The present study compared morphological and functional parameters of the left ventricle by magnetic resonance imaging (MRI) in competitive athletes engaged in endurance and power activities and sedentary control subjects. Twenty male subjects, 7 endurance-trained athletes (ETA) (age 23.8±3.5 yr), 7 strength-trained athletes (STA) (age 22.8±4.0 yr), and 6 sedentary controls (age 24.1±2.2 yr) were studied by MRI. In the ETA group body size related left ventricular mass (rel.LVM) was significantly higher than that in the STA group (71.0±9.2 vs 57.4±15.7 g/m3). The difference between their size related left ventricular wall thickness (rel.LVWT) values (9.37±1.0 vs 8.37±1.8 mm/m) was near to the level of significance (p=0.057). Relative left ventricular internal diameter (rel.LVID) was significantly higher in the ETA group compared to the STA group (42.3±1.0 vs 40.1±2.5 mm/m, p<0.05). The muscular quotient (MQ=LVWT/LVID) of the ETA group was not significantly higher compared to the strength athletes. Relative left ventricular end-diastolic volume (LVEDV) was also higher in the ETA group than in the STA group (69.5±6.7 vs 59.9±8.2 ml/m3, p<0.05) and the controls (53.6±3.7, p<0.001). Significantly higher relative stroke volume (SV) was measured in the ETA group compared to the STA group and the controls (41.0±5.7; 32.6±6.9; 32.0±3.2 ml/m3). According to the present data, the strongest impact on LV cavity size and wall thickness is caused by long-term high intensity endurance training. Intense strength training does not necessarily induce wall thickening.
Based on the data collected by KNOLL Hungary Ltd. in Hungary in 1999, 37% of the adult population is overweight while 23% is obese. Inappropriate diet containing excess calories and physical inactivity are responsible for these statistical values. In their former studies, the authors investigated the effects of different stages of obesity on the cardiovascular system, and have verified that even moderate obesity elicits pathological geometric and functional changes in the heart. In the present study, effect of a half-year-long life-style modification program on the morphologic and functional characteristics of the heart was investigated in twenty-one obese women. Life-style modification contained a diet with reduced energy uptake (1000–1300 Cal/day) and a regular physical training of minimum 3–4 hours weekly. By the end of the sixth month the weight loss was 5.1 kg (5.9%) on an average. There was a marked reduction in cardiac dimensions measured by echocardiography, with a very slight, non-significant decrease in left ventricular internal diameter, and a marked, significant reduction in the left ventricular wall thickness. Decrease of the left ventricular muscle mass exceeded the decrease of body weight. A marked elevation was found in the E/A quotient that reflected a definite improvement in diastolic function. Results indicate that physical training programs have a favourable effect on the echocardiographic parameters, therefore the process is reversible even without a pharmacological intervention.
Authors:E. Jóna, G. Rudinská, M. Sapietová, V. Pavlík, M. Drábik, and S. Mojumdar
Interactions of 3-R-and 2-R pyridine (R=CH3, Cl, NH2) with Ni(II)-exchanged montmorillonite have been studied. Thermal and X-ray analyses indicate that pyridine derivatives are
intercalated into the interlayer spaces of montmorillonite. Infrared spectral data shown that the Lewis and/or Br�nsted type
of interactions of pyridine derivatives is connected with different steric and inductive effects of the substituents (R) on
the pyridine ring. The alkylpyridines increase the electron density on the donor nitrogen atom and support the coordination
to the central atom. The halogen substituents have a negative inductive effect (–I), so that those ligands show a lower basicity
and weaker σ-bonding properties than pyridine and also the lower possibility of the coordination.
