Differences according to gender in reporting physical symptoms during echocardiographic screening in healthy teenage athletes

Movahed, Mohammad Reza; Martinez, Adolfo; Morrell, Holly E. R.; Greaves, Seaneen; Greaves, Jeff; Sattur, Sudhakar

doi:10.1017/s104795110800214x

Cited by 5 publications

(7 citation statements)

References 27 publications

(45 reference statements)

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“…Another possible explanation for the sex distribution among POTS patients could be related to women being more likely to report symptoms of orthostasis than men. It has been previously observed that, regardless of age or physical conditioning, women generally report more physical symptoms than men, a phenomenon not associated with psychological disorders (2,12,20). Although the sex differences we report may point to previously unidentified contributors to HR responses to tilt, further studies with larger sample sizes will be needed to further address this issue.…”

Section: Variability In Hemodynamic Responses To Tiltmentioning

confidence: 57%

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Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt

Ramírez-Marrero¹,

Charkoudian²,

Hart³

et al. 2008

Journal of Applied Physiology

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MJ. Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt. J Appl Physiol 105: 1448 -1453, 2008. First published August 28, 2008 doi:10.1152/japplphysiol.90796.2008.-Orthostatic stress such as head-up tilt (HUT) elicits a wide range of heart rate (HR) and arterial pressure (AP) responses among healthy individuals. In this study, we evaluated cardiovascular dynamics in healthy subjects with different HR responses to HUT, but without autonomic dysfunction. We measured AP (brachial artery) and HR (ECG) during 5 min of 60°H UT in 76 healthy normotensive individuals. We then chose individuals on the basis of the extremes of HR responses to HUT (high ϭ ⌬HR Ն 20 beats/min, and low ϭ ⌬HR Յ 10 beats/min; n ϭ 15 per group). Peak HR during HUT was 87 Ϯ 10 beats/min in the high and 69 Ϯ 14 beats/min in the low group (P Ͻ 0.05). High HR responders had lower systolic pressure at baseline (121 Ϯ 9 vs. 129 Ϯ 11 mmHg, P Ͻ 0.05) and during HUT (120 Ϯ 10 vs. 131 Ϯ 13 mmHg, P Ͻ 0.05), and higher plasma norepinephrine (NE) response to HUT (⌬NE: 156.9 Ϯ 17.8 vs. 89.0 Ϯ 17.2 pg/ml; P Ͻ 0.05). ⌬NE during HUT was also significantly correlated with ⌬HR when all 76 subjects were included in a regression analysis (r ϭ 0.39; P Ͻ 0.001). Pulse pressure was lower during HUT in high HR responders compared with low HR responders (45 Ϯ 1 vs. 55 Ϯ 2 mmHg, P Ͻ 0.05). High HR responders also had larger fluctuations in systolic and pulse pressure during HUT (coefficient of variation ϭ 10.7 Ϯ 0.7 vs. 5.7 Ϯ 0.3%; 7.9 Ϯ 0.5 vs. 4.1 Ϯ 0.4%, respectively, P Ͻ 0.05). Sex distribution was different between groups (high: 5 women, 10 men; low: 10 women, 5 men). Higher HR with lower AP during HUT is consistent with normal baroreflex mechanisms of integration. Although interindividual variability appears to be a fundamental part of cardiovascular regulation, the mechanisms of these differences and the sex discrepancy requires further investigation. baroreflex; arterial pressure; orthostasis; sympathetic nervous system; norepinephrine NORMAL cardiovascular dynamics during orthostasis include the displacement of blood from the central circulation into the lower extremities, reduction of venous return, and decreased stroke volume and cardiac output (10). Arterial pressure (AP) is usually not significantly altered during orthostasis in normal individuals due to rapid baroreflex-mediated increases in heart rate (HR) and sympathetic vasoconstrictor nerve activity (5, 22), resulting in increased total peripheral resistance via norepinephrine (NE) secretion (8, 10). These well-synchronized cardiovascular events prevent major abrupt changes in AP and the development of symptoms during orthostatic stress. In autonomic disorders such as the postural tachycardia syndrome (POTS), patients experience exaggerated increases in HR responses (Ն30 beats/min) to head-up tilt (HUT). These patients also present with symptoms of heart palpitations, dizziness, and headaches in the upright posture even when AP appears well maintained although less st...

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Section: Variability In Hemodynamic Responses To Tiltmentioning

confidence: 57%

“…Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt. J Appl Physiol 105: 1448 -1453, 2008. First published August 28, 2008 doi:10.1152/japplphysiol.90796.2008.-Orthostatic stress such as head-up tilt (HUT) elicits a wide range of heart rate (HR) and arterial pressure (AP) responses among healthy individuals.…”

mentioning

confidence: 99%

Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt

Ramírez-Marrero¹,

Charkoudian²,

Hart³

et al. 2008

Journal of Applied Physiology

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“…Other studies have confirmed the association between female gender and undiagnosed breathing problems [9,21]. Female athletes report physical symptoms, such as shortness of breath, nearly twice as often as their male counterparts in another study [22].…”

Section: Discussionmentioning

confidence: 71%

Exercise-induced dyspnea is a problem among the general adolescent population

Johansson

Norlander

Hedenström

et al. 2014

Respiratory Medicine

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“…Special questions on dentition and risk factors were included in addition to general issues (20 questions). Physical activity : This topic is often a source of misunderstandings 16,17 as some heart defects do not impose restrictions on the child (i.e., ventricular septal defect after surgery, atrial septal defect, and pulmonary stenosis after catheter intervention) while others (i.e., Fontan circulation and aortic root replacement in Marfan syndrome) are associated with severe limitations. In small children overprotection may lead to later developmental impairment 18,19 . However, the effects of overprotection in early life have not yet been sufficiently explored.…”

Section: Methodsmentioning

confidence: 99%

“…In small children overprotection may lead to later developmental impairment. 18,19 However, the effects of overprotection in early life have not yet been sufficiently explored. Due to the importance of this topic the questionnaire contains six questions on exercise.…”

Section: Signs and Symptoms Of The Child's Individual Chdmentioning

confidence: 99%

Knowledge of Congenital Heart Disease of Mothers: Presentation of a Standardized Questionnaire and First Results

Löbel¹,

Geyer²,

Grosser³

et al. 2011

Congenital Heart Disease

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Differences according to gender in reporting physical symptoms during echocardiographic screening in healthy teenage athletes

Abstract: There is a high prevalence of reporting physical symptoms in young healthy athletes without any relation to cardiac abnormalities. Young female athletes report physical symptoms nearly twice as often as their male counterparts.

Cited by 5 publications

References 27 publications

Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt

Cardiovascular dynamics in healthy subjects with differing heart rate responses to tilt

Exercise-induced dyspnea is a problem among the general adolescent population

Knowledge of Congenital Heart Disease of Mothers: Presentation of a Standardized Questionnaire and First Results

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