Author Topic: Athletes and Heart Attacks  (Read 542 times)

0 Members and 1 Guest are viewing this topic.

Offline Friendly Angel

  • Frequent Poster
  • ******
  • Posts: 3984
  • Post count reset to zero in both forum apocalypses
Athletes and Heart Attacks
« on: April 09, 2018, 01:36:39 PM »
Very young professional cyclist died in the Paris-Roubaix race yesterday.  Heart attack, crash, died in hospital before the race was over.  Recently a college basketball player too.

1.  Drugs?  -  PEDs cause thick blood - used to be a big problem.  Seems unlikely because even though the drugs are certainly still there, the testing is good enough that the dosage is probably not lethal... it's definitely happened in the past though.  https://www.theguardian.com/sport/2003/dec/08/cycling.cycling

2.  Congenital defect?  -  I conjecture that this could go unnoticed in a young healthy person, until too late.

3.  Athlete's heart?  -  This is something that mostly affects older endurance athletes - guys that have been running or cycling at a relatively high level for many years.
Amend and resubmit.

Online Harry Black

  • International Man of Mystery
  • Global Moderator
  • Poster of Extraordinary Magnitude
  • *****
  • Posts: 13232
Re: Athletes and Heart Attacks
« Reply #1 on: April 09, 2018, 03:21:03 PM »
Is athletes heart a real thing or is it just what we call it when a person we would not expect has a heart attack?
If for example, heart rhythm can just go weird at random, statistically inevitable points, we would notice far more when this happens to an athlete than a person who may have had other factors that could be causative, even if it wasnt the cause in a particular case.

If anyone has or can point to any expert knowledge on this, I would be very interested!

Online 2397

  • Well Established
  • *****
  • Posts: 1441
Re: Athletes and Heart Attacks
« Reply #2 on: April 09, 2018, 03:38:27 PM »
Should know more about his particular case after the autopsy.

In general, exercise probably helps people not die from heart attacks. But athletes can push themselves much harder than the typical fit person.

Here's an article that talks about heart problems and screening for cyclists.

Quote
Athletes’ hearts experience very high and very low (resting) rates on a daily basis. “This back and forth,” writes John Mandrola, “may create the milieu that triggers premature beats, which could then induce AF.”

Just like a cyclist’s leg muscles, their heart is forced to get stronger, adapt to the demands placed on it, and may sustain inflammation and injury resulting in scarring — studies have observed raised markers of inflammation in endurance athletes.

It is known that scarring can disrupt the flow of electrical signals in the heart, creating another potential trigger point for arrhythmic beats.

Offline Friendly Angel

  • Frequent Poster
  • ******
  • Posts: 3984
  • Post count reset to zero in both forum apocalypses
Re: Athletes and Heart Attacks
« Reply #3 on: April 09, 2018, 03:52:46 PM »
Is athletes heart a real thing or is it just what we call it when a person we would not expect has a heart attack?

It's a real thing, not really well-understood.

The official name is "Athletic Heart Syndrome".

Mayo says the cause for young athlete heart attacks is usually a congenital defect:
https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/in-depth/sudden-death/art-20047571
Amend and resubmit.

Offline Physicity

  • Off to a Start
  • *
  • Posts: 24
Re: Athletes and Heart Attacks
« Reply #4 on: April 14, 2018, 03:41:19 AM »
It's be interesting to know how much higher the rate of heart problem is in athletes versus non athletes of the same age.    I was doing a marathon and saw a young guy, 21 or 22, being resuscitate on the route, the post race report said he'd had a cardiac arrest.  But that's just one person out of how many tens of thousands I've seen at marathons.

Some endurance runners get idiopathic cardiomyopathy, where one of the chambers is much larger than normal and the walls get thinned, which can cause fatalities.  But you need to be doing serious mileage frequently over an extended period. Last I heard, no one is sure of how common the same defect is in non endurance athletes, so whether it is caused by the endurance activities or simply aggravated by them is unclear.

Online Harry Black

  • International Man of Mystery
  • Global Moderator
  • Poster of Extraordinary Magnitude
  • *****
  • Posts: 13232
Re: Athletes and Heart Attacks
« Reply #5 on: April 14, 2018, 07:45:08 AM »
It's be interesting to know how much higher the rate of heart problem is in athletes versus non athletes of the same age.    I was doing a marathon and saw a young guy, 21 or 22, being resuscitate on the route, the post race report said he'd had a cardiac arrest.  But that's just one person out of how many tens of thousands I've seen at marathons.

Some endurance runners get idiopathic cardiomyopathy, where one of the chambers is much larger than normal and the walls get thinned, which can cause fatalities.  But you need to be doing serious mileage frequently over an extended period. Last I heard, no one is sure of how common the same defect is in non endurance athletes, so whether it is caused by the endurance activities or simply aggravated by them is unclear.
I know alot of young men who have burned the candle at both ends, putting in incredible work on their bodies but still drinking heavily and taking coke.

I wonder how much that factors into what we see with some.

