TY - CHAP A1 - Scharhag, Jürgen A1 - Hotzkow, Kristin A1 - Kopinski, Stephan A1 - Barche, Martin A1 - Mayer, Frank T1 - Echocardiographic 3d speckle tracking values on cardiac wall motion in elite adult, adolescent and pediatric athletes T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2012 SN - 0195-9131 VL - 44 SP - 241 EP - 241 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Mayer, Frank A1 - Bonaventura, Klaus A1 - Cassel, Michael A1 - Müller, Steffen A1 - Weber, Josefine A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Baur, Heiner A1 - Scharhag, Jürgen T1 - Medical results of preparticipation examination in adolescent athletes JF - British journal of sports medicine : the journal of sport and exercise medicine N2 - Background Preparticipation examinations (PPE) are frequently used to evaluate eligibility for competitive sports in adolescent athletes. Nevertheless, the effectiveness of these examinations is under debate since costs are high and its validity is discussed controversial. Purpose To analyse medical findings and consequences in adolescent athletes prior to admission to a sports school. Methods In 733 adolescent athletes (318 girls, 415 boys, age 12.3+/-0.4, 16 sports disciplines), history and clinical examination (musculoskeletal, cardiovascular, general medicine) was performed to evaluate eligibility. PPE was completed by determination of blood parameters, ECG at rest and during ergometry, echocardiography and x-rays and ultrasonography if indicated. Eligibility was either approved or rated with restriction. Recommendations for therapy and/or prevention were given to the athletes and their parents. Results Historical (h) and clinical (c) findings (eg, pain, verified pathologies) were more frequent regarding the musculoskeletal system (h: 120, 16.4%; c: 247, 33.7%) compared to cardiovascular (h: 9, 1.2%; c: 23, 3.1%) or general medicine findings (h: 116, 15.8%; c: 71, 9.7%). ECG at rest was moderately abnormal in 46 (6.3%) and severely abnormal in 25 athletes (3.4%). Exercise ECG was suspicious in 25 athletes (3.4%). Relevant echocardiographic abnormalities were found in 17 athletes (2.3%). In 52 of 358 cases (14.5%), x-rays led to diagnosis (eg, Spondylolisthesis). Eligibility was temporarily restricted in 41 athletes (5.6%). Three athletes (0.4%) had to be excluded from competitive sports. Therapy (eg, physiotherapy, medication) and/or prevention (sensorimotor training, vaccination) recommendations were deduced due to musculoskeletal (t:n = 76,10.3%; p:n = 71,9.8%) and general medicine findings (t:n = 80, 10.9%; p:n = 104, 14.1%). Conclusion Eligibility for competitive sports is restricted in only 5.5% of adolescent athletes at age 12. Eligibility refusals are rare. However, recommendations for therapy and prevention are frequent, mainly regarding the musculoskeletal system. In spite of time and cost consumption, adolescent preparticipation before entering a career in high-performance sports is supported. Y1 - 2012 U6 - https://doi.org/10.1136/bjsports-2011-090966 SN - 0306-3674 VL - 46 IS - 7 SP - 524 EP - 530 PB - BMJ Publ. Group CY - London ER - TY - JOUR A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Cassel, Michael A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - How to test maximal oxygen uptake a study on timing and testing procedure of a supramaximal verification test JF - Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme N2 - On utilise de plus en plus les tests de verification pour confirmer l'atteinte du consommation d'oxygene maximale (VO(2 max)). Toutefois, le moment et les methodes d'evaluation varient d'un groupe de travail a l'autre. Les objectifs de cette etude sont de constater si on peut administrer un test de verification apres un test d'effort progressif ou s'il est preferable de le faire une autre journee et si on peut determiner le VO(2 max) tout de meme lors de la premiere seance chez des sujets ne repondant pas au critere de verification. Quarante sujets (age, 24 +/- 4 ans; VO(2 max), 50 +/- 7 mL center dot min(-1)center dot kg(-1)) participent a un test d'effort progressif sur tapis roulant et, 10 min plus tard, a un test de verification (VerifDay1) a 110 % de la velocite maximale (v(max)). Le critere de verification est un VO(2) de pointe au VerifDay1 < 5,5 % a la valeur retenue au test d'effort progressif. Les