Lecture 24

Question 1

What are some of the risk factors for CVD?

Answer 1

• high systolic blood pressure
• high diastolic blood pressure
• diabetes
• high total cholesterol

Question 2

Running is better for all cause mortality. What does this mean?

Answer 2

This means that for every (eg. male, female subgroup, running reduces your risk of dying from any disease

Question 3

Running is better for CVD. What does this mean?

Answer 3

This means that for every (eg. male, female subgroup, running reduces your risk of dying from CV disease

Question 4

Do you have to run fast or very far to decrease your risk of dying?

Answer 4

no
The optimum distance, frequency and speed for running to reduce your chance of dying is
<6 miles per week, 3 times a week, at a speed of 7.1-7.5 mph

Question 4

Can running too much be detrimental?

Answer 4

Yes, you’d better just not do it to keep safe

Question 5

Are you still protected from CVD if you stop running?

Answer 5

Yes so you’re fine

Question 6

What are four adaptations to aerobic training?

Answer 6

• hypertrophy in the left ventricle which leads to
• increased SV
• increased CO
• increased contractility

Question 7

What increases when the LV hypertrophies?

Answer 7

VO2 max

Question 8

As well as hypertrophy coming as a result of a physiological effect of exercise, what else can it come as an effect of?

Answer 8

pathophysiological effects of exercise

Question 9

What can come as a result of the cardiac modelling?

Answer 9

Arrhythmia

Question 10

What is cardiac remodelling?

Answer 10

This is when there is an increase in the left ventricle to such as extent that you increase your stroke volume.

Question 11

What happens in an athlete’s heart, as well as the LV getting bigger?

Answer 11

The RV also gets bigger which can lead to a pro-arrhythmic presentation

Question 12

When we are trained and then detrained, what happens to the LV hypertrophy? What happens to the right ventricle?

Answer 12

LV will start to reduce in size
The RV will persist which can lead to cardiac fibrosis and also lead to an increase in the size of the atria which may not go back to their size

Question 13

When CO is massively increased, you can get more than ________mL getting into the atria during ventricular systole to maintain the output. What does this mean?

Answer 13

200 (more than 80mLis abnormal)

This means that we are stretching the atria that is proportional the the extent and duration of the exercise

Question 14

What is periodisation and why do athletes do it?

Answer 14

This is when you have a really intense training block for 4-6 weeks and then 2-3 weeks of an easier programme so that you can get some recovery of your body

Question 15

What does the cardiac remodelling trigger?

Answer 15

atrial fibrillation

Question 16

The stress of getting more blood pumping through the heart (haemodynamic stress) and the remodelling in the atria lead to what?

Answer 16

atrial fibrillation

Question 17

How much more common is atrial fibrillation in endurance athletes compared to non-endurance athletes?

Answer 17

5.3 times more

Question 18

What drug is used to treat atrial fibrillation?

Answer 18

flecanide

Question 19

Atrial fibrillation increased progressively in cross country _______ with ________ race completion time, ________ of races completed, surrogates of training _________ & ________.

Answer 19

skiers
shorter
number
volume
duration

Question 20

If you are not letting your body recover, what can you develop?

Answer 20

atrial fibrillation

Question 21

As well as atrial fibrillation, what is more common to occur in athletes than non-athletes? Which ventricle is this more likely to occur from?

Answer 21

ventricular arrhythmias

The right ventricle

Question 22

Which hypertrophy is physiological and which is pathophysiological?

Answer 22

LV hypertrophy is physiological and RV hypertrophy is pathophysiological

Question 23

Explain how RV hypertrophy and myocardial fibrosis come about

During exercise, the ___________ artery pressure and the ________ ventricular ________ increases ______________. We are trying to get increased _________ return going through the __________ atria into the ______________ ventricle in order to push it up into the lungs to get ___________. The amount of blood that is now going into the ________ ventricle increases and the _________ stress leads to an accute injury which is why we see _________________ fibrosis and the wall stress leads to hypertrophy of the __________ ventricular wall.

Answer 23

During exercise, the pulmonary artery pressure and the right ventricular afterload increases disproportionately. We are trying to get increased venous return going through the right atria into the right ventricle in order to push it up into the lungs to get reoxygenated. The amount of blood that is now going into the right ventricle increases and the wall stress leads to an accute injury which is why we see myocardial fibrosis and the wall stress leads to hypertrophy of the right ventricular wall.

Question 24

What four factors affect the risk of arrhythmia?

Answer 24

• exercise: type of sport and intensity/duration and recovery
• environment: drugs, nutrition etc
• polygenic predisposition: multiple polymorphisms modifying genes
• personal: gender, blood pressure

Question 25

Endurance exercise most likely increases your chance of living longer but may increase your risk of some arrhythmias. True or false?

Answer 25

TRUE