Offline lonely moa

  • A rather tough old bird.
  • Stopped Going Outside
  • *******
  • Posts: 4475
Re: Athletes and Heart Attacks
« Reply #6 on: April 14, 2018, 03:59:53 PM »
All the time.  Endurance athletics has it's Dark Side. 



Micah True, Jim Fixx, the list goes on.  Mark Sisson and Brad Kearns (both former professional Ironman athletes) have talked about their dead colleagues a few times on their podcast.
"Our minds are not quite designed to understand how the world works, but, rather, to get out of trouble rapidly an have progeny."  Nassim Nicholas Taleb

Offline Alex Simmons

  • Seasoned Contributor
  • ****
  • Posts: 716
Re: Athletes and Heart Attacks
« Reply #7 on: April 15, 2018, 12:29:15 AM »
Very young professional cyclist died in the Paris-Roubaix race yesterday.  Heart attack, crash, died in hospital before the race was over.  Recently a college basketball player too.

1.  Drugs?  -  PEDs cause thick blood - used to be a big problem.  Seems unlikely because even though the drugs are certainly still there, the testing is good enough that the dosage is probably not lethal... it's definitely happened in the past though.  https://www.theguardian.com/sport/2003/dec/08/cycling.cycling

2.  Congenital defect?  -  I conjecture that this could go unnoticed in a young healthy person, until too late.

3.  Athlete's heart?  -  This is something that mostly affects older endurance athletes - guys that have been running or cycling at a relatively high level for many years.

Re drugs, specifically EPO, the evidence this actually caused many athlete deaths back in EPO's heyday is almost non-existent. There are various stories, usually all from the same unattributed and unverified sources, anecdotes, 4th hand comments etc but there is little if any hard evidence that such stories are actually true. Such stories were likely made up in a crummy attempt to scare athletes away from using EPO.

Yes, elite athletic training can and does push to body to levels that are not normal and if you have a pre-existing condition or pre-disposition for heart problems then such strain is going to increase the risks.

Offline xenu

  • Frequent Poster
  • ******
  • Posts: 3324
  • Chicago Blackhawks 2010,13,15 Stanley Cup Champion
Re: Athletes and Heart Attacks
« Reply #8 on: April 15, 2018, 07:10:28 AM »
Would training with EPO help you? Then for the race not use it?  Would this alow the muscles to get stronger by being able to train harder?
"In the beginning the Universe was created. This has made a lot of people very angry and has been widely regarded as a bad move."
Douglas Adams

Offline bimble

  • Keeps Priorities Straight
  • ***
  • Posts: 465
Re: Athletes and Heart Attacks
« Reply #9 on: April 15, 2018, 04:06:43 PM »
Would training with EPO help you? Then for the race not use it?  Would this alow the muscles to get stronger by being able to train harder?

A BBC reporter did a test on that back in 2015 to test the new 'passport' system that WADA had been introducing - http://www.bbc.co.uk/news/uk-scotland-32983932

Quote
It would last for 14 weeks and have three phases. I would have my blood taken once a week and sent off to a lab for analysis. A doctor would monitor my health throughout.

    Baseline - weeks 1-3: establish what my "normal" blood levels are. Performance test at end of week 3
    Loading - weeks 4-10: undergo a programme of between 2-3 micro-dose injections of EPO per week. Each injection would be supervised. Performance test at end of week 10
    Washout - weeks 11-14: critical phase of the experiment, when I stop taking EPO and the passport is meant to be most effective.

The plan was to collect 14 blood analyses and have them put through the biological passport software to see if it would catch me.

The short of it was he got a 7% bump in performance, but the EPO wasn't picked up by the system.

Offline Friendly Angel

  • Frequent Poster
  • ******
  • Posts: 3984
  • Post count reset to zero in both forum apocalypses
Re: Athletes and Heart Attacks
« Reply #10 on: April 16, 2018, 06:48:47 PM »

Re drugs, specifically EPO, the evidence this actually caused many athlete deaths back in EPO's heyday is almost non-existent. There are various stories, usually all from the same unattributed and unverified sources, anecdotes, 4th hand comments etc but there is little if any hard evidence that such stories are actually true. Such stories were likely made up in a crummy attempt to scare athletes away from using EPO.


OK maybe but you have to agree it's highly suspicious. I'm not sure what evidence we might expect - there were quite a few deaths of young Euro riders in the early days of EPO; my link said 20 in four years (87-90). 

I don't think they even had an EPO test back then.  What would an autopsy show that would indicate EPO were the cause?  I'm pretty sure they didn't check hematocrits - maybe they will for Goolaert.

At least some of them died in their sleep - that is extra highly suspicious.  A congenital defect is more likely to reveal itself under stress.  And these guys all get EKGs as part of their physicals so anything obvious like an arrhythmia would show up there.
Amend and resubmit.

Offline Alex Simmons

  • Seasoned Contributor
  • ****
  • Posts: 716
Re: Athletes and Heart Attacks
« Reply #11 on: April 17, 2018, 06:01:51 PM »

Re drugs, specifically EPO, the evidence this actually caused many athlete deaths back in EPO's heyday is almost non-existent. There are various stories, usually all from the same unattributed and unverified sources, anecdotes, 4th hand comments etc but there is little if any hard evidence that such stories are actually true. Such stories were likely made up in a crummy attempt to scare athletes away from using EPO.


