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The correlation of blood pressure changes and cardiac morpho- functional restructuring in young athletes

https://doi.org/10.21508/1027-4065-2020-65-2-62-70

Abstract

A steady increase in the number of young sportsmen predetermines the relevance of studying the nature and severity of cardiovascular system remodeling in young athletes, including the development of arterial hypertension (AH) and left ventricular myocardial hypertrophy (LVHM).

Objective. To study the prevalence and nature of arterial hypertension (AH) and its associations with signs of cardiovascular remodeling in young athletes taking into account pathogenetic relationship and genetic determination.

Characteristics of children and methods. The study included 80 young athletes (including 42 boys, average age 14,5±1,54 years), divided into 4 groups depending on the kind of sports (1 – cyclic, 2 – game, 3 – complex coordination, 4 – power). We used the following research methods: “office” (i.e. during visit to the doctor) measurement of blood pressure, electrocardiography, echocardiography, color Doppler scanning of the neck vessels, daily monitoring of blood pressure, bicycle ergometry, genetic testing using the original panel with 448 markers.

Results. An increase in blood pressure at rest was detected in 2,5% of children engaged in power sports, an insufficient decrease at night – in 16,3% of children, and an excessive reaction of blood pressure to dosed physical activity – in 25% of children. These changes correlated with signs of sports remodeling, in particular with the formation of left ventricular myocardial hypertrophy, which was diagnosed in 7–12,5% of athletes. According to the results of genetic testing, pronounced polymorphism in the NO synthase gene at three loci (rs10918594, rs12143842, rs16847548) was associated with a reorganization of the cardiovascular system in 45% of athletes.

Conclusion. Violation of the circadian profile of blood pressure and excessive reaction to physical activity demonstrate 7,5–25% of young athletes, especially those involved in complex coordination and power sports. These changes were associated with the severity of sports remodeling and determined by a genetic predisposition.

About the Authors

L. A. Balykova
Ogarev National Research Mordovia State University
Russian Federation


A. S. Glotov
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation


S. A. Ivyansky
Ogarev National Research Mordovia State University
Russian Federation


A. A Shirokova
Ogarev National Research Mordovia State University
Russian Federation


O. M. Soldatov
Children’s Republican Clinical Hospital
Russian Federation


I. A. Grishutkina
Ogarev National Research Mordovia State University
Russian Federation


K. A. Varlashina
Ogarev National Research Mordovia State University
Russian Federation


A. V. Krasnopolskaya
Ogarev National Research Mordovia State University
Russian Federation


References

1. Trachsel L.D., Carlen F., Brugger N., Seiler C., Wilhelm M. Masked hypertension and cardiac remodeling in middle-aged endurance athletes. J Hypertens 2015; 33(6):1276–1283. DOI: 10.1097/HJH.0000000000000558

2. Lin J., Wang F., Weiner R.B., DeLuca J.R., Wasfy M.M., Berkstresser B. et al. Blood Pressure and LV Remodeling Among American-Style Football Players. JACC Cardiovasc Imaging 2016; 9(12):1367–1376. DOI: 10.1016/j.jcmg.2016.07.013

3. Małek Ł.A., Czajkowska A., Mróz A., Witek K., Barczuk-Falęcka M., Nowicki D. et al. Left ventricular hypertrophy in middle-aged endurance athletes: is it blood pressure related? Blood Press Monit 2019; 24:(3): 110–113. DOI: 10.1097/ MBP.0000000000000377

4. Pressler A., Jähnig A., Halle M., Haller B. Blood pressure response to maximal dynamic exercise testing in an athletic population. J Hypertens 2018; 36(9):1803–1809. DOI: 10.1097/ HJH.0000000000001791

5. Zmijewski P., Cięszczyk P., Ahmetov I.I., Gronek P., Lulińska-Kuklik E., Dornowski M. et al. The NOS3 G894T (rs1799983) and -786T/C (rs2070744) polymorphisms are associated with elite swimmer status. Biol Sport 2018; 35(4): 313–319. DOI: 10.5114/biolsport.2018.76528

6. Harmon K., Asif I., Maleszewski J., Owens J.S., Prutkin D.M., Salerno J.C. et al. Incidence and Etiology of Sudden Cardiac Arrest and Death in High School Athletes in the United States. Mayo Clin Proc 2016; 91(11): 1493–1502. DOI: 10.1016/j.mayocp.2016.07.021

7. Elliott P.M., Anastasakis A., Borger M.A., Borggrefe M., Cecchi F., Charron P. et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: The Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 2014; 35(39): 2733–2779. DOI: 10.1093/ eurheartj/ehu284

8. Carbone A., d’Andrea A., Riegler L., Scarafile R., Pezzullo E., Martone F. et al. Cardiac damage in athlete’s heart: When the “supernormal” heart fails! World J Cardiol 2017; 9(6): 470– 480. DOI: 10.4330/wjc.v9.i6.470

9. Смоленский А.В., Михайлова А.В., Татаринова А.Ю. Артериальная гипертония у спортсменов и ремоделирование спортивного сердца. Международный журнал сердца и сосудистых заболеваний 2017; 14(5): 36–45. [Smolenskij A.V., Mihajlova A.V., Tatarinova A.Yu. Hypertension in athletes and remodeling of a sports heart. Mezhdunarodnyi zhurnal serdtsa i sosudistykh zabolevanii (International Journal of Heart and Vascular Diseases) 2017; 14(5): 36–45. (in Russ.)]

