Marina Djelic

Respiratory parameters in elite athletes – does sport have an influence?

INTRODUCTION Unlike large population studies about cardiovascular components and how they adapt to intensive physical activity, there is less research into the causes of enlargement of the respiratory system in athletes (e.g. vital capacity, maximum flow rates and pulmonary diffusion capacity). The purpose of this research was to study and compare pulmonary function in different types of sports and compare them with controls in order to find out which sports improve lung function the most. MATERIALS AND METHOD Pulmonary functional capacities, vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximum voluntary ventilation (MVV) of 493 top athletes belonging to 15 different sports disciplines and of 16 sedentary individuals were studied. Pulmonary function test was performed according to ATS/ERS guidelines. RESULTS Basketball, water polo players and rowers had statistically higher vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) than the healthy sedentary control individuals. Football and volleyball players had lower VC while FVC was higher in the football group compared to controls. Peak expiratory flow was lower in boxing, kayak, rugby, handball, taekwondo and tennis. The maximum voluntary ventilation (MVV) was significantly higher in water polo players and rowers. Boxers had statistically lower MVV than the controls. Players of other sports did not differ from the control group. CONCLUSION The study suggests that specific type of training used in basketball, water polo or rowing could have potential for improving pulmonary function and rehabilitation.

A novel laboratory approach for the demonstration of hemodynamic principles: the arterial blood flow reflection.

In the frame of a laboratory training course for medicine students, a new approach for laboratory exercises has been applied to teach the phenomena of circulation. The exercise program included measurements of radial artery blood flow waveform for different age groups using a noninvasive optical sensor. Arterial wave reflection was identified by measurements of blood flow waveforms before and after arterial branching. Students were able to distinguish between different waveforms of blood flow within different age groups. Furthermore, students were given the opportunity to explore the effect of aging on the elasticity of blood vessels. This exercise is an introduction to the fundamental physical laws of hemodynamics that can facilitate the learning and understanding of cardiovascular physiology to students of medicine.

United in Prevention–Electrocardiographic Screening for Chronic Obstructive Pulmonary Disease

CONFLICT OF INTEREST: NONE DECLARED Introduction P-wave abnormalities on the resting electrocardiogram have been associated with cardiovascular or pulmonary disease. So far, “Gothic” P wave and verticalization of the frontal plane axis is related to lung disease, particularly obstructive lung disease. Aim We tested if inverted P wave in AVl as a lone criteria of P wave axis >70° could be screening tool for emphysema. Material and method 1095 routine electrocardiograms (ECGs) were reviewed which yielded 478 (82,1%) ECGs with vertical P-axis in sinus rhythm. Charts were reviewed for the diagnosis of COPD and emphysema based on medical history and pulmonary function tests. Conclusion Electrocardiogram is very effective screening tool not only in cardiovascular field but in chronic obstructive pulmonary disease. The verticality of the P axis is usually immediately apparent, making electrocardiogram rapid screening test for emphysema.

Superior lung capacity in swimmers: Some questions, more answers!

BACKGROUND Physical activity has a positive effect on the function of the whole human body system. The influence of physical activity on the development of the respiratory system is still a matter for debate. Swimming is considered the sport with the most profound effect on the lungs. AIM The first aim was to determine pulmonary function and to correlate it with anthropometric features of sportsmen, represented by land- and the water-based elite athletes comparing with their sedentary counterparts; the second aim was to examine whether the training factors (frequency and amount) influence pulmonary function in swimmers, when controlled for anthropometric features. METHODS Thirty-eight elite male swimmers were matched for age and sex with two hundred and seventy-one elite football players and one hundred controls who were not involved in any routine exercise. Lung volumes were recorded by Pulmonary Function test and analyzed statistically. RESULTS AND CONCLUSION Swimmers had statistically higher values of VC, FVC, FEV1 and FEV1/FVC when compared to both the football players and the controls, as the latter two showed no in-between differences. There was significant positive correlation between age, body weight and body height and each of the above named pulmonary parameters, when presented separately for swimmers, football players and the control group. When controlled for the anthropometric features, larger lung volumes in swimmers were not influenced by training period, age at the beginning of training and weekly extent of personal training. Further comprehensive longitudinal studies are needed to confirm these observations.

Sport-specific influences on respiratory patterns in elite athletes.