sujets ne repondant pas au critere de verification passent un autre test de verification, mais a 115 % du VerifDay1', et ce, 10 min plus tard pour confirmer le VO(2) de pointe du VerifDay1 en tant que VO(2 max). Tous les autres sujets repassent le VerifDay1 a un jour different (VerifDay2). Six sujets sur quarante ne repondent pas au critere de verification. Chez quatre d'entre eux, on confirme l'atteinte du VO(2 max) au VerifDay1'. Le VO(2) de pointe au VerifDay1 est equivalent a celui du VerifDay2 (3722 +/- 991 mL center dot min(-1) comparativement a 3752 +/- 995 mL center dot min(-1), p = 0,56), mais le temps jusqu'a l'epuisement est significativement plus long au VerifDay2 (2:06 +/- 0:22 min:s comparativement a 2:42 +/- 0:38 min:s, p < 0,001, n = 34). Le VO(2) de pointe obtenu au test de verification ne semble pas conditionne par un test d'effort progressif maximal prealable. On peut donc realiser le test d'effort progressif et le test de verification lors de la meme seance d'evaluation. Chez presque tous les individus ne repondant pas au critere de verification, on peut determiner le VO(2 max) au moyen d'un autre test de verification plus intense. Y1 - 2011 U6 - https://doi.org/10.1139/H10-099 SN - 1715-5312 VL - 36 IS - 1 SP - 153 EP - 160 PB - NRC Research Press CY - Ottawa ER - TY - JOUR A1 - Scharhag-Rosenberger, Friederike A1 - Wochatz, Monique A1 - Otto, Christoph A1 - Cassel, Michael A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - Blood lactate concentrations are mildly affected by mobile gas exchange measurements JF - International journal of sports medicine N2 - We sought to investigate the effects of wearing a mobile respiratory gas analysis system during a treadmill test on blood lactate (bLa) concentrations and commonly applied bLa thresholds. A total of 16 recreational athletes (31 +/- 3 years, V0205: 58 6 ml min(-1)-kg(-1)) performed one multistage treadmill test with and one without gas exchange measurements (GEM and noGEM). The whole bLa curve, the lactate threshold (LT), the individual anaerobic thresholds according to Stegmann(IAT(sr)) and Dickhuth (IAT(Di)), and a fixed bLa concentration of 4 mmob.l(-1) (OBLA) were evaluated. The bLa curve was shifted slightly leftward in GEM compared to noGEM (P<0.05), whereas the heart rate response was not different between conditions (P= 0.89). There was no difference between GEM and noGEM for LT (2.61 +/- 0.34 vs. 2.64 +/- 0.39 m(-1) s(-1) P=0.49) and IAT(st) (3.47 +/- 0.42 vs. 3.55 +/- 0.47m-s(-1), P=0.12). However, IATD(Di) (3.57 +/- 0.39 vs. 3.66 +/- 0.44m-s(-1), P<0.01) and OBLA (3.85 +/- 0.46 vs. 3.96 +/- 0.47m-s-1, P<0.01) occurred at slower running velocities in GEM. The bLa response to treadmill tests is mildly affected by wearing a mobile gas analysis system. This also applies to bLa thresholds located at higher exercise intensities. While the magnitude of the effects is of little importance for recreational athletes, it might be relevant for elite athletes and scientific studies. KW - cardiopulmonary exercise testing KW - performance diagnostics KW - lactate threshold KW - VO2mdx KW - metabolic device Y1 - 2014 U6 - https://doi.org/10.1055/s-0033-1354386 SN - 0172-4622 SN - 1439-3964 VL - 35 IS - 7 SP - 590 EP - 594 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Mayer, Frank A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Cassel, Michael A1 - Müller, Steffen A1 - Scharhag, Jürgen T1 - The intensity and effects of strength training in the elderly JF - Deutsches Ärzteblatt international : a weekly online journal of clinical medicine and public health N2 - Background: The elderly need strength training more and more as they grow older to stay mobile for their everyday activities. The goal of training is to reduce the loss of muscle mass and the resulting loss of motor function. The dose-response relationship of training intensity to training effect has not yet been fully elucidated. Methods: PubMed was selectively searched for articles that appeared in the past 5 years about the effects and dose-response relationship of strength training in the elderly. Results: Strength training in the elderly (> 60 years) increases muscle strength by increasing muscle mass, and by improving the recruitment of motor units, and increasing their firing rate. Muscle mass can be increased through training at an intensity