – complete prevention requires evidence

Wenn Sportler vor laufender Kamera bei einem Wettkampf versterben, konfrontieren das die Zuschauer in besonderer Weise mit den Risiken des Sports. Die Todesfälle der Fussballer Marc-Vivien Foé am FIFA Confederations Cup 2003 und Paulo Sérgio Oliveira da Silva «Serginho» in Sao Paulo 2004, oder des kürzlich bei Paris-Roubaix verstorbenen Radrennfahrers Michael Goolaerts haben eine weltweite Welle der Betroffenheit ausgelöst. Für die Sportmedizin resultiert daraus der klare Leistungsauftrag, durch geeignete Vorsorgeuntersuchungen und Massnahmen an Wettkämpfen diese tragischen Ereignisse so gut wie möglich zu verhindern.

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Resting ECG as screening tool for Sudden Cardiac Death: PRO and CON

During our Annual meeting of the Society for Pediatric Sports Medicine in Basel 2017 one of the highlight sessions was the PRO-CON discussion about the use of a resting ECG as screening tool to detect youth at risk for sudden cardiac death. We present the two statements of the cardiology experts that were finally not so controversial as the PRO-CON may suggest. Well as often in medicine, it is the choice of each of you, how to deal with the situation. On one side we are taught to know and listen to the “evidence in medicine”, but on the other side we so often end up in our traditional professional perspective as decision maker that is not always wrong …

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Sex-specific reaction of the cardiac autonomic nervous system to different training phases in Swiss elite runners

Background: Heart rate variability (HRV) as a measure of the cardiac autonomic nervous system activity (CANA) has the potential to tailor endurance training and may contribute to the prevention of overtraining. We aimed to investigate whether there are sex differences and sex-specific reactions of the CANA to different training periods (TPs) in Swiss elite runners. Methods: Two HRV measurements (each 5 minutes supine and 5 minutes standing) per athlete were performed, the first during preparation period (PP) and the second during competition period (CP).

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EKG and sports

There was a longstanding controversy on the role of resting ECG in the preparticipation examination in athletes, as well as in children and adolescent, in leisure time or top athletes. Besides other arguments, this was due to the limited validity, to the false positive and false negative findings often followed by a thorough clinical examination. However, recent studies from different research groups yielded a significant improvement in establishing ECG criteria in athletes discriminating normal from abnormal or pathological findings in athletes.This in addition is supported and improved by a software-based ECG device considering the new Seattle criteria. These new criteria from the Seattle conference reliably discriminate normal from abnormal findings. Frequent ECG findings in athletes, especially in those engaged in endurance sports showed sinus bradycardia, AV-block and signs of left ventricular hypertrophy.

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From Cardiac Rehabilitation to Ambulatory Preventive Care: The Swiss Way

Over the last years, cardiac rehabilitation services have expanded their indication to include not just patients after myocardial infarction or surgery, but also a variety of non-acute cardiovascular disease (CVD) states like stable coronary artery disease, peripheral artery disease, neurovascular disease as well as asymptomatic patients with no history of CVD but with a constellation of cardiovascular risk factors, especially metabolic syndrome and diabetes mellitus. In 2015, 110 ambulatory cardiovascular prevention and rehabilitation programs existed in Switzerland: 57 for cardiac, 17 for peripheral artery disease and 36 for diabetes rehabilitation.

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The heart of master athletes: benefits and risks

Regular physical activity (PA) is a cornerstone of good health in the ageing population. Cardiorespiratory fitness is an important surrogate marker for survival. In primary cardiovascular disease prevention, PA is considered an effective monotherapy with beneficial effects on the cardiovascular risk profile (e.g. lipid profile, blood pressure, diabetes mellitus, body composition) and endothelial function. In secondary prevention, PA is an addition to, rather than a replacement for evidence-based medication.