- שמור - 1 1 Echocardiographic findings in young healthy subjects before and after intense...
-
Upload
justin-crawford -
Category
Documents
-
view
214 -
download
2
Transcript of - שמור - 1 1 Echocardiographic findings in young healthy subjects before and after intense...
1-שמור- 1-שמור-
Echocardiographic Echocardiographic findings in young healthy findings in young healthy subjects before and after subjects before and after
intense physical intense physical trainingtraining? ?
Alon Grossman MD MHA, Michal Benderly Ph. DAlon Grossman MD MHA, Michal Benderly Ph. D,,
Alex Prokupetz MHA, Yuval Levy MD MHA, Ofra Kalter-Leibovici Alex Prokupetz MHA, Yuval Levy MD MHA, Ofra Kalter-Leibovici MDMD
Israel Defense Force, Medical Corps, Israel Defense Force, Medical Corps,
Israeli Air Force, aero medical center Israeli Air Force, aero medical center
2-שמור-
IntroductionIntroduction
Screening for structural heart disease is an Screening for structural heart disease is an
essential part of the screening process in essential part of the screening process in
military settings and professional athletes.military settings and professional athletes.
2 main reasons for such screening:2 main reasons for such screening:
arrhythmias or sudden deatharrhythmias or sudden death
disqualification following a costly training perioddisqualification following a costly training period
3-שמור-
IntroductionIntroduction
Modern equipment are probably more Modern equipment are probably more
accurate than those obtained in the past.accurate than those obtained in the past.
M-mode values were performed in M-mode values were performed in
relatively heterogeneous relatively heterogeneous
populations ,making it difficult to apply to populations ,making it difficult to apply to
young healthy subjects.young healthy subjects.
4-שמור-
AimsAims
To determine normal M mode To determine normal M mode
echocardographic values in healthy young echocardographic values in healthy young
adults.adults.
To evaluate whether an intense period of To evaluate whether an intense period of
physical activity influences these values.physical activity influences these values.
5-שמור-
MethodsMethods
Subjects were 17-25 year old flight academy Subjects were 17-25 year old flight academy
candidates evaluated at the IAF aero medical candidates evaluated at the IAF aero medical
center in the years 1994-2010.center in the years 1994-2010.
At the IAF aero medical center, subjects At the IAF aero medical center, subjects
undergo a screening process which includes a undergo a screening process which includes a
comprehensive physical examination and ECG. comprehensive physical examination and ECG.
6-שמור-
MethodsMethods When a morphologic cardiac abnormality is When a morphologic cardiac abnormality is
suspected based on physical or ECG suspected based on physical or ECG
findings, subjects are referred to findings, subjects are referred to
echocardiographyechocardiography (clinical group).(clinical group).
In the absence of physical or ECG findings, In the absence of physical or ECG findings,
all subjects undergo an additional non-all subjects undergo an additional non-
medical selection process following which all medical selection process following which all
undergo echocardiography undergo echocardiography (routine group).(routine group).
7-שמור-
ResultsResults
Demographic characteristics of study Demographic characteristics of study populationpopulation
Routine (3525)Clinical (3517)P valueAge (years)18.5±118.2±0.90.000
Height (cm)176.4±6.2176.7±6.50.206
Weight (kilograms)68.5±8.567.5±8.60.000
Body mass index (kg/m2)22±2.321.6±2.30.000
Systolic blood pressure123.7±12123.2±13.10.023
Diastolic blood pressure69.9±970.2±9.60.125
Heart rate72.0±13.873.9±14.60.000
8-שמור-
ResultsResults
M mode characteristics of study populationM mode characteristics of study population::
Entire cohort (7042)
'Routine' group (3525)
'Clinical' group (3517)
P value
Aortic root (mm)
28.2±2.228.5±2.127.9±2.20.000
LA diameter (mm)
33.4±3.633.3±3.333.3±3.80.113
LVED diameter (mm)
50.8±3.550.7±3.450.8±3.50.072
LVES diameter (mm)
31±3.431.2±3.330.7±3.40.000
IVS thickness (mm)
9±0.99±0.89±10.358
PW thickness (mm)
8.6±18.6±18.6±0.90.934
LVMI (grams/m2)
109.4±16.1108.8±15.8109.9±16.50.483
PASP (mmHg)26.1±4.525.2±4.427.5±4.40.000
9-שמור-
DiscussionDiscussion
Normal M mode parameters are presented, with or Normal M mode parameters are presented, with or
without a prior prolonged physical training period.without a prior prolonged physical training period.
Training period influences the echocardiographic Training period influences the echocardiographic
findings.findings.
M-mode values in young subjects is crucial M-mode values in young subjects is crucial
because most cardiac dimensions are age and because most cardiac dimensions are age and
gender -dependant.gender -dependant.
10-שמור-
DiscussionDiscussion
The study represent a cohort of The study represent a cohort of young physically young physically
active malesactive males, but not the endurance athletes, but not the endurance athletes..
Routine group Routine group underwent echocardiography underwent echocardiography
following a relatively intense period of physical following a relatively intense period of physical
activity.activity.
Clinical groupClinical group underwent the examination underwent the examination
without such an intense period preceding it. without such an intense period preceding it.
DiscussionDiscussion
11-שמור-
DiscussionDiscussion
o Routine group Routine group AO root and LVED diameter AO root and LVED diameter
were slightly were slightly increasedincreased . .
o Clinical groupClinical group LVMI and PASP were slightly LVMI and PASP were slightly
increasedincreased . .
o LA diameter, LVED diameter, IVS thickness LA diameter, LVED diameter, IVS thickness
and PW thickness were and PW thickness were similarsimilar between the between the
two groups.two groups.
12-שמור-
DiscussionDiscussion
o Increased LVES in Increased LVES in routine grouproutine group, support , support
the lack of influence of an intense period of the lack of influence of an intense period of
physical activity in non-professional physical activity in non-professional
athletes on cardiac output.athletes on cardiac output.
o The intense period of physical activity The intense period of physical activity
resulted in a temporary increase in cardiac resulted in a temporary increase in cardiac
output, thus leading to a lower PASP.output, thus leading to a lower PASP.
13-שמור-
Study limitationsStudy limitations
Only male studies.Only male studies.
No objective assessment of the amount of No objective assessment of the amount of
physical activity.physical activity.
Routine echocardiographic examination does Routine echocardiographic examination does
not include evaluation of diastolic function.not include evaluation of diastolic function.
14-שמור-
ConclusionsConclusions
Normal M mode characteristics in young healthy Normal M mode characteristics in young healthy
males may be slightly different than values males may be slightly different than values
based on heterogenous and smaller cohorts.based on heterogenous and smaller cohorts.
A short period of intense physical activity in A short period of intense physical activity in
young healthy physically active non-athlete young healthy physically active non-athlete
males leads to mild changes in cardiac males leads to mild changes in cardiac
morphology.morphology.