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Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.

ABSTRACT: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias.Prospective observational cohort study including healthy volunteers.One hundred and nine experienced marathon runners wore a portable ECG recorder during a marathon race in Berlin, Germany. Athletes underwent blood tests 2-3 days prior, directly after and 1-2 days after the race.Overall, 108 athletes (median 48 years (IQR 45-53), 24% women) completed the marathon in 249±43?min. Blinded ECG analysis revealed abnormal findings during the marathon in 18 (16.8%) athletes. Ten (9.3%) athletes had at least one episode of non-sustained ventricular tachycardia, one of whom had atrial fibrillation; eight (7.5%) individuals showed transient ST-T-segment deviations. Abnormal ECG findings were associated with advanced age (OR 1.11 per year, 95%?CI 1.01 to 1.23), while sex and cardiovascular risk profile had no impact. Directly after the race, high-sensitive troponin T was elevated in 18 (16.7%) athletes and associated with ST-T-segment deviation (OR 9.9, 95% CI 1.9 to 51.5), while age, sex and cardiovascular risk profile had no impact.ECG monitoring during a marathon is feasible. Abnormal ECG findings were present in every sixth athlete. Exercise-induced transient ST-T-segment deviations were associated with elevated high-sensitive troponin T (hsTnT) values.ClinicalTrials.gov NCT01428778; Results.

SUBMITTER: Herm J

PROVIDER: S-EPMC5629744 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.

Herm Juliane J Töpper Agnieszka A Wutzler Alexander A Kunze Claudia C Krüll Matthias M Brechtel Lars L Lock Jürgen J Fiebach Jochen B JB Heuschmann Peter U PU Haverkamp Wilhelm W Endres Matthias M Jungehulsing Gerhard Jan GJ Haeusler Karl Georg KG

BMJ open 20170803 8

<h4>Objectives</h4>While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was t ...[more]

PMID: 28775185

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Project description:Background: Properly performed training is a matter of importance for endurance athletes (EA). It allows for achieving better results and safer participation. Recently, the development of machine learning methods has been observed in sports diagnostics. Velocity at anaerobic threshold (VAT), respiratory compensation point (VRCP), and maximal velocity (Vmax) are the variables closely corresponding to endurance performance. The primary aims of this study were to find the strongest predictors of VAT, VRCP, Vmax, to derive and internally validate prediction models for males (1) and females (2) under TRIPOD guidelines, and to assess their machine learning accuracy. Materials and Methods: A total of 4001 EA (nmales = 3300, nfemales = 671; age = 35.56 ± 8.12 years; BMI = 23.66 ± 2.58 kg·m−2; VO2max = 53.20 ± 7.17 mL·min−1·kg−1) underwent treadmill cardiopulmonary exercise testing (CPET) and bioimpedance body composition analysis. XGBoost was used to select running performance predictors. Multivariable linear regression was applied to build prediction models. Ten-fold cross-validation was incorporated for accuracy evaluation during internal validation. Results: Oxygen uptake, blood lactate, pulmonary ventilation, and somatic parameters (BMI, age, and body fat percentage) showed the highest impact on velocity. For VAT R2 = 0.57 (1) and 0.62 (2), derivation RMSE = 0.909 (1); 0.828 (2), validation RMSE = 0.913 (1); 0.838 (2), derivation MAE = 0.708 (1); 0.657 (2), and validation MAE = 0.710 (1); 0.665 (2). For VRCP R2 = 0.62 (1) and 0.67 (2), derivation RMSE = 1.066 (1) and 0.964 (2), validation RMSE = 1.070 (1) and 0.978 (2), derivation MAE = 0.832 (1) and 0.752 (2), validation MAE = 0.060 (1) and 0.763 (2). For Vmax R2 = 0.57 (1) and 0.65 (2), derivation RMSE = 1.202 (1) and 1.095 (2), validation RMSE = 1.205 (1) and 1.111 (2), derivation MAE = 0.943 (1) and 0.861 (2), and validation MAE = 0.944 (1) and 0.881 (2). Conclusions: The use of machine-learning methods allows for the precise determination of predictors of both submaximal and maximal running performance. Prediction models based on selected variables are characterized by high precision and high repeatability. The results can be used to personalize training and adjust the optimal therapeutic protocol in clinical settings, with a target population of EA.

Project description:BackgroundUlnar neuropathy at the elbow is an entrapment neuropathy, while ulnar nerve dislocation might also be involved in its incidence and severity. Wheelchair marathon athletes may be at an increased risk for Ulnar Neuropathy. However, there is a paucity of research into the prevalence of Ulnar Neuropathy and ulnar nerve dislocation in this population.ObjectiveTo investigate the prevalence of ulnar neuropathy at the elbow and ulnar nerve dislocation in wheelchair marathon athletes.ParticipantsWheelchair marathon athletes (N = 38) who participated in the 2017, 2018, and 2019 Oita International Wheelchair Marathon. 2 athletes participated only one time, 36 athletes repeatedly. Data from athletes`latest assessment were used.MethodsThe day before the race, questionnaires, physical examinations, and ultrasonography were conducted to screen for Ulnar Neuropathy in both upper limbs. Ulnar nerve dislocation was confirmed by physical examination and ultrasonography.Results11 (29%) athletes were diagnosed with Ulnar Neuropathy. There were no significant differences in age, height, weight, Body Mass Index, or history of primary illness between athletes with and without Ulnar Neuropathy. In the group without Ulnar Neuropathy, 44% of athletes reported to have been engaging in other wheelchair sports, compared to 9% in the group with Ulnar Neuropathy (p = 0.037). Ulnar nerve dislocation was diagnosed in 15 (39%) athletes by ultrasonography. Out of the 14 elbows of 11 athletes diagnosed with Ulnar Neuropathy, 9 (64%) elbows had ulnar nerve dislocation.ConclusionThe prevalence of Ulnar Neuropathy in wheelchair marathon athletes was higher than previously reported in able-bodied, non-athlete individuals and lower than in non-athletes with lower limb dysfunction. Therefore, while wheelchair sports may provide some protection against Ulnar Neuropathy, this study further supports the importance of screening for Ulnar Neuropathy, as well as for ulnar nerve dislocation as a potential risk factor for the development of Ulnar Neuropathy.

Dataset Information

Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.

Publications

Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.

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