Authors:E. Jóna, P. Šimon, K. Nemčeková, V. Pavlík, G. Rudinská, and E. Rudinská
Three glasses with the composition of Li2O⋅2SiO2
(b) and Li2O⋅2SiO2⋅0.1TiO2
(c) were prepared and the relationship between structural and kinetic parameters
of thermal stability vs. crystallization has been studied by X-ray diffraction,
IR spectra and thermal analysis. The XRD patterns proved the presence of lithium
metasilicate as a primary crystalline phase which subsequently transformed
to lithium disilicate where the transformation is supported by the presence
of TiO2. The order of thermal stability vs.
crystallization of studied glass systems based on the results of XRD is (a)<(b)<(c). The same order was obtained from the values of
activation energy. It has been shown that the values of activation energies
obtained from the Ozawa and Kissinger methods are equivalent and that the
Kissinger method should be used to obtain the activation energy from the dependence
of the maximum peak temperature on the heating rate. It has been discussed
that the activation energy represents only an incomplete description of the
kinetics of the crystallization process.
Authors:L Petridis, Zs Kneffel, Zs Kispéter, P Horváth, Z Sidó, and G Pavlik
The purpose of this study was to examine the effects of different sport activities on cardiac adaptation. Echocardiographic data of 137 athletes and 21 non-athletes were measured and compared in two age groups 15-16 and 17-18 years of age. Athletes belonged into three groups according to their sports activity (endurance events, power athletes, ball game players). The observed variables were related to body size by indices in which the exponents of the numerator and the denominator were matched. Left ventricular hypertrophy was manifest in all athletic groups. Power athletes had the largest mean left ventricular wall thickness (LVWTd) in both age groups. In the older age group differences between the athletic groups were smaller, but the endurance and power athletes had significantly higher wall thickness. Left ventricular internal diameter (LVIDd) was the largest in the endurance athletes, while mean relative muscle mass (LVMM) was the largest in the power athletes. LVMM of the older endurance athletes was significantly larger. Muscular quotient (MQ) was the highest in the endurance athletes; in the 17-18-year group there was no inter-event difference. Bradycardia was most manifest in the endurance athletes and ball game players, power athletes had higher resting heart rates than non-athletic subjects. It can be inferred that endurance training induces firstly an enlargement of the left ventricle what is then followed by an increase of muscle mass. In the studied functional and regulatory parameters no difference was found between the athletic and non-athletic groups.
Authors:Zsolt Komka, E. Bosnyák, E. Trájer, A. Protzner, Zs. Major, G. Pavlik, M. Tóth, and A. Udvardy
Sudden cardiac death (SCD) of athletes usually occurs during warm-up or shortly after training. At this point sympathetic tone is still elevated but oxygen demand does not differ from resting levels. It is supposed not to have a primarily ischemic origin but most likely relates to repolarization abnormalities which can be associated with intracellular cAMP level caused by increased sympathetic tone. The mediators of sympathetic nervous system are the catecholamines (epinephrin, norepinephrin). Measuring QT-dispersion can show the repolarization's inhomogeneity. 27 elite soccer players, 28 triathletes and 29 non-trained control person took part in our study. It was recorded cardiac ultrasound, an ECG and taken blood before and after exercise. We found significantly higher QT-dispersion and catecholamines in soccer players compared to the triathletes and the controls. However the soccer players did not show larger athlete's heart than the triathletes. After exercise the increased repolarization inhomogeneity persisted in soccer players, but in triathletes it decreased. Increased sympathetic tone in athletes can enhance arrhythmia propensity. Our data may explain why the soccer players die of sudden cardiac death most commonly in Europe.
Authors:Zs Major, R Kirschner, N Medvegy, K Kiss, GM Török, G Pavlik, G Simonyi, Zs Komka, and M Medvegy
Early repolarization in the anterior ECG leads (ERV2–4) is considered to be a sign of right ventricular (RV) remodeling, but its etiology and importance are unclear.
A total of 243 top-level endurance-trained athletes (ETA; 183 men and 60 women, weekly training hours: 15–20) and 120 leisure-time athletes (LTA; 71 men and 49 women, weekly training hours: 5–6) were investigated. The ERV2–4 sign was evaluated concerning type of sport, gender, transthoracic echocardiographic parameters, and ECG changes, which can indicate elevated RV systolic pressure [left atrium enlargement (LAE), right atrium enlargement (RAE), RV conduction defect (RVcd)].