corresponding to 60% to 85% of the individual maximum voluntary strength. Improving the rate of force development requires training at a higher intensity (above 85%), in the elderly just as in younger persons. It is now recommended that healthy old people should train 3 or 4 times weekly for the best results; persons with poor performance at the outset can achieve improvement even with less frequent training. Side effects are rare. Conclusion: Progressive strength training in the elderly is efficient, even with higher intensities, to reduce sarcopenia, and to retain motor function. Y1 - 2011 U6 - https://doi.org/10.3238/arztebl.2011.0359 SN - 1866-0452 VL - 108 IS - 21 SP - 359 EP - U30 PB - Dt. Ärzte-Verl. CY - Cologne ER - TY - JOUR A1 - Koch, Sarah A1 - Cassel, Michael A1 - Linne, Karsten A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - ECG and echocardiographic findings in 10-15-year-old elite athletes JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background: Data on electrocardiographic and echocardiographic pre-participation screening findings in paediatric athletes are limited. KW - ECG KW - echocardiography KW - paediatric athlete KW - pre-participation screening KW - sudden cardiac death Y1 - 2014 U6 - https://doi.org/10.1177/2047487312462147 SN - 2047-4873 SN - 2047-4881 VL - 21 IS - 6 SP - 774 EP - 781 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Shave, Rob A1 - Baggish, Aaron A1 - George, Keith A1 - Wood, Malissa A1 - Scharhag, Jürgen A1 - Whyte, Gregory A1 - Gaze, David A1 - Thompson, Paul D. T1 - Exercise : induced cardiac troponin elevation evidence, mechanisms, and implications N2 - Regular physical exercise is recommended for the primary prevention of cardiovascular disease. Although the high prevalence of physical inactivity remains a formidable public health issue, participation in exercise programs and recreational sporting events, such as marathons and triathlons, is on the rise. Although regular exercise training reduces cardiovascular disease risk, recent studies have documented elevations in cardiac troponin (cTn) consistent with cardiac damage after bouts of exercise in apparently healthy individuals. At present, the prevalence, mechanism(s), and clinical significance of exercise-induced cTn release remains incompletely understood. This paper will review the biochemistry, prevalence, potential mechanisms, and management of patients with exercise-induced cTn elevations. (J Am Coll Cardiol 2010; 56: 169-76) Y1 - 2010 UR - http://content.onlinejacc.org/ U6 - https://doi.org/10.1016/j.jacc.2010.03.037 SN - 0735-1097 ER - TY - JOUR A1 - Scharhag, Jürgen A1 - Kindermann, Wilfried T1 - Pitfalls in the differentiation between athlete's heart and hypertrophic cardiomyopathy Y1 - 2009 UR - http://www.springerlink.com/content/119981 U6 - https://doi.org/10.1007/s00392-009-0035-z SN - 1861-0684 ER - TY - CHAP A1 - Otto, Christoph A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Scharhag, Jürgen A1 - Mayer, Frank T1 - Differences in using the same supramaximal verification test protocol for treadmill and cycle ergometry T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2012 SN - 0195-9131 VL - 44 SP - 295 EP - 295 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - CHAP A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Schüler, Stefan A1 - Lundby, Carsten A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - Physiological changes over four maximal incremental cycling tests within one day T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine Y1 - 2012 SN - 0195-9131 VL - 44 SP - 933 EP - 934 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Scharhag-Rosenberger, Friederike A1 - Carlsohn, Anja A1 - Lundby, Carsten A1 - Schueler, Stefan A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - Can more than one incremental cycling test be performed within one day? JF - European journal of sport science : official journal of the European College of Sport Science N2 - Changes in performance parameters over four consecutive maximal incremental cycling tests were investigated to determine how many tests can be performed within one single day without negatively affecting performance. Sixteen male and female subjects (eight trained (T): 25 +/- 3 yr, BMI 22.6 +/- 2.5 kg center dot m(-2), maximal power output (P-max) 4.6 +/- 0.5 W center dot