Browsing by Author "Nedeljkovic, I. (55927577700)"

An enhanced risk of undesirable events has been described in individuals who take part in mainly high intensity physical activities. Underlying cardiac disorders are the most common cause of sudden death during sports activities. Left ventricular remodeling is associated with a long-term athletic training. Echocardiography is an easy, non-invasive and efficient way to the precise distinction between these exercise-induced changes, called " physiological" hypertrophy, that revert after detraining, and those of cardiac disorders or "pathological" hypertrophy. The identification of a cardiac disease in an athlete usually leads to his disqualification in an attempt to reduce the risk. On the other hand, a false diagnosis of a cardiac disease in an athlete may also lead to disqualification, thus depriving him of the various benefits from sports participation. Pronounced left ventricular dilatation and hypertrophy should always be suspected for underlying cardiac disease. Physiological left ventricular remodeling is associated with normal systolic and diastolic left ventricle function. Both global and regional left ventricle diastolic function should be evaluated. New echocardiographic techniques (tissue Doppler imaging, strain rate) have revealed "super - diastolic" left ventricle function in athletes, adding the new quality in differential diagnosis od athlete's heart syndrome. © 2011 Akadémiai Kiadó, Budapest.

Introduction: The association between secundum atrial septal defect and mitral valve disease has been recognized for many years. Case presentation: A female patient was admitted to the hospital with sudden onset of congestive heart failure symptoms. Diagnostic methods revealed an enlarged right ventricle, secundum atrial septal defect, tricuspid regurgitation and pulmonary hypertension, mitral regurgitation with chordal rupture of the mitral valve. Treatment involved replacement of the mitral valve with a mechanical prosthesis and closure of the atrial septal defect with sutures. Conclusion: In a patient with asymptomatic atrial septal defect, a sudden increase in left to right cardiac shunting due to acute mitral regurgitation precipitated right heart failure.

Aim. The aim of this study was to extend the analysis of the systolic right ventricular (RV) adaptation to combined endurance and strength training, to assess the utility of tissue Doppler imaging in detecting the degree of these changes and to find independent RV predictors of the maximal functional capacity. Methods. Standard Doppler and TDI were used to assess cardiac parameters at rest in 37 elite male athletes (16 wrestlers, 21 water polo players) and 20 sedentary subjects of similar age. Progressive maximal test on treadmill was used to assess VO2max The obtained parameters were adjusted for HR, FFM, and BSA. Results. Wrestlers showed higher VO 2max than controls, but lesser than water polo players. RV diameter was larger in athletes. Right atrial pressure (RVE/e) was higher in water polo players than in other groups. Systolic function assessed by tricuspid annular plane systolic excursion (TAPSE) and RVs' was the highest in wrestlers. Global RV systolic parameters myocardial performance index (MPI) and preejection time/ ejection time index (PET/ET) were similar. On multivariate analysis systolic parameters were independent predictors of VO2max only in wrestlers: RVs' (beta=3.18, P=0.001) and RV ET (beta=2.32, P=0.001). RVE/e correlated with RVs' (r=-0.57, P=0.000). TAPSE correlated with RV ET (r=0.32, P=0.015) and RVs (beta=0.28, P=0.033). Conclusion. Systolic function assessed by TAPSE and RVs has more improved in less endurance athletes. RVs and TDI ejection time predict VO2max in wrestlers, and possibly in other athletes with lesser right atrial pressure. TDI enables quantifying RV adaptation degree in athletes, but complementary to M-mode technique.

Aim. The aim of this study was to extend the analysis of the systolic right ventricular (RV) adaptation to combined endurance and strength training, to assess the utility of tissue Doppler imaging in detecting the degree of these changes and to find independent RV predictors of the maximal functional capacity. Methods. Standard Doppler and TDI were used to assess cardiac parameters at rest in 37 elite male athletes (16 wrestlers, 21 water polo players) and 20 sedentary subjects of similar age. Progressive maximal test on treadmill was used to assess VO2max The obtained parameters were adjusted for HR, FFM, and BSA. Results. Wrestlers showed higher VO 2max than controls, but lesser than water polo players. RV diameter was larger in athletes. Right atrial pressure (RVE/e) was higher in water polo players than in other groups. Systolic function assessed by tricuspid annular plane systolic excursion (TAPSE) and RVs' was the highest in wrestlers. Global RV systolic parameters myocardial performance index (MPI) and preejection time/ ejection time index (PET/ET) were similar. On multivariate analysis systolic parameters were independent predictors of VO2max only in wrestlers: RVs' (beta=3.18, P=0.001) and RV ET (beta=2.32, P=0.001). RVE/e correlated with RVs' (r=-0.57, P=0.000). TAPSE correlated with RV ET (r=0.32, P=0.015) and RVs (beta=0.28, P=0.033). Conclusion. Systolic function assessed by TAPSE and RVs has more improved in less endurance athletes. RVs and TDI ejection time predict VO2max in wrestlers, and possibly in other athletes with lesser right atrial pressure. TDI enables quantifying RV adaptation degree in athletes, but complementary to M-mode technique.