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PREDICTION THE DEVELOPMENT OF STRESS-INDUCED MYOCARDIAL DAMAGE IN YOUNG ATHLETES

E. V. LINDE (1), E. A. DEGTYARYOVA (2), V. V. LINYAEVA (1) 1 -SPORTS MEDICINE CENTER «HERAKLION MED», MOSCOW, RUSSIA 2 -STATE HEALTH CARE INSTITUTION PEDIATRIC INFECTIOUS CLINICAL HOSPITAL №6 OF MOSCOW HEALTH DEPARTMENT, MOSCOW, RUSSIA

Objective: to develop criteria for prediction «of stress cardiomyopathy young athletes by comparing the «quality» of adaptation with the highest level of tests on anti-myocardial antibodies and inflammatory cytokines, reflecting the degree of myocardial damage.
Materials and Methods: we examined 49 healthy young athletes involved in orienteering. In the subgroup of «beginners» included 27 young athletes with similar data training and competitive pressures (sports experience 2.5±0,2 years and the training load 9,3±0,4 hours per week), mean age 13.0 athletes ±0,4 years. In the subgroup of «qualified» – 22 young sportsmen 1st adult category (sports experience 4,5 ± 0,3 years and the training load 17,6 ± 0,4 hours per week), the average age of subgroup was 13.7±0.4 years (55% of boys and 45% girls).Clinical data was compared with the results of maximal treadmill tests, biochemical and immunological parameters. Additionally we examined their sports history. Given the significant difference in sports qualification, two groups formed «novice» and «qualified». The clinical examination included the collection and evaluation of cardiac medical history, examination of children's cardiology, electrocardiography, determining the concentration of pro-inflammatory cytokines (tumor necrosis factor – alpha (TNF-α), interleukin-6 and interleukin-8) in the blood serum, and determination of antibody titers in serum of young athletes to heterophile antigens endothelium, cardiomyocytes, smooth muscle and cardiac conduction system were evaluated by indirect immunofluorescence. The findings compared with the average in titers anti-myocardial antibodies in the serum of control group.
Results: analysis of the results of the first and second stages of the study revealed a negative correlation between serum concentrations of TNF-α, obtained before the load and the main indicators of cardio-respiratory endurance: oxygen consumption at maximum load level (r = –0,7) and the maximum speed in the test (r = –0,53). Directly in the «maximum» test obtained significant correlations between the concentration of TNF-α, max heart rate (r=0,83) and maximum oxygen pulse (r = –0,49).
Conclusions: serum concentrations of TNF-α was significantly correlated with the main indicators of cardio-respiratory endurance sports history and data that allows you to use the dynamics of this index as an objective criterion for the adequacy of the training process, the individual adaptation possibilities of the athlete and the need for cardio-protection. Young athletes «at risk» of persistent disturbances of cardiac rhythm and conduction, low cardiac abnormalities, reduced cardio-respiratory endurance require special attention of clinicians.
Keywords: 
physiological myocardial hypertrophy in athletes; immune-regulatory imbalance cytokines, anti-myocardial antibodies.