Role of exercise stress test in master athletes

Abstract

Background: The effectiveness of cardiovascular screening in minimising the risk of athletic field deaths in master athletes is not known. Objective: To evaluate the prevalence and clinical significance of ST segment depression during a stress test in asymptomatic apparently healthy elderly athletes. Methods: A total of 113 male subjects aged over 60 were studied (79 trained and 34 sedentary); 88 of them (62 trained and 26 sedentary) were followed up for four years (mean 2.16 years for athletes, 1.26 years for sedentary subjects), with a resting 12 lead electrocardiogram (ECG), symptom limited exercise ECG on a cycle ergometer, echocardiography, and 24 hour ECG Holter monitoring. Results: A significant ST segment depression at peak exercise was detected in one athlete at the first evaluation. A further case was seen during the follow up period in a previously ''negative'' athlete. Both were asymptomatic, and single photon emission tomography and/or stress echocardiography were negative for myocardial ischaemia. The athletes remained symptom-free during the period of the study. One athlete died during the follow up for coronary artery disease: he showed polymorphous ventricular tachycardia during both the exercise test and Holter monitoring, but no significant ST segment depression. Conclusions: The finding of false positive ST segment depression in elderly athletes, although still not fully understood, may be related to the physiological cardiac remodelling induced by regular training. Thus athletes with exercise induced ST segment depression, with no associated symptoms and/or complex ventricular arrhythmias, and no adverse findings at second level cardiological testing, should be considered free from coronary disease and safe to continue athletic training.

Comparative Analysis of Competitive State Anxiety Among Team Sport and Individual Sport Athletes in Iran

“…Pigozzi, showed the skill level of athletes is an important factor for control of competitive state anxiety [7]. The research [8] confirmed that elite athletes have lower levels of competitive state anxiety than non-elite athletes.…”

Biventricular myocardial adaptation to different training protocols in competitive master athletes

“…Although the beneficial effect of physical exercise on cardiovascular function and health is well known, the lack of studies in older subjects raises some questions about cardiovascular function and the nature of LVH after longterm practice of competitive sports [10][11][12][13]. Regarding diastolic function, the pattern of mitral inflow has been considered an extremely important parameter to identify the nature of hypertrophy.…”

“…Although standard Doppler echocardiography has been widely used to distinguish the athlete's heart from pathologic LVH, few echocardiographic reports have defined changes in the right ventricle induced by training and related them to changes induced by LV adaptation [4][5][6]. In addition, conflicting data have been reported about the nature (physiologic vs. pathologic) of LVH in master athletes and veterans [10][11][12][13].…”

Electrocardiographic exercise stress testing: An update beyond the ST segment

“…Such false positive results may be associated with conditions that lead to increased left ventricular mass, pressure and/or volume overload, or greater oxygen requirements, resulting in a supply demand imbalance which can decrease blood flow to the subendocardium [26]. In addition, certain clinical situations, medications, sympathetic nerve stimulation, electrolyte abnormalities, or metabolic changes may affect the STsegment at increasing heart rates resulting in false positive results [22,[27][28][29].…”