Gábor Pavlik

Marathon running alters the DNA base excision repair in human skeletal muscle.

Reactive oxygen and nitrogen species generated either as products of aerobic metabolism or as a consequence of environmental mutagens, oxidatively modify DNA. Formamidopyrimidine-DNA glycosylase (Fpg) and endonuclease III (endo III) or their functional mammalian homologues repair 7,8-dihydro-8-oxoguanine (8-oxoG) and damaged pyrimidines, respectively, to curb the deleterious effects of oxidative DNA alterations. A single bout of physical exercise can induce oxidative DNA damage. However, its effect on the activity of repair enzymes is not known. Here we report that the activity of a functional homolog of Fpg, human 8-oxoG DNA glycosylase (hOGG1), is increased significantly, as measured by the excision of 32P labeled damaged oligonucleotide, in human skeletal muscle after a marathon race. The AP site repair enzyme did not change significantly. Despite the large individual differences among the six subjects measured, data suggest that a single-bout of aerobic exercise increases the activity of hOGG1 which is responsible for the excision of 8-oxoG. The up-regulation of DNA repair enzymes might be an important part of the regular exercise induced adaptation process.

Super-marathon race increases serum and urinary nitrotyrosine and carbonyl levels

Background In normal conditions, proteins are not present in the urine, however, exercise of long duration could result in proteinurea. Increased levels of reactive oxygen and nitrogen species (RONS) are formed during exhaustive physical exercise and causes alterations to cellular proteins.

Echocardiographic characteristics of male athletes of different age

Two dimensionally guided M mode and Doppler echocardiographic data for 578 male subjects (106 non-athletic and 472 athletes) were analysed from two aspects: (a) in the young adult category (19–30 years of age), competitors in different groups of sports were studied; (b) in the different age groups (children, 10–14 years; adolescent juniors, 15–18 years; young adults, 19–30 years; adults, 31–44 years; older adults 45–60 years), data for athletes and non-athletes were compared. Morphological variables were related to body size by indices in which the exponents of the numerator and denominator were matched. Morphological signs of athletic heart were most consistently evident in the left ventricular muscle mass: in the young adult group, the highest values were seen in the endurance athletes, followed by the ball game players, sprinters/jumpers, and power athletes. A thicker muscular wall was the main reason for this hypertrophy. Internal diameter was only increased in the endurance athletes, and this increase was more evident in the younger groups. The E/A quotient (ratio of peak velocity during early and late diastole) indicated more effective diastolic function in the endurance athletes. The values for E/A quotient also suggested that regular physical activity at an older age may protect against age dependent impairment of diastolic function.

Non-invasive imaging in the diagnosis of acute viral myocarditis

Autopsy series of consecutive cases have demonstrated an incidence of myocarditis at approximately 1–10%; on the contrary, myocarditis is seriously underdiagnosed clinically. In a traditional view, the gold standard has been myocardial biopsy. However, it is generally specific but invasive and less sensitive, mostly because of the focal nature of the disease. Thus, non-invasive approaches to detect myocarditis are necessary. The traditional diagnostic tools are electrocardiography, laboratory values, especially troponin T or I, creatine kinase and echocardiography. For a long period, nuclear technique with indium-111 antimyosin antibody has been used as a diagnostic approach. In the last years, the use of this technique has declined because of radiation exposure and 48-h delay in obtaining imaging after injection to prevent blood pool effect. Thus, a non-invasive diagnostic approach without radiation and online image availability has been awaited. Cardiac magnetic resonance imaging has these promising characteristics. With this technique, it is possible to analyse inflammation, oedema and necrosis in addition to functional parameters such as left ventricular function, regional wall motion and dimensions. Thus, cardiovascular magnetic resonance imaging has emerged as the most important imaging tool in the diagnostic procedure and the review focus on this field. But there are also advances in echocardiography and computer tomography, which are described in detail.Autopsy series of consecutive cases have demonstrated an incidence of myocarditis at approximately 1–10%; on the contrary, myocarditis is seriously underdiagnosed clinically. In a traditional view, the gold standard has been myocardial biopsy. However, it is generally specific but invasive and less sensitive, mostly because of the focal nature of the disease. Thus, non-invasive approaches to detect myocarditis are necessary. The traditional diagnostic tools are electrocardiography, laboratory values, especially troponin T or I, creatine kinase and echocardiography. For a long period, nuclear technique with indium-111 antimyosin antibody has been used as a diagnostic approach. In the last years, the use of this technique has declined because of radiation exposure and 48-h delay in obtaining imaging after injection to prevent blood pool effect. Thus, a non-invasive diagnostic approach without radiation and online image availability has been awaited. Cardiac magnetic resonance imaging has these promising characteristics. With this technique, it is possible to analyse inflammation, oedema and necrosis in addition to functional parameters such as left ventricular function, regional wall motion and dimensions. Thus, cardiovascular magnetic resonance imaging has emerged as the most important imaging tool in the diagnostic procedure and the review focus on this field. But there are also advances in echocardiography and computer tomography, which are described in detail.