OK maybe but you have to agree it's highly suspicious. I'm not sure what evidence we might expect - there were quite a few deaths of young Euro riders in the early days of EPO; my link said 20 in four years (87-90). 

I don't think they even had an EPO test back then.  What would an autopsy show that would indicate EPO were the cause?  I'm pretty sure they didn't check hematocrits - maybe they will for Goolaert.

At least some of them died in their sleep - that is extra highly suspicious.  A congenital defect is more likely to reveal itself under stress.  And these guys all get EKGs as part of their physicals so anything obvious like an arrhythmia would show up there.

That's what the story says but very few if any cases have actually been verified as being due to the use of EPO.

Try this 2011 published paper for a more critical look at the evidence:
https://www.tandfonline.com/doi/full/10.1080/17460263.2011.555208#.UxTHFI5LrzI

Quote
Abstract
In the wake of previous contributions by scholars like Verner Møller and Paul Dimeo, which have demonstrated the mythical nature of the accounts concerning two famous ‘doping deaths’ (the cyclists Arthur Linton and Knud Enemark Jensen), this article thoroughly examines the existing evidence (both anecdotal and scientific) concerning the much repeated claim that EPO ‘killed’ 18 Dutch and Belgian cyclists in the late 1980s and early 1990s. This examination shows that these claims almost absolutely lack empirical evidence, and that in fact the existing truly experimental and epidemiological research downplays or even rules out the existence of a casual link between EPO intake and sudden death in healthy adults. It is therefore concluded that EPO has been constructed by the expert literature and the lay press as the ‘drug of mass destruction’ of the war on drugs in sport, and that the story about the ‘EPO deaths’ is to be seen as anti-doping propaganda.

Read the Conclusion section if you don't want to read the whole thing at this time.

As much as I detest doping and those who enable it, it does not help when we rely on falsehoods to promote a given cause. It just (further) reduces the credibility of anti-doping, and just emphasises the problem that anti-doping agencies are mostly about public relations and not about anti-doping.
« Last Edit: April 17, 2018, 06:10:06 PM by Alex Simmons »

Offline Alex Simmons

  • Seasoned Contributor
  • ****
  • Posts: 716
Re: Athletes and Heart Attacks
« Reply #12 on: April 17, 2018, 06:21:41 PM »
Would training with EPO help you?
Then for the race not use it? 
Would this alow the muscles to get stronger by being able to train harder?
1. Yes, but the performance response is individually variable. The enhancement however can be significant.

2. The objective to is gain performance enhancement but to not be "glowing" during times when likelihood of being tested by anti-doping is high (e.g. at races). Testing is also conducted "Out Of Competition" but the low frequency of OOC testing and the ways in which even those can be avoided means that anti-doping is mostly about catching dopes than it is about catching dopers.

3. Stronger isn't the right technical term as strength has a specific meaning in exercise physiology unrelated to the nature of performance enhancement provided by EPO but in lay terms, yes. EPO not only increases your aerobic capacity (sustainable power output) it also improves/hastens recovery from hard efforts and enables athletes to sustain a higher overall workload in training. This has beneficial effects that can last years.

Offline Friendly Angel

  • Frequent Poster
  • ******
  • Posts: 3984
  • Post count reset to zero in both forum apocalypses
Re: Athletes and Heart Attacks
« Reply #13 on: April 17, 2018, 06:35:20 PM »
That's what the story says but very few if any cases have actually been verified as being due to the use of EPO.

Try this 2011 published paper for a more critical look at the evidence:
https://www.tandfonline.com/doi/full/10.1080/17460263.2011.555208#.UxTHFI5LrzI

Thanks, that was interesting.  I'd be happy to find out I've been believing over-sensationalized hype from journalists like Kimmage for all these years.

So what do you predict will come of Goolaert's autopsy?

Unrelated photo of Saturday's ride:

Amend and resubmit.

Offline Alex Simmons

  • Seasoned Contributor
  • ****
  • Posts: 716
Re: Athletes and Heart Attacks
« Reply #14 on: April 17, 2018, 07:50:25 PM »
That's what the story says but very few if any cases have actually been verified as being due to the use of EPO.

Try this 2011 published paper for a more critical look at the evidence:
https://www.tandfonline.com/doi/full/10.1080/17460263.2011.555208#.UxTHFI5LrzI

Thanks, that was interesting.  I'd be happy to find out I've been believing over-sensationalized hype from journalists like Kimmage for all these years.

So what do you predict will come of Goolaert's autopsy?

Unrelated photo of Saturday's ride:

The evidence suggests journalists and media have been awful at undertaking any actual investigation and verification of sources, let alone apply some scientific rigour to the story in question. Most of them are just attention seeking. Like that idiot Vayer.

I have no prediction for what some random athlete's autopsy will show. Athletes, like the rest of the population, have various pre-existing conditions and occasionally deaths occur.

Nice to be out on the bike. I need to make a new bike leg attachment for my new prosthesis so I can get back out there.

 

personate-rain