BJSM -- eLetters for Ansley et al., 41 (1) 2-7

Home > E-Letter

To SUBMIT an e-letter please go to the abstract/full text of the article and click the 'Submit a response' link in the box to the right of the text. For further help click here.

Electronic Letters to:

L Ansley, D Petersen, A Thomas, A St Clair Gibson, P Robson-Ansley, T D Noakes, A M Hunter

The effect of breathing an ambient low-density, hyperoxic gas on the perceived effort of breathing and maximal performance of exercise in well-trained athletes • Commentary
Br J Sports Med 2007; 41: 2-7 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Hepatic oxygenation: rate-limiting factor in athletes.: Richard G Fiddian-Green (29 January 2007)

Hepatic oxygenation: rate-limiting factor in athletes.

29 January 2007

Richard G Fiddian-Green,
FRCS, FACS
None

Send letter to journal:
Re: Hepatic oxygenation: rate-limiting factor in athletes.

richardfg{at}hotmail.com Richard G Fiddian-Green

Dear Editor

If my understanding of tissue energetics is correct then a rate-limiting factor in athletes might well be the adequacy of hepatic oxygenation [1]. If so the presence of celiac axis stenosis might be a contributing and reversible factor.

Celiac axis stenosis, which may be caused by a contricting band of fibrous tissue, was found in 1.7% of 3449 patients from 0 to 18 years examined with abdominal color duplex sonography [2]. "Their symptoms included, abdominal pain (71%), nausea (29%), thoracic pain (22%), heartburn (17%), weight loss (15%), vomiting (15%), systolic murmur (15%), postprandial accentuation of symptoms (15%), diarrhea (14%), respiratory discomfort (14%), and syncope (12%). Many of these symptoms are experienced by athletes and exercise is a very good stress test in the diagnosis of chronic visceral ischaemia [3]. More importantly the results of stenting or surgical correction are very good.

It would be interesting to screen athletes for the presence of celiac axis stenosis or compression using abdominal color duplex sonography and considering correcting the abnormality. What of the possibility of enhancing athletic performance by increasing hepatic arterial inflow with a jump graft? Not a step one would necessarily recommend but an interesting theoretical corollary.

References

1. Should screening for occlusive coelic axis disease be included in goal-directed therapy? Richard G Fiddian-Green (5 March 2006) eLetter re: Stephen Trzeciak, R. Phillip Dellinger, Nicole L. Abate, Robert M. Cowan, Mary Stauss, J. Hope Kilgannon, Sergio Zanotti, and Joseph E. Parrillo Translating Research to Clinical Practice: A 1-Year Experience With Implementing Early Goal-Directed Therapy for Septic Shock in the Emergency Department,* Chest 2006; 129: 225-232

2. Scholbach T. Celiac artery compression syndrome in children, adolescents, and young adults: clinical and color duplex sonographic features in a series of 59 cases. J Ultrasound Med. 2006 Mar;25(3):299- 305

3. Mensink PB, van Petersen AS, Geelkerken RH, Otte JA, Huisman AB, Kolkman JJ Clinical significance of splanchnic artery stenosis. Br J Surg. 2006 Nov;93(11):1377-82.