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Scientific Programme

Sports and Exercise Medicine and Health

OP-MH02 - Sport Medicine

Date: 03.07.2024, Time: 11:00 - 12:15, Lecture room: Carron 1

Description

Chair TBA

Chair

TBA
TBA
TBA

ECSS Paris 2023: OP-MH02

Speaker A Ben Berryman

Speaker A

Ben Berryman
University of Exeter, Medical School
United Kingdom
"Investigating the impact of exercise on right ventricle functional reserve in elite adolescent footballers using stress echocardiography "

INTRODUCTION: The athletes right ventricle (RV) undergoes remodelling secondary to training, characterised by enlarged end-diastolic volume and augmented myocardial reserve, allowing for increased cardiac output during exercise. Global RV function is determined mainly by transverse and longitudinal function, with transverse proposed to have a greater contribution to global function[1], and this could be of importance during physical activity. This study investigated the relationship between RV function components and exercise intensity in adolescent athletes. It was hypothesised that RV transverse function would increase more than longitudinal function during exercise. METHODS: A total of 30 elite male adolescent footballers (mean age 14.9 ± 1.0 y) underwent combined cardiopulmonary exercise test (CPET) and stress echocardiography. Fractional area change (FAC – global function), tricuspid annular plane systolic excursion (TAPSE – longitudinal function) and fractional septal free-wall distance (F-SFD – transverse function) [1] were measured at rest, 0 W, then 50 W increments during exercise. Exercise steps were classified by intensity domain based on the gas exchange threshold (GET) in low (50 W), moderate (below the GET) and high (above the GET). Changes in CPET parameters, RV function and RV cardiac reserve (relative difference in RV function to rest) were analysed using linear mixed models. RESULTS: All mean RV function parameters increased from rest to high intensity (FAC: 41 vs. 62.3%, TAPSE: 25 vs 33.5 mm, F-SFD: 20.8 vs 41.4%, p<0.001 for all). Transverse function reserve at high intensity exercise was significantly higher than longitudinal function reserve (mean F-SFD reserve: 126.9%, 95% CI [89.8-164.1] vs TAPSE reserve: 38.4%, 95% CI [27.6-49.3], p<0.05). Mean FAC reserve at high intensity was 54.1%, 95% CI [45.2-63.1]. The absolute difference between TAPSE and F-SFD reserve increased from low to high intensity exercise (p<0.05), while the TAPSE to F-SFD ratio decreased (p<0.05). FAC, TAPSE and F-SFD all demonstrated linear relationships with HR, VO2 and O2 pulse (p<0.05), FAC demonstrated the strongest relationship with each parameter. CONCLUSION: As hypothesised, transverse function increased more than longitudinal function during exercise, but FAC correlated best with oxygen uptake. These findings reflect the complex, three-dimensional nature of RV function augmentation in response to exercise. Therefore, assessing only TAPSE and FAC, as commonly conducted in practice, does not fully characterise the global RV exercise response in athletes. A multi-parametric approach should be used, including transverse function reserve. References [1] Kind, T, et al., Right ventricular ejection fraction is better reflected by transverse rather than longitudinal wall motion in pulmonary hypertension, J of Cardiovascular Magnetic Resonance, 2010, 12, p.1-11.

Read CV Ben Berryman

ECSS Paris 2023: OP-MH02

Speaker B Mary-Jessica  Laguette

Speaker B

Mary-Jessica Laguette
University of Cape Town, Human Biology
South Africa
"The COL11A1 gene is associated with risk of ACL rupture in a large international cohort: a preliminary study"

