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Medscape
03-07-2025
- Health
- Medscape
Elite Rowers Face Lasting Atrial Fibrillation Risk
Former world-class rowers have an elevated risk for atrial fibrillation (AF) in the years after retirement, according to an observational case-control study. Researchers found 1 in 5 former Olympic, world, or national-level Australian rowers aged 45-80 years had the heart rhythm anomaly. The ex-rowers, who had competed for at least 10 years, were nearly seven times more likely to have been diagnosed with AF compared to a control group. During a follow-up period of around 4 years, new cases of AF were also higher among the ex-rowers (6.3% vs 2.3%), according to the researchers, who published their findings last month in the European Heart Journal . 'As a clinician, I was not surprised that rowers experienced more AF,' said André La Gerche, PhD, MD, a cardiologist and head of the Heart Exercise And Research Trials Lab at the Victor Chang Cardiac Research Institute and St Vincent's Hospital in Melbourne, Australia, and senior author of the study. 'However, I was very surprised by the magnitude of the difference. Furthermore, I learnt that the risk persists years after retirement and is not just due to genetic factors.' André La Gerche, PhD, MD The findings are 'consistent with prior research demonstrating that endurance athletes — especially highly trained endurance athletes — seem to have this higher risk of AF,' said Gregory Marcus, MD, MAS, a cardiac electrophysiologist and the inaugural Endowed Professor of Atrial Fibrillation Research at the University of California, San Francisco. Gregory Marcus, MD, MAS 'These numbers nudge me in the direction of more aggressively screening for AF specifically in masters-aged rowers, such as with the use of Holter monitors or wearable devices approved to detect AF,' said Jeffrey Hsu, MD, an assistant professor of medicine in the Division of Cardiology at the David Geffen School of Medicine at the University of California, Los Angeles. Jeffrey Hsu, MD La Gerche and his team captured data from 121 former rowers — 75% men, all White, with a median age of 62 years — who were matched with more than 11,000 control individuals from the UK Biobank who had never rowed and had varying fitness levels. The ex-rowers had similar rates of ischemic heart disease and diabetes as did the control individuals, but lower blood pressure. They also were less likely to have ever smoked. The athletes showed persistent changes in cardiac function after retirement. Ex-rowers had larger left ventricles, lower heart rates, longer PQ intervals, and longer QT intervals compared to control individuals. The research, 'raises the question of whether certain types of intensive exercise — like elite-level competitive rowing — leads to long-lasting, perhaps even irreversible, enlargement of the cardiac chambers,' Hsu said. Genetics factored into the risk for AF among both groups. While the prevalence of rare variants in genes associated with cardiomyopathy was low across the study, the combined risk for individual genes associated with AF was a strong predictor of the disease in both athletes (odds ratio [OR], 3.7) and nonathletes (OR, 2.0). The proportions were similar between them ( P = .37), indicating genetics did not fully account for the increased risk in the ex-rowers, La Gerche said. Marcus flagged a few factors that may have skewed the results. The former athletes tended to be tall, White, and in many cases, drank more alcohol than control individuals — all of these factors increase the risk for AF. Because the ex-rowers volunteered for a cardiovascular study, selection bias could have skewed prevalence higher, Marcus said. After a sensitivity analysis, ex-rowers still had a 2.5-fold higher risk for AF in the case of a 100% selection bias. La Gerche emphasized the findings shouldn't dissuade clinicians from encouraging regular exercise or high-level sports training. 'The overall health outcomes of these rowers are generally superb,' La Gerche said. 'Rather, this highlights an important 'Achilles heel' that requires attention and, ideally, effective prevention strategies so that sports can be enjoyed by more people, more often.' The study was funded by the National Health and Medical Research Council. La Gerche, Hsu, and Marcus reported having no relevant financial conflicts of interest.
The Guardian
01-04-2025
- Health
- The Guardian
NAD boosters: Kendall Jenner and Hailey Bieber are into them, but do they actually stop ageing?
The fountain of youth is an enduring legend. Different iterations of the fabled spring – which is said to give anyone who drinks or bathes in its waters the power to defy ageing – have echoed across cultures for thousands of years. In the modern age, this quest for youthfulness is known as 'biohacking' – where individuals take a do-it-yourself approach to enhance their biology, often through supplements – and the latest trend is NAD boosters. Ever since Kendall Jenner and Hailey Bieber took IV drips with NAD in an episode of The Kardashians, influencers on TikTok and Instagram have followed suit, telling their followers NAD boosters will 'literally give you the fountain of youth … you will stop ageing in its tracks', in addition to other claimed benefits such as boosting energy and improving hair, skin and metabolic function. But do any of these claims stack up or are we still in the realm of myth? NAD (also referred to as NAD+ and short for nicotinamide adenine dinucleotide) is a naturally occurring molecule involved in more than 500 different reactions in the body, including energy generation, explains Prof Nigel Turner, the head of the Cellular Bioenergetics Laboratory at the Victor Chang Cardiac Research Institute. More recently – in the last 25 years – it has become apparent the molecule also has really critical functions in ageing, Turner says. 'The whole hype around the NAD boosting therapies is the fact that there's pretty good scientific evidence that as we age … the levels of NAD decline, and so the efficiency of all these pathways and reactions within the body declines, because the levels naturally drop with ageing,' Turner says. NAD boosting therapies have been marketed in the form of pills, shots and IV infusions. They are selling manufactured supplements of the nicotinamide precursor compounds that can be converted into NAD. The two primary versions marketed are nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR). Prof David Vaux, a molecular biologist and honorary fellow of the Walter and Eliza Hall Institute, said while a number of labs are promoting them as treatments for ageing, 'in my opinion, it's way too early. I haven't seen convincing evidence that they prolong life span in animal models, and I certainly wouldn't take any myself until they'd been proven to work, be safe and efficacious in a properly run, double-blind placebo-controlled human trial.' Turner says while studies in mice and pre-clinical models have shown the replenishment of NAD is associated with changes in the way cells function, better metabolic health and some anti-ageing effects, the evidence of the translation of that research into humans is in its infancy. 'What comes through in the limited amount of studies that have been done in humans, is that it appears that giving these supplements to already healthy or relatively healthy people is not going to do too much because your body's already got enough.' However, of the already limited studies, those that have shown some benefits tend to be in overweight and older populations, where the NAD levels may be compromised a bit more, he says. Scientists have developed various measures to assess people's perceptions of ageing – which may be evident in many different beliefs. Here are a few examples: 1 Do things get better, worse or stay the same as you get older? 2 In each pair of the following words, which one do you associate with retirement and beyond: uninvolved or involved; unable or able; dependent or independent; idle or busy? 3 When does middle age end and old age begin? If you answered 'better' or 'the same' on (1) and 'involved', 'able', 'independent' and 'busy' on (2), you are more likely to experience better health as you age. On question (3), people who believe old age starts at a later point – over 70 years – live longer than people who believe that old age starts at 60 or younger. The body already has a series of pathways that allow for the constant maintenance or replenishment of the NAD that's being broken down all the time, including through our diets, Turner says. Vitamin B, specifically vitamin B3 (which is found in Vegemite, among other food sources) is also a precursor, one of these pathways that eventually lead to the formation of NAD, he says. Vaux stresses that the Therapeutic Goods Administration has two kinds of approval: medicines are either registered (when a drug is proved to be effective for treating certain conditions) or they are listed (which means it is safe but there is no evidence it works). Only the second kind of TGA approval has been given for any NAD boosters, he says, 'but the people marketing them don't make that distinction. They just say 'approved by the TGA' and trick people into thinking that they actually work.' A/Prof Lindsay Wu runs the Laboratory for Ageing Research at the University of New South Wales. Wu is also the founder of a company developing NAD precursors and trying to establish efficacy for specific conditions and diseases, as well as safety. 'We don't yet have that data, whether there is truly these massive effects,' Wu says. However, 'a lot of the people who are taking these NAD precursors are in fact young, healthy people [or] middle-aged people. The whole concept of doing this is to replace NAD levels when they get low – but fit healthy people don't need this … Their NAD levels are already going to be very high.' Eating a healthy diet and doing exercise have been associated with boosting NAD levels, Turner says. However, he stresses that the best evidence for promoting longevity comes back to a healthy lifestyle, including not smoking or drinking excessively. 'People seem to want to be able to do all of those things and then just take a pill that will overcome it,' he says. 'I still hold great hope that [NAD is] going to be a pathway that will have some benefit, but it's not going to meet the claims that you see online. It's not going to take a person who's got grey hair and turns them back into a 20-year-old.' Natasha May is Guardian Australia's health reporter Antiviral is a fortnightly column that interrogates the evidence behind the health headlines and factchecks popular wellness claims What health trend do you want examined? Your contact details are helpful so we can contact you for more information. They will only be seen by the Guardian. Your contact details are helpful so we can contact you for more information. They will only be seen by the Guardian.
Daily Tribune
14-03-2025
- Health
- Daily Tribune
Man Survives 100 Days with Artificial Titanium Heart in Groundbreaking Medical Trial
A groundbreaking medical trial in Australia has seen a man survive for 100 days with an artificial titanium heart, marking a significant milestone in cardiac technology. The patient, a man in his 40s who has chosen to remain anonymous, received the BiVACOR Total Artificial Heart (TAH) in November at St. Vincent's Hospital Sydney. In February, he became the first person to be discharged from the hospital while relying on the device. Earlier this month, he successfully underwent a donor heart transplant and is now recovering well, according to a joint statement from St Vincent's Hospital, Monash University, and BiVACOR, the company behind the artificial heart. The BiVACOR TAH is designed to replace both ventricles of a failing heart. It features a single moving part—a magnetically levitated rotor—constructed from titanium, eliminating the need for mechanical bearings or valves that could wear out over time. Australian bioengineer Daniel Timms, who founded BiVACOR after losing his father to heart disease, called the achievement a major step forward in heart failure treatment. "This milestone represents decades of hard work, and we are deeply grateful to the patient and his family for trusting our technology," Timms said. Professor Chris Hayward of the Victor Chang Cardiac Research Institute, who has been overseeing the patient's recovery, said the success of the device could transform the future of heart transplants. "Within the next decade, artificial hearts may become a viable alternative for patients who are unable to receive donor hearts in time," Hayward stated. The BiVACOR device has been undergoing trials in the United States as part of the FDA's Early Feasibility Study. Five patients have been implanted with the device so far, including a 58-year-old man in Texas last year, who survived for eight days before receiving a donor heart. Researchers hope the study will expand to 15 patients. The Australian trial is part of Monash University's Artificial Heart Frontiers Program, a AU$50 million ($31 million) initiative aimed at advancing artificial heart technology. Cardiovascular disease remains the leading cause of death worldwide, with around 18 million fatalities annually, according to the World Health Organization. Experts believe that artificial hearts like the BiVACOR TAH could help address the shortage of donor hearts and improve survival rates for patients with end-stage heart failure. Medical researchers say further trials will be needed before the BiVACOR heart can be considered for widespread use, but this latest development marks a promising step forward in the field of cardiac care.