Echocardiographic data in hungarian top-level water polo players.

PURPOSE Water polo is a sport involving extremely intense exercise training that might be expected to result in major cardiac adaptations. The purpose of our study was to evaluate cardiac size, determine VO(2max) of top-level water polo players, and compare the findings with those of other top-level athletes. METHODS Treadmill VO(2max) and 2D guided M-mode and Doppler echocardiographic data were obtained on players (N = 15) of the Olympic champion (Sydney 2000) Hungarian team and compared with data of Hungarian sedentary subjects (N = 19), and top-level endurance (N = 16) and power athletes (N = 15). RESULTS Aerobic power of the water polo players was significantly lower (57.8 +/- 12.3 mL.min(-1).kg(-1)) than that of endurance athletes (70.9 +/- 8.9), higher than sedentary controls (49.7 +/- 4.3), and not different from that of power athletes (50.5 +/- 6.0). Body size related mean left ventricular wall thickness (LVWT/BSA(0.5)) was the highest in the water polo players (16.8 +/- 1.5 vs 15.9 +/- 1.1 in endurance, 14.5 +/- 1.0 in the power athletes, and 12.8 +/- 0.6 mm.m in nonathletes). Left ventricular muscle mass (LVMM/BSA(1.5)) was higher in the water polo players (115 +/- 22 g.m) than in power athletes (86 +/- 12) or nonathletes (74 +/- 9) and similar to that of endurance athletes (112 +/- 15). Resting heart rate was lower in the water polo players (55.1 +/- 9.7 beats.m(-1)) and endurance athletes (59.3 +/- 10.6) than in power athletes (66.0 +/- 16.1) or in sedentary subjects (72.9 +/- 10.9). CONCLUSIONS Results indicate that high-level water polo results in marked cardiac hypertrophy that involves predominantly an increase of wall thickness, and in a VO(2max) lower than that of endurance athletes but similar to those of basketball and soccer players.

The athlete’s heart Part I (Review)

Importance of the athletes heart has been arisen in the last decades. Consequences of the sedentary way of life are the most threatening through the impairments of the cardiovascular system. Endurance performance is mostly limited by the characteristics of the athletes heart. Sudden death of the athletes is always associated with cardiac disorders. Main characteristics of the athletes heart can be divided into morphologic, functional and regulatory ones. The main morphologic characteristics are the physiologic left ventricular (LV) hypertrophy and a richer coronary capillary network. The functional adaptation contains a better systolic and diastolic function, modified metabolism and electric characteristics. The most easily detected modification is the better LV diastolic function. Adaptation of the cardiac regulation is manifested mostly by a lower heart rate (HR). Summarizing: the athletes heart is an enlarged but otherwise normal heart characterized by a low heart rate, an increased pumping capacity, and a greater ability to deliver oxygen to skeletal muscle.

Gastroesophageal reflux disease: work-related disease?

Background: An occupation-related susceptibility of professional singers to experience gastroesophageal reflux has been suggested. Aims: To investigate the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers, wind players, glassblowers and water polo players in comparison with a sample of general population. Subjects and Methods: A total of 202 professional opera choristers from well-known choirs in different Hungarian regions, 71 professional wind players, 43 glassblowers, 54 water polo players were identified and 115 control subjects were compared prospectively. Reflux symptoms together with selected individual characteristics and lifestyle habits were investigated in study groups through a reflux questionnaire. Results:Professional opera choristers reported a statistically significantly higher prevalence of heartburn, regurgitation and hoarseness than control subjects (p < 0.001). Among professional wind players, heartburn and regurgitation were significantly more frequent compared with controls (p < 0.05 and p < 0.01, respectively). Glassblowers reported a significantly higher prevalence of acid regurgitation in comparison with controls (p < 0.01). The prevalence of reflux symptoms in water polo players was similar to that of controls. In opera choristers, wind players and glassblowers, reflux symptoms appeared to be significantly correlated with the cumulative lifetime duration of professional singing, playing and working activity, respectively (p < 0.05). Conclusions: Our results demonstrate that professional opera choristers, professional wind players and glassblowers have a higher prevalence of reflux symptoms compared with control subjects. Gastroesophageal reflux in these professions should be considered as a work-related disorder that may have an impact on quality of life and may negatively interfere with professional performance.