Stroke volume and left ventricular mass were higher in ETAs vs. LTAs in both genders (p < 0.01). Prevalence of the ERV2–4 sign was significantly higher in men than in women [p = 0.000, odds ratio (OR) = 36.4] and in ETAs than in LTAs (p = 0.000). The highest ERV2–4 prevalence appeared in the most highly trained triathlonists and canoe and kayak paddlers (OR = 13.8 and 5.2, respectively). Within the ETA group, the post-exercise LAE, RAE, and RVcd changes developed more frequently in cases with than without ERV2–4 (LAE: men: p < 0.05, females: p < 0.005; RAE: men: p < 0.05, females: p < 0.005; RVcd: N.S.). These post-exercise appearing LAE, RAE, and RVcd are associated with the ERV2–4 sign (OR = 4.0, 3.7, and 3.8, respectively).
According to these results, ERV2–4 develops mainly in male ETAs due to long-lasting and repeated endurance training. The ERV2–4 sign indicates RV’s adaptation to maintain higher compensatory pulmonary pressure and flow during exercise but its danger regarding malignant arrhythmias is unclear.
Authors:Imre Rurik, Péter Apor, Mária Barna, István Barna, J. Róbert Bedros, Péter Kempler, Éva Martos, Elemér Mohos, Gábor Pavlik, Gyula †Pados, József Pucsok, Gábor Simonyi, and György Bíró
Összefoglaló. Az elhízás és következményes megbetegedései fontos
népegészségügyi problémát jelentenek hazánkban is. Kezelése komoly szakmai
kihívás, ugyanakkor prevenciója eredményesebb lehet. Az elhízott betegekkel
leggyakrabban találkozó háziorvosok, más szakorvosok és egészségügyi szakemberek
részéről nagy igény van egy viszonylag rövid, áttekinthető, naprakész
gyakorlatias útmutatóra. A különböző orvosszakmai társaságokban tevékenykedő,
évtizedes szakmai tapasztalatokkal rendelkező szerzők összefoglalják
tudományosan megalapozott, bizonyítékokon alapuló ismereteiket. Az elhízás
kezelését lépcsőzetesen célszerű megkezdeni, előtte felmérve a beteg
motivációját, általános állapotát, lehetőségeit. A szerzők leírják az
energiaszükséglet meghatározásával, az étrenddel és a fizikai aktivitás
megtervezésével kapcsolatos alapvető szempontokat. Felsorolják a hazánkban
elérhető gyógyszereket és metabolikus sebészeti beavatkozásokat, az életmódi
támogatás igényét. Az elhízás megelőzésében az élet első 1000 napjának
táplálkozása, a későbbiekben a szülői minta a meghatározó. Sok kihasználatlan
lehetősége van a háziorvosok, a lakóközösségek, az állami szervek koordinált
együttműködésének, helyi kezdeményezéseknek. Az elhízás betegségként való
meghatározása egyaránt igényel egészségpolitikai és kormányzati támogatást, az
elhízottak ellátására szakosodott multidiszciplináris centrumok számának és
kompetenciájának növelését. Orv Hetil. 2021; 162(9): 323–335.
Summary. Obesity and related morbidities have a high public health
impact in Hungary. The treatment is a challenge, but prevention seems more
effective. General practitioners, other specialists and health care
professionals who are treating obese persons require short, summarized, updated
and practical guideline. Hungarian medical professionals of different scientific
societies, having decennial practices, are summarizing their evidence-based
knowledge. Obesity management requires step by step approach, evaluating
previously the general health condition, motivation and options of the patients.
The measurement of energy requirement, planning of diet and physical activities,
available surgical methods and medications are described in detail with life
style and mental support needed. The most important period in the prevention of
obesity is the first 1000 days from conception. Other significant factors are
the life style habits of the parents. Proper obesity prevention requires better
coordination of primary health care, community and governmental activities.
Obesity should be defined as morbidity, therefore stronger governmental support
and more health-policy initiatives are needed, beside increasing number and
developing of multidisciplinary centres. Orv Hetil. 2021; 162(9): 323–335.