Objectives Reports of Ischaemic Heart Disease (IHD) in athletes who have retired from sports have increased over the past few years. To date there are few available data on how stable angina (SA) progresses in this special population, and little is known about the impact prior physical activity has on the treatment of stable angina. The goal of our study was to investigate the influence of previous regular sports activities on the rehabilitation outcomes in patients with SA.
Methods 64 patients: 28 females and 36 males, mean age – 61,2 ± 4,1 with SA (classes II-III) were divided into two groups: G1 – former elite athletes (n = 32) who have a history of practicing endurance sports 8 years and longer; G2 – sedentary people (n = 32). Patients in G1, once retired, had a similar to the sedentary group level of physical activity. Patients of both groups developed SA at similar ages, had comparable duration of the disease, and similar echocardiography parameters at the beginning of the study. Both groups were provided with the same standard rehabilitation program. Patients were followed prospectively over a 6-month period. The number of hospital admissions (HA) and the number of myocardial infarction (MI) were recorded. The treadmill ergospirometry test (MOD Bruce protocol) was performed at baseline and after 6 months. We performed a regression analysis between an increase in physical work capacity (PWC) and age, duration of SA, baseline PWC (in both groups) and, additionally, in G1, between increase in PWC and the age at the beginning of sports career, duration of sports career, and time after retirement.
Results After 6 months the improvements in PWC were +23 ± 8,6 W in G1, and +14 ± 2,5 W in G2. Clinical outcomes in G1: HA – 1 (hypertensive crisis); G2 – HA – 3 incl. 2 with MI. There were no significant correlations between age, duration of SA, baseline PWC and increase in PWC in either group. In G1 there were strong negative correlation (r = − 0.66) between age at the beginning, very weak negative correlation (r = − 0.12) between time after finishing and increase in PWC. Very strong positive correlation (r = 0.88) between duration of sports career and increase in PWC was found (Figure 1).
Conclusions Retired elite athletes with SA had better clinical outcomes under similar treatment after 6 months rather than sedentary individual. The changes in PWC in former elite athletes, who practice sports for 10 years or more, were more pronounced compared to sedentary patients or those who practiced for less than 10 years. During our study we noticed better compliance and adherence to treatment in the athlete group. The obtained results show that a history of regular sports activities has beneficial effect on compensatory abilities of the cardiovascular system in patients with IHD, even after a significant break in training (20 years and more) and a lack of regular physical activity post retirement. Further studies are needed to clarify what causes the improvement in PWC in retired athletes with SA: are they related to the heart changes, e.g. better microcirculation as a result of activation of previously developed collaterals, more efficient heart metabolism, or is it due to better compliance?
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