kg(-1); eight untrained (UT): 27 +/- 3 yr, BMI 22.3 +/- 1.2 kg center dot m(-2), P-max 2.9 +/- 0.3 W center dot kg(-1)) performed four successive maximal incremental cycling tests separated by 1.5 h of passive rest. Individual energy requirements were covered by standardised meals between trials. Maximal oxygen uptake (VO2max) remained unchanged over the four tests in both groups (P = 0.20 and P = 0.33, respectively). P-max did not change in the T group (P = 0.32), but decreased from the third test in the UT group (P < 0.01). Heart rate responses to submaximal exercise were elevated from the third test in the T group and from the second test in the UT group (P < 0.05). The increase in blood lactate shifted rightward over the four tests in both groups (P < 0.001 and P < 0.01, respectively). Exercise-induced net increases in epinephrine and norepinephrine were not different between the tests in either group (P 0.15). If VO2max is the main parameter of interest, trained and untrained individuals can perform at least four maximal incremental cycling tests per day. However, because other parameters changed after the first and second test, respectively, no more than one test per day should be performed if parameters other than VO2max are the prime focus. KW - Maximal oxygen uptake KW - cardiopulmonary exercise testing KW - consecutive tests KW - study design KW - exhaustion KW - fatigue Y1 - 2014 U6 - https://doi.org/10.1080/17461391.2013.853208 SN - 1746-1391 SN - 1536-7290 VL - 14 IS - 5 SP - 459 EP - 467 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Scharhag, Jürgen A1 - Knebel, F. A1 - Mayer, Frank A1 - Kindermann, Wilfried T1 - Does marathon running damage the heart? - an update JF - Deutsche Zeitschrift für Sportmedizin : offizielles Organ der Deutschen Gesellschaft für Sportmedizin und Prävention (Deutscher Sportärztebund) e.V. (DGSP) und Weiterbildungsorgan der Österreichischen Gesellschaft für Sportmedizin und Prävention N2 - Since the legend of the ancient Marathon run, the risk of endurance exercise-induced cardiovascular damage or sudden cardiac death is discussed. In recent studies, the exercise-induced increases in cardiac biomarkers in endurance athletes as well as acute alterations in cardiac function and cardiovascular abnormalities have been reported. As elevations of the cardiac biomarkers troponin and BM) have been observed frequently for the vast majority of athletes after Marathon runs or strenuous exercise bouts followed by a decrease within a short period, a physiological reaction rather than a pathologicial cause is presumed. Also a transient decrease of cardiac function demonstrated by newer echocardiographic techniques (tissue Doppler or speckle tracking imaging, 3D echocardiography) after strenuous exercise often termed "cardiac fatigue" should not be considered necessarily as pathologic, as cardiac function also depends on hemodynamic load and heart rate. Furthermore, exercise-induced changes in cardiac function did not correlate with exercise-induced increases in cardiac biomarkers in most studies. The functional cardiac alterations can also be detected by magnetic resonance imaging (MRI) after Marathon runs. However, no signs of acute or chronic myocardial damage have been demonstrated in MRI studies in cardiovascular healthy athletes after running a Marathon, although especially in older athletes undetected cardiovascular diseases such as coronary artery disease or myocardial necrosis or fibrosis can be present. hi conclusion, according to recent studies. there seems to be a lack of evidence to support endurance exercise-induced cardiac damage in the healthy heart which is adapted tostrenous exercise by regular endurance training. Nevertheless, as running a Marathon results in a high cardiac load, a sufficient endurance training period as well as a preparticipation or regular medical screening to exclude relevant congenital or aquired cardiovascular diseases is recommended from a sports cardiology perspective to exclude relevant congenital or acquired cardiovascular diseases KW - Marathon KW - cardiac biomarkers KW - endurance exercise KW - athlete's heart KW - cardiac fatigue Y1 - 2011 SN - 0344-5925 VL - 62 IS - 9 SP - 293 EP - 298 PB - WWF-Verl.