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Nathan Goodyear

Exercise-induced right ventricular dysfunction and structural remodelling in endurance ... - 0 views

eurheartj.oxfordjournals.org/...998

endurance athletes training heart health injury

shared by Nathan Goodyear on 09 Jan 15 - No Cached
  • In a cohort of well-trained athletes, we demonstrated that intense endurance exercise causes an acute reduction in RV function that increases with race duration and correlates with increases in biomarkers of myocardial injury
  • no relationship between LV function and biomarker levels
  • focal gadolinium enhancement and increased RV remodelling were more prevalent in those athletes with a longer history of competitive sport, suggesting that repetitive ultra-endurance exercise may lead to more extensive RV change and possible myocardial fibrosis
  • ...22 more annotations...
  • he cardiac impact of both acute and cumulative exercise is greatest on the RV.
  • Greater reductions in RV function occurred in those athletes competing for a longer duration, suggesting that the heart has a finite capacity to maintain the increased work demands of exercise
  • cardiac injury is greatest in the least trained
  • Previous investigators have documented reductions in RV function in less trained subjects over the marathon distance
  • We enrolled elite and subelite athletes and found a significant association between fitness (VO2max) and the reduction in post-race RVEF
  • Even after many years of detraining, cardiac dilation may not completely regress in elite athletes
  • The focus on well-trained athletes may be of particular relevance, given that they perform exercise of highest intensity and duration most frequently, and, thus, may be at a greater risk of cumulative injury.
  • The lack of correlation between increases in troponin and changes in LV function seen in this study has been previously interpreted as evidence that post-exercise elevations in cardiac biomarkers are benign.
  • a significant correlation between changes in RVEF and post-race biomarker levels and this relationship was even stronger in the athletes who completed the race of longest duration, the ultra-triathlon
  • The correlations with RVEF, but not LVEF, provide further evidence of the differential effects of intense exercise on RV and LV function
  • BNP release during intense exercise is associated with greater relative increases in RV systolic pressures, but not LV pressures
  • BNP may provide a measure of both acute RV load and the resultant fatigue which occurs when this load is sustained
  • It has been demonstrated that ventricular load increases with exercise intensity and is greater for the RV than the LV,29 thus potentially explaining why the RV is more susceptible to fatigue after prolonged exercise.
  • This study demonstrates, for the first time, an association between endurance exercise of increasing duration and structural, functional, and biochemical markers of cardiac dysfunction in highly trained athletes
  • Functional abnormalities were confined to the RV and were largely reversible 1 week following the event
  • there remained a significant minority of athletes in whom there was evidence of myocardial fibrosis in the interventricular septum
  • RV abnormalities may be acquired through cumulative bouts of intense exercise and provides direction for prospective investigations aimed at elucidating whether extreme exercise may promote arrhythmias in some athletes.
  • the acute injury and chronic remodelling of the myocardium both disproportionately affect the RV and it remains possible that the two are linked.
  • focal DGE was confined to the interventricular septum and commonly at the site of RV attachment
  • emerging evidence that intense endurance exercise may be associated with an excess in arrhythmic disorders, the mechanisms for which remain unexplained
  • RVEF (and not LVEF) was reduced in athletes with complex ventricular arrhythmias when compared with healthy athletes and non-athletes without arrhythmias
  • it is premature to conclude that these changes may represent a proarrhythmic substrate
  • Nathan Goodyear on 09 Jan 15
     
    Study finds endurance racing results in reduce Right ventricle ejection fraction even in elite athletes.  This post-race RVEF reduction is associated with VO2max.
Nathan Goodyear

Endogenous Estrogens Influence Endothelial Function in Young Men - 0 views

circres.ahajournals.org/...1127.long

aromatase inhibition anastrozole arimidex men

shared by Nathan Goodyear on 25 Apr 12 - No Cached
  • Nathan Goodyear on 25 Apr 12
     
    aromatase inhibition with anastrozole, in this study, resulted in impaired flow mediated dilation.  No resultant change in inflammatory markers were seen.  Again, my problem with this study is the use of serum for the hormone evaluation.  I would bet not enough aromatase inhibition was provided.
Nathan Goodyear

Effects of Testosterone on Coronary Vasomotor Regulation in Men With Coronary Heart Dis... - 0 views

circ.ahajournals.org/...1690.full

Testosterone heart cardiovascular disease men male hormone hormones

shared by Nathan Goodyear on 03 Dec 13 - No Cached
  • Nathan Goodyear on 03 Dec 13
     
    Intracoronary Testosterone infusion of Testosterone found to increase arterial dilation and improve blood flow.
Nathan Goodyear

Acute Effects of Triiodothyronine (T3) Replacement Therapy in Patients with Chronic Hea... - 0 views

jcem.endojournals.org/...1351

T3 hypothyroid hypothyroidism cardiac disease

shared by Nathan Goodyear on 01 Feb 11 - No Cached
  • In DC patients, short-term synthetic L-T3 replacement therapy significantly improved neuroendocrine profile and ventricular performance
  • Nathan Goodyear on 01 Feb 11
     
    T3 provides significant improvement in cardiac function in those with dilated cardiomyopathy
Meredith Blige

How Can I Stop Snoring? - 1 views

Snoring is really getting in the way of my married life. Every time I sleep my wife keeps on complaining about my disturbing snores. So I often have to sleep on the couch. I often ask myself on Ho...