INTRODUCTION: ACL rupture is an acute injury with a lengthy recovery time and a high cost. A growing body of evidence suggests an association between genetic variants within collagen genes and risk of musculoskeletal soft tissue injuries. Type XI and type V collagen play a crucial role in fibrillogenesis. Alterations to the properties of tissue structures as a result of genetic variations could predispose individuals to injuries. Variants within type XI genes, together with type V collagen variants, were previously implicated in the risk of Achilles tendinopathy in a combined South African (SA) and Australian (AUS) population. Aim: To investigate the independent association of variants within the type XI collagen genes, namely COL11A1 rs1676486 G>A, COL11A1 rs3753841 A>G, COL11A2 rs1799907 A>T and COL11A2 rs16868943 G>A with ACL rupture risk in a large combined cohort. METHODS: A large case-control genetic association study was conducted comprised of 1329 physically active and unrelated participants from SA (n=459), Sweden (SWE n=211), Poland (POL n=291), and AUS (n=368). Genotyping was performed using Taqman SNP genotyping assays and the QuantStudio 3 Real-Time PCR System and software (Applied Biosystems, Waltham, MA, USA). Statistical analysis was performed using R statistical packages. RESULTS: The COL11A1 rs1676486 G/G genotype was significantly associated with increased risk of ACL ruptures in the combined cohort (p=2.7 X 10-6, OR: 0.57, 95% CI: 0.45 - 0.72) using the dominant model of inheritance. Similarly, the G/G genotype was also independently associated with increased risk of ACL rupture in the POL and SWE sporting population group. No other associations were noted. CONCLUSION: The COL11A1 rs1676486 G/G genotype was associated with increased risk of ACL ruptures in the large combined cohort. This work supports the hypothesis that variants within type XI collagen may be involved in susceptibility to ACL injuries as well. Interestingly, this functional variant is associated with risk of other musculoskeletal injuries such as lumbar disc herniation. The next aim includes examination of risk modulation in combination with type V collagen gene variants as the two collagen type interact at the functional level as well as in the context of the risk of Achilles tendinopathy. Importantly, sex specific associations and gene-gene interactions must be explored. Deciphering the molecular basis and altered risk modulation for these genetic associations remains a priority towards a better understanding of the aetiology of these conditions and identifying novel therapeutic targets.

Read CV Mary-Jessica Laguette

ECSS Paris 2023: OP-MH02

Speaker C Alison September

Speaker C

Alison September
University of Cape Town, HPALS research centre, Division of Physiological Sciences, Department of Human Biology
South Africa
"Novel implication of genomic loci within ITGB2, COL5A1 and VEGFA collectively associating with anterior ligament rupture susceptibility in large cohort from South Africa, Poland, Sweden and Australia"

INTRODUCTION: Independently, genetic loci within genes ITGB2 (beta 2 subunit of integrin), COL5A1 (alpha 1 chain of type V collagen) and VEGFA1 (vascular endothelial growth factor A) have been associated with rupture susceptibility of the anterior cruciate ligament (ACL-R). These genes have diverse functions including cell-cell communication, maintaining structural integrity and regulating new blood vessel formation which are all integral to ligament tissue integrity. The aim of the study was to identify key genetic loci which collectively maybe relevant to maintaining extracellular matrix tissue integrity of the ligament. METHODS: A genetic association was conducted for a combined cohort recruited from Australia, Poland, Sweden, and South Africa. Participants analysed in this study included uninjured controls CON=584; participants with ACL ruptures ACL-R=731 and a sub-group with non-contact mechanism of ACL ruptures NON=425. Participants were genotyped for ITGB2 (rs2230528 C/T); COL5A1 (rs12722 C/T) and VEGFA (rs699947 C/A, rs2010963 G/C) polymorphisms. Statistical analyses were conducted using the programming environment R. Inferred allele combinations were constructed as a proxy for potential gene-gene interactions using genotype data. Statistical significance was accepted when p < 0.05, and the false discovery rate (FDR) procedure was used to adjust for multiple comparisons. RESULTS: Significant distributions were noted for combinations between ITGB2 (rs2230528 C/T); COL5A1 (rs12722 C/T) and VEGFA (rs699947 C/A, rs2010963 G/C). The C-C-A-G combination was overrepresented in the CON (19%) compared to the ACL-R (ACL-14: 5%, p=1.x10-4; OR:0.93; 95% CI: 0.61-1.41) group and ACL-NON (ACL-NON: 14%, p=0.002; OR:0.96; 95% CI: 0.61-1.51) subgroup. The C-T-C-C combination was overrepresented in the CON (13%) compared to the ACL-R (ACL-R:10 %, p=0.023; OR:0.76; 95% CI: 0.46-1.26) group and ACL-NON (ACL-NON: 10%, p=0.003; OR:1.11; 95% CI: 0.63-1.79) subgroup. Similar findings were found when males and females were analysed separately. CONCLUSION: The novel associations highlight key genetic loci which in combination are associated with ACL ruptures susceptibility in a large cohort. In addition, the diversity of the gene functions in this risk model highlight the collective contribution towards maintaining tissue integrity.

Read CV Alison September

ECSS Paris 2023: OP-MH02