-Ges. CY - Greven ER - TY - JOUR A1 - Karlowatz, Ruth-Jessica A1 - Scharhag, Jürgen A1 - Rahnenfuehrer, Jörg A1 - Schneider, Ulrich A1 - Jakob, Ernst A1 - Kindermann, Wilfried A1 - Zang, Klaus Dieter T1 - Polymorphisms in the IGF1 signalling pathway including the myostatin gene are associated with left ventricular mass in male athletes JF - British journal of sports medicine : the journal of sport and exercise medicine N2 - Background Athlete's heart as an adaptation to long-time and intensive endurance training can vary considerably between individuals. Genetic polymorphisms in the cardiological relevant insulin-like growth factor 1 (IGF1) signalling pathway seem to have an essential influence on the extent of physiological hypertrophy. Objective Analysis of polymorphisms in the genes of IGF1, IGF1 receptor (IGF1R) and the negative regulator of the cardiac IGF1 signalling pathway, myostatin (MSTN), and their relation to left ventricular mass (LVM) of endurance athletes. Methods In 110 elite endurance athletes or athletes with a high amount of endurance training (75 males and 35 females) and 27 male controls, which were examined by echocardiographic imaging methods and ergometric exercise-testing, the genotypes of a cytosine-adenine repeat polymorphism in the promoter region of the IGF1 gene and a G/A substitution at position 3174 in the IGF1R gene were determined. Additionally, a mutation screen of the MSTN gene was performed. Results The polymorphisms in the IGF1 and the IGF1R gene showed a significant relation to the LVM for male (IGF1: p=0.003; IGF1R: p=0.01), but not for female athletes. The same applies to a previously unnoticed polymorphism in the 1 intron of the MSTN gene, whose deletion allele (AAA -> AA) appears to increase the myostatic effect (p=0.015). Moreover, combinations of the polymorphisms showed significant synergistic effects on the LVM of the male athletes. Conclusions The authors' results argue for the importance of polymorphisms in the IGF1 signalling pathway in combination with MSTN on the variant degree of physiological hypertrophy of male athletes. Y1 - 2011 U6 - https://doi.org/10.1136/bjsm.2008.050567 SN - 0306-3674 VL - 45 IS - 1 SP - 36 EP - 41 PB - BMJ Publ. Group CY - London ER - TY - GEN A1 - Koch, Sarah A1 - Cassel, Michael A1 - Linne, Karsten A1 - Mayer, Frank A1 - Scharhag, Jürgen T1 - ECG and echocardiographic findings in 10–15-year-old elite athletes N2 - Background: Data on electrocardiographic and echocardiographic pre-participation screening findings in paediatric athletes are limited. Methods and results: 10-15 year-old athletes (n = 343) were screened using electro- and echocardiography. The electrocardiogram (ECG) was normal in 220 (64%), mildly abnormal in 108 (31%), and distinctly abnormal in 15 (4%) athletes. Echocardiographic upper reference limits (URL, 97.5 percentile) for the left ventricular (LV) wall thickness in 10-11-year-old boys and girls were 9-10 mm and 8-9 mm, respectively; in 12-13-year-old boys and girls 9-10 mm; and in 14-15-year-old boys and girls 10-11 mm and 9-10 mm, respectively. Three athletes were excluded from competitive sports: one for symptomatic Wolff-Parkinson-White syndrome with a normal echocardiogram; one for negative T-waves in V-1-V-4 and a dilated right ventricle by echocardiography suggestive of (arrhythmogenic) right ventricular disease; and one for normal ECG and biscupid aortic valve including an aneurysm of the ascending aorta detected by echocardiography. Related to echocardiographic findings, the sensitivity and specificity of the ECG to identify cardiovascular abnormalities was 38% and 64%, respectively. The ECG's positive-predictive and negative-predictive values were 13% and 88%, respectively. The numbers needed to screen and calculated costs were 172 for ECG ( 7049), 172 for echocardiography ( 11,530), and 114 combining ECG and echocardiography ( 9323). Conclusions: Compared to adults, paediatric athletes presented with fewer distinctly abnormal ECGs, and there was no gender difference in paediatric athletes' ECG-pattern distribution. A combination of ECG and echocardiography for pre-participation screening of paediatric athletes is superior to ECG alone but 30% more costly. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 368 KW - ECG KW - echocardiography KW - paediatric athlete KW - pre-participation screening KW - sudden cardiac death Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-403186 ER -