Snoring

started by Meredith Blige on 23 Aug 11 no follow-up yet
spineneuro

Now Awake Spinal Fusion Surgery In India - 0 views

www.briefingwire.com/...spinal-fusion-surgery-in-india

spinal fusion surgery spinal fusion surgery recovery spine fusion

shared by spineneuro on 11 May 22 - No Cached
  • spineneuro on 11 May 22
     
    Any manner that calls for access to the spinal nerves, vertebrae, and discs involves transferring the muscle tissue. Advances in minimally invasive surgery for spinal fusion surgery have supposed there is less tissue dilation and muscle dissection. Specifically, with minimally invasive spine surgical operation, small incisions can allow access for instruments or microscopic cameras, in place of the conventional long incision.
Nathan Goodyear

Testosterone Induces Dilation of Canine Coronary Conductance and Resistance Arteries In... - 0 views

circ.ahajournals.org/...2614.abstract

testosterone vasodilation androgen receptor AR androgen receptor antagonist blockade antagonist male men

shared by Nathan Goodyear on 14 May 13 - No Cached
  • Nathan Goodyear on 14 May 13
     
    another animal study, but blockade of androgen receptor, in this study, was not found to diminish the vasodilatory effect of testosterone.  This indicates that some of the vasoactive responses to testosterone are independent of AR and this has been shown in other studies ie. AR knockout mice.
Nathan Goodyear

Changes in arterial distensibility and flow-mediated dilation after acute resistance vs... - 0 views

www.ncbi.nlm.nih.gov/...20885204

resistance training exercise hypertension blood pressure lifestyle intervention

shared by Nathan Goodyear on 17 May 16 - No Cached
  • Nathan Goodyear on 17 May 16
     
    resistance exercise found to lower blood pressure.  Another feather in the cap of lifestyle intervention.  The blood pressure lowering effects with resistance training outperformed aerobic exercise.
Nathan Goodyear

Acute Anti-Ischemic Effect of Testosterone in Men With Coronary Artery Disease - 0 views

circ.ahajournals.org/...1666.full

low T low Testosterone CAD CVD testosterone artery dilation heart myocardium myocardial ischemia cardiology men male hormone hormones

shared by Nathan Goodyear on 17 Jul 12 - No Cached
  • Nathan Goodyear on 17 Jul 12
     
    Testosterone shown to have vasodilatory effect in men.  In this small study, the short course of IV testosterone reduced exercise induced heart ischemia.  This was in men with pre-existing CAD.
Nathan Goodyear

Thyroid Replacement Therapy and Heart Failure - 0 views

circ.ahajournals.org/...385.full

thyroid T3 hormone hormones cardiovascular disease heart health failure CHF MI myocardial infarction heart attack heart disease

shared by Nathan Goodyear on 24 Sep 14 - No Cached
  • A good biomarker of intracardiac TH signaling would be helpful but has not been identified. In the absence of such a marker, a rational, cautious therapeutic approach might be to restore and maintain over time biochemical euthyroidism as documented by normal circulating levels of TSH, FT4, and FT3.
  • a low-T3 state resulting from altered peripheral TH metabolism secondary to caloric restriction is associated with impaired cardiac contractility
  • Low-T3 syndrome is the central finding and defines the illness in a variety of acute and chronic severe nonthyroidal illnesses with cardiac origin, including MI, HF, and surgically treated cardiac disease.1 Low circulating levels of T3 in the absence of primary thyroid hypofunction have been found in 20% to 30% of patients with dilated cardiomyopathy.
  • ...1 more annotation...
  • FT3 levels were inversely correlated to coronary artery disease
  • Nathan Goodyear on 24 Sep 14
     
    Great review of the current understanding of thyroid hormone metabolism in cardiac tissue.  Low T3 and increased rT3 (via increased D3 activity) is CLEARLY associated with poor cardiac performance and post MI and CHF is associated with poor outcomes.  T3 is critical in cardiac remodeling and recovery post MI.  T3 is actually a vasodilatory in the coronary arteries.   Why a endocrinologist would call rT3 useless only points to their ignorance of the literature.
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