10. Barbitoff Y.A., Bezdvornykh I.V., Polev D.E., Serebryakova E.A., Glotov A.S., Glotov O.S., Predeus A.V. Catching hidden variation: Systematic correction of reference minor allele annotation in clinical variant calling. Genetics in Medicine 2018; 20(3): 360–364. DOI: 10.1038/gim.2017.168

11. Гуревич Т.С., Матвеев С.В., Кириллов Д.А. Ранние эхокардиографические признаки перенапряжения сердечнососудистой системы у спортсменов (диагностика, реабилитация). Лечебная физкультура и спортивная медицина 2012; 6: 15–19. [Gurevich T.S., Matveev S.V., Kirillov D.A. Early echocardiographic signs of cardiovascular overstrain in athletes (diagnosis, rehabilitation). Lechebnaya fizkul’tura i sportivnaya meditsina 2012; 6: 15–19. (in Russ.)]

12. Макаров Л.М., Федина Н.Н., Комолятова В.Н., Беспроточный Д.А., Киселева И.И. Нормативные параметры артериального давления у юных элитных спортсменов при пробе с дозированной физической нагрузкой. Педиатрия. Журнал имени Г.Н. Сперанского 2015; 94(2): 102–104. [Makarov L.M., Fedina N.N., Komoljatova V.N., Besprotochnyj D.A., Kiseljova I.I. Normal values of blood pressure in young elite athletes during an exercise test. Pediatriya. Zhurnal im. G.N. Speranskogo (Pediatria. Journal named after G.N. Speransky) 2015; 94:(2): 102–104 (in Russ.)]

13. Широкова A.А., Балыкова Л.А., Ивянский С.А., Варлашина К.Н., Солдатов Ю.О., Казанкина B.С. и др. Возможности суточного мониторирования артериального давления и пробы с дозированной физической нагрузкой в диагностике артериальной гипертензии у юных атлетов. Практическая медицина 2019; 17(2): 74–79. [Shirokova A.A., Balykova L.A., Ivjanskij S.A., Varlashina K.N., Soldatov Yu.O., Kazankina V.S. et al. 24-hour monitoring of blood pressure and exercise tests in the diagnosis of arterial hypertension in young athletes. Prakticheskaya meditsina 2019; 17(2): 74–79. (in Russ.)

14. Балыкова Л.А., Ивянский С.А., Урзяева А.Н. Метаболическая терапия в детской спортивной кардиологии. Сердце и спорт у детей и подростков: проблемы «взаимодействия». Под ред. Е.А. Дягтеревой. М., 2011; 199–213. [Balykova L.A., Ivyansky S.A., Urzyaeva A.N. Metabolic therapy in pediatric sports cardiology. Heart and sport in children and adolescents: problems of “interaction”. E.A. Dyagtereva (ed.). Moscow, 2011; 199–213. (in Russ.)]

15. Brady T.M. Obesity-Related Hypertension in Children. Front Pediatr. 2017; 5: 197. DOI: 10.3389/fped.2017.00197

16. Балыкова Л.А., Ивянский С.А., Щекина Н.В., Михеева К.Н., Урзяева А.Н. Артериальная гипертензия у детейспортсменов. Российский вестник перинатологии и педиатрии 2015; 60(6): 48–54. [Balykova L.A., Ivjanskij S.A., Shhekina N.V., Miheeva K.N., Urzjaeva A.N. Arterial hypertension in young athletes. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2015; 60(6): 48–54 (in Russ.)]

17. Rowland T., American College of Sports Medicine, North American Society for Pediatric Exercise Medicine (NASPEM). Cardiopulmonary Exercise Testing in Children and Adolescents. United States of America, 2017; 65–79.

18. Caselli S., Serdoz A., Mango F., Lemme E., Vaquer Seguì A., Milan A. et al. High blood pressure response to exercise predicts future development of hypertension in young athletes. Eur Heart J 2019; 40(1): 62–68. DOI: 10.1093/eurheartj/ ehy810

19. Leischik R., Spelsberg N., Niggemann H., Dworrak B., Tiroch K. Exercise-induced arterial hypertension – an independent factor for hypertrophy and a ticking clock for cardiac fatigue or atrial fibrillation in athletes? F1000Res 2014; 3: 105. DOI: 10.12688/f1000research.4001.1

20. Lovic D., Narayan P., Pittaras A., Faselis Ch., Doumas M., Kokkinos P. et al. Left ventricular hypertrophy in athletes and hypertensive patients. J Clin Hypertens (Greenwich) 2017; 19(4): 413–417. DOI: 10.1111/jch.12977

21. Wang X., Chandrashekar K., Wang L., Lai E.Y., Wei J., Zhang G. et al. Inhibition of Nitric Oxide Synthase 1 Induces Salt-Sensitive Hypertension in Nitric Oxide Synthase 1α Knockout and Wild-Type Mice. Hypertension 2016; 67(4): 792–799. DOI: 10.1161/HYPERTENSIONAHA.115.07032

22. Gomez A.T., Prutkin J.M., Rao A.L. Evaluation and Management of Athletes With Long QT Syndrome. Sports Health 2016; 8(6): 527–535. DOI: 10.1177/1941738116660294


Review

For citations:


Balykova L.A., Glotov A.S., Ivyansky S.A., Shirokova A.A., Soldatov O.M., Grishutkina I.A., Varlashina K.A., Krasnopolskaya A.V. The correlation of blood pressure changes and cardiac morpho- functional restructuring in young athletes. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2020;65(2):62-70. (In Russ.) https://doi.org/10.21508/1027-4065-2020-65-2-62-70

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ISSN 1027-4065 (Print)
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