Cardiovagal autonomic function in sedentary and trained offspring of hypertensive parents

In young normotensive subjects, parental hypertension is associated with stiffening of the carotid artery and reduction in cardiovagal outflow and baroreflex gain. In subjects without parental hypertension regular exercise training was found to attenuate age‐related reduction in carotid compliance and baroreflex gain. The aim of the present study was to test the hypothesis that regular physical activity is associated with better parameters of carotid artery elasticity, increased cardiovagal outflow and higher baroreflex gain in normotensive offspring of hypertensive parents. We studied 98 healthy, sedentary or endurance exercise trained subjects (49 men, 18–27 years of age) with or without family history of hypertension (FH+ and FH−, respectively) in a cross‐sectional design. In the sedentary group spontaneous baroreflex indices (sequence method and spectral techniques) were lower in FH+ subjects than in their FH− peers, while in trained subjects these indices were not different between FH+ and FH−. Furthermore, in the FH+ group trained subjects had higher baroreflex indices than their sedentary peers, while in the FH− group no significant differences were found. Carotid compliance and distensibility coefficient (echo‐tracking ultrasound and applanation tonometry) were not different in FH− sedentary and trained subjects, but were higher in FH+ trained subjects as compared to their sedentary peers. Significant but modest relationships were found between spontaneous baroreflex indices and carotid artery elastic parameters across all subjects. Our present data indicate that in subjects with parental hypertension aerobic exercise training is associated with higher levels of cardiovagal outflow and baroreflex gain, which finding, however, is not explained by greater elasticity of the carotid artery.

Cardiac Involvement After Respiratory Tract Viral Infection : Detection by Cardiac Magnetic Resonance

The purpose of our study was to investigate whether cardiovascular magnetic resonance imaging can detect early myocardial tissue edema as a first step in the development of myocarditis. Methods We examined 36 consecutive patients who were presented with symptoms of fatigue, weakness, and/or palpitations after respiratory tract infection but normal left ventricular function and compared these patients with 21 consecutive controls without acute symptoms. Electrocardiogram-triggered, T2-weighted, fast spin echo triple-inversion recovery sequences were performed in all patients. Results We found a significant difference between patients with suspected myocarditis and controls in global myocardial signal intensity. The ratio of global myocardial signal intensity/muscle signal intensity was 2.4 ± 0.3 in patients and 1.9 ± 0.3 in controls, which was highly significant (P < 0.001). Conclusions Patients with symptoms of fatigue, weakness, and/or palpitations after respiratory tract infection showed an elevated signal intensity of the myocardium, indicating edematous tissue, which may be the first step in the development of myocarditis.

Increased Short-Term Variability of the QT Interval in Professional Soccer Players: Possible Implications for Arrhythmia Prediction

Background Sudden cardiac death in competitive athletes is rare but it is significantly more frequent than in the normal population. The exact cause is seldom established and is mostly attributed to ventricular fibrillation. Myocardial hypertrophy and slow heart rate, both characteristic changes in top athletes in response to physical conditioning, could be associated with increased propensity for ventricular arrhythmias. We investigated conventional ECG parameters and temporal short-term beat-to-beat variability of repolarization (STVQT), a presumptive novel parameter for arrhythmia prediction, in professional soccer players. Methods Five-minute 12-lead electrocardiograms were recorded from professional soccer players (n = 76, all males, age 22.0±0.61 years) and age-matched healthy volunteers who do not participate in competitive sports (n = 76, all males, age 22.0±0.54 years). The ECGs were digitized and evaluated off-line. The temporal instability of beat-to-beat heart rate and repolarization were characterized by the calculation of short-term variability of the RR and QT intervals. Results Heart rate was significantly lower in professional soccer players at rest (61±1.2 vs. 72±1.5/min in controls). The QT interval was prolonged in players at rest (419±3.1 vs. 390±3.6 in controls, p<0.001). QTc was significantly longer in players compared to controls calculated with Fridericia and Hodges correction formulas. Importantly, STVQT was significantly higher in players both at rest and immediately after the game compared to controls (4.8±0.14 and 4.3±0.14 vs. 3.5±0.10 ms, both p<0.001, respectively). Conclusions STVQT is significantly higher in professional soccer players compared to age-matched controls, however, further studies are needed to relate this finding to increased arrhythmia propensity in this population.