THE ROLE OF HEREDITARY FACTORS IN THE GENESIS OF ELECTROPHYSIOLOGICAL REMODELING ATHLETE’S HEART
Aim: To assess the effect of certain gene polymorphisms on the electrical activity of the athletes heart.
Materials and Methods: Were examined 458 elite athletes by clinical, functional examination and diagnostic genetic testing - a standard ECG, ultrasound of the heart, gasoanalysis (ergospyrometry), identification of polymorphisms of genes ACE, NFATC4, PPARA and PPARD.
Results: Found strong positive correlation D-allele with hypertrophy of more than 13 mm in athletes, which is seen as a factor in family history of myocardial infarction and risk of sudden cardiac death (SCD). The risk of sudden cardiac death in ID-genotype carriers increased by 1.8 times, while the DD-genotype carriers - more than 2.2 times. Unfavorable combination of homozygous gene DD (ACE) was found in 25% of skaters-rounder, 18% of the rowers, 20% of the shooters, 30% of divers, 21% of wrestlers. Athletes these groups had significantly (p<0,05) decrease in physical performance, the trend to an inadequate increase in blood pressure and heart rate in the exercise, as well as a progressive disorder of the heart muscle electrogenesis (progressive decrease in segment ST) with a load at the threshold of anaerobic metabolism. The results support the view on the participation of susceptibility genes in the stress transformation of “athlete’s heart”, who had their pathological effects only in certain conditions. Given that we identified, “susceptibility genes” stress-induced transformation of the athlete’s heart are the object of study “sports genetics” and are used for screening and profiling of young athletes, we strongly recommend to timely detect the genotype homozygous for young athletes and, in some cases, the heterozygous form of the above polymorphisms.
Conclusions: The presence of young athletes in genotype 2 or more risk alleles (RRARA C, RRARD C, SNB D, NFATC4 Ala160 and VEGFA G) can be used as a marker for the formation of “at risk” cardiac pathology in order to customize the training process and employment restrictions endurance sports.