ABSTRACT OBJECTIVE: To examine differences in lung function among sports that are of a similar nature and to determine which anthropometric/demographic characteristics correlate with lung volumes and flows. METHODS: This was a cross-sectional study involving elite male athletes (N = 150; mean age, 21 ± 4 years) engaging in one of four different sports, classified according to the type and intensity of exercise involved. All athletes underwent full anthropometric assessment and pulmonary function testing (spirometry). RESULTS: Across all age groups and sport types, the elite athletes showed spirometric values that were significantly higher than the reference values. We found that the values for FVC, FEV1, vital capacity, and maximal voluntary ventilation were higher in water polo players than in players of the other sports evaluated (p < 0.001). In addition, PEF was significantly higher in basketball players than in handball players (p < 0.001). Most anthropometric/demographic parameters correlated significantly with the spirometric parameters evaluated. We found that BMI correlated positively with all of the spirometric parameters evaluated (p < 0.001), the strongest of those correlations being between BMI and maximal voluntary ventilation (r = 0.46; p < 0.001). Conversely, the percentage of body fat correlated negatively with all of the spirometric parameters evaluated, correlating most significantly with FEV1 (r = −0.386; p < 0.001). CONCLUSIONS: Our results suggest that the type of sport played has a significant impact on the physiological adaptation of the respiratory system. That knowledge is particularly important when athletes present with respiratory symptoms such as dyspnea, cough, and wheezing. Because sports medicine physicians use predicted (reference) values for spirometric parameters, the risk that the severity of restrictive disease or airway obstruction will be underestimated might be greater for athletes.

Influências específicas do esporte nos padrões respiratórios em atletas de elite

Objetivo: Analisar as diferenças na função pulmonar em atletas praticantes de esportes de natureza semelhante e determinar quais características antropométricas/ demográficas se correlacionam com os fluxos e volumes pulmonares. Métodos: Estudo transversal com atletas de elite do sexo masculino (N = 150; média de idade de 21 ± 4 anos), praticantes de um dos quatro esportes investigados. Os atletas foram classificados de acordo com o tipo e a intensidade de exercício relacionado ao esporte. Todos os atletas foram submetidos a antropometria completa e testes de função pulmonar (espirometria). Resultados: Em todas as faixas etárias e tipos de esporte, os atletas de elite apresentaram valores espirométricos significativamente maiores que os valores de referência. Os valores de CVF, VEF1, capacidade vital e ventilação voluntária máxima foram maiores nos praticantes de polo aquático que nos praticantes dos outros esportes avaliados (p < 0,001). Além disso, o PFE foi significativamente maior em jogadores de basquete do que em jogadores de handebol (p < 0,001). A maioria dos parâmetros antropométricos/demográficos apresentou correlações positivas com os parâmetros espirométricos avaliados. O IMC se correlacionou positivamente com todos os parâmetros espirométricos avaliados (p < 0,001), sendo a correlação mais forte entre o IMC e a ventilação voluntária máxima (r = 0,46; p < 0,001). De forma contrária, o percentual de gordura corporal se correlacionou negativamente com todos os parâmetros espirométricos, mais significativamente com VEF1 (r = −0,386; p < 0,001). Conclusões: Nossos resultados sugerem que o tipo de esporte praticado tem um impacto significativo na adaptação fisiológica do sistema respiratório. Esse conhecimento é particularmente importante quando os atletas apresentam sintomas respiratórios tais como dispneia, tosse e sibilância. Visto que os especialistas em medicina do esporte utilizam valores previstos (de referência) para os parâmetros espirométricos, o risco de se subestimar a gravidade de doença restritiva ou obstrução de vias aéreas pode ser maior nos atletas.

Polymorphisms in ACE and ACTN3 Genes and Blood Pressure Response to Acute Exercise in Elite Male Athletes from Serbia

Physiological adaptations to various types of prolonged and intensive physical activity, as seen in elite athletes from different sports, include changes in blood pressure (BP) response to acute exercise. Also, functional polymorphisms of the angiotensin I converting enzyme (ACE) and alfa-actinin-3 (ACTN3) genes are shown to be associated with BP parameters changes, both in athletes and sedentary population. In this study, an Alu insertion (I)/deletion (D) polymorphism in ACE gene, as well as nonsense mutation in the gene encoding ACTN3 have been scored in 107 elite Serbian athletes classified according to their sporting discipline to power/sprint (short distance runners/swimmers), endurance (rowers, footballers, middle-distance swimmers) or mixed sports (water polo, handball, volleyball players). Presence of nonfunctional allele in ACTN3 is associated with significantly increased maximal systolic BP (SBPmax, p = 0.04). Athletes with Alu insertion in ACE had significantly (p = 0.006) larger decline of systolic BP after 3 minutes of recovery (SBPR3), calculated as the percentage of maximal SBP response during exercise stress testing. Concomitant presence of non-functional variant in ACTN3 gene decreased this beneficiary effect of ACE mutation on SBPR3. Long term enrollment in power/sprint sports significantly increased resting diastolic BP (DBPrest: 74 mmHg) and SBPmax (197 mmHg) and improved SBPR3 (74.8%) compared to enrolment in endurance (72 mmHg; 178 mmHg; 81.1%) and mixed sports (69 mmHg; 185 mmHg; 80.0%). Lack of the effect of genotype by sport interaction on BP parameters suggests that the long-term effects of different disciplines on BP are not mediated by these two genes.

The training type influence on male elite athletes’ ventilatory function

Background/aim To assess and compare measured ventilatory volumes (forced expiratory volume in 1 s (FEV1), peak expirium flow (PEF) and maximal voluntary ventilation (MVV)), ventilatory function capacities (forced vital capacity (FVC) and vital capacity (VC)) and FEV1/VC ratio in a sample of power and endurance elite athletes and their age-matched and sex-matched sedentary control group. Methods A cross-sectional study was applied on male elite athletes (n=470) who were classified according to the type of the predominantly performed exercise in the following way: group 1: endurance group (EG=270), group 2: power athletes group (SG=200) and group 3: sedentary control group (CG=100). The lung VC, FVC, FEV1, FEV1/FVC ratio, PEF and MVV were measured in all of the observed subjects, who were also classified with regard to body mass index (BMI) and the percentage of the body fat (BF%). Results The CG had the highest BF% value, while the endurance group had the lowest BMI and BF% value, which is significantly different from the other two groups (p<0.05). The observed values of VC, FVC and FEV1 in the EG were significantly higher than those from the other two groups (p<0.05). There were no differences concerning the observed FEV1/FVC ratio. Conclusions A continued endurance physical activity leads to adaptive changes in spirometric parameters (VC, FVC and FEV1), highlighting the fact that there is a need for specific consideration of different respiratory ‘pattern’ development in different types of sport, which also has to be further evaluated.

Is there relationship between dynamic volumes of pulmonary function and cardiac workload (maximal oxygen uptake) in young athletes

Due to the new Bologna process, the requirement to publish peer-reviewed articles prior to defending a doctoral thesis is becoming increasingly popular in Portugal, ranging from advisable to mandatory in some universities. In fact, in the Faculty of Medicine of Porto University the doctoral candidate must have a minimum of 2 articles as first author in peer-reviewed journals with impact factor. The Standards for PhD Education in Biomedicine and Health Sciences in Europe,5 even recommend that the minimum requirement for the PhD thesis in medicine and health sciences should be the equivalent of at least three ‘‘in extenso’’ papers published in internationally recognized journals. In addition the quality of the thesis will be judged by the impact factor of the journals. Again in the Faculty of Medicine of Porto University to be approved ‘‘with honours’’ the PhD candidate must have one of the following: (1) one article published as first author, in a journal within the percentile 90 from ISIS ranked list in its area; (2) two articles published as first author, in a journal within the percentile 70 from ISIS ranked list in its area; (3) four articles published as first author, in journals with an average ranking within the percentile 40 from ISIS ranked list in its area. So it seems that the trends for PhD doctorates will rise significantly in the coming years and with them good quality publications will be emerging from such a high number of PhD thesis.

History of sports medicine in east European countries

The purpose of this article is to provide a historical background of medicine, science and sports with the focus on the development of modern sports medicine in European countries, with an accent on Eastern European countries that have a long sports medicine tradition. The development of modern sports medicine began at the end of 19th and the beginning of 20th century, and it has been associated with social and cultural changes in the world of medicine, science and sports. Advanced medical knowledge, skills and practices, and the progress of scientific achievements enabled sports people to improve their performance level. Increased popularisation and commercialisation of sports have resulted from urbanization and city lifestyle, leading to the lack of physical activity and increased psychological pressure. In addition, the growing need and interest in sports and successes in professional sports have become a symbol of international recognition and