MDNews - Mid Hudson

Building on a Rich Tradition ALTHOUGH HEALTH QUEST'S sports cardiology program is unique in the Mid-Hudson region, the young discipline of sports cardiology is rooted in older traditions, such as military medicine. For example, James Lyons, MD, Director of the Heart Failure Program at The Heart Center, became interested in sports cardiology when he worked in cardiac training at the National Naval Medical Center in Maryland. "We conducted all the testing and screening for new recruits and new officers," he says. "We cared for midshipmen at the Naval Academy and for athletes and non-athletes who were being commissioned before graduation. All of them went through rigorous screening to make sure they were fit for duty or to continue with athletic training. So while sports cardiology is a new and evolving field, as a military medical field, this is something we have been doing for years." Dr. Haleem and Dr. Jafar discuss a patient's 3-D echocardiogram. Patricia Liguori, Medical Assistant, performs an EKG on an athlete. amount of time he or she trains is also part of the calculus. To achieve this synthesis and make the correct exercise prescriptions, the specialists in The Heart Center's sports cardiolog y program work closely with at h letes, coaches a nd tra i ners. The athlete and his or her coaches set the goals, Dr. Jafar explains, and the medical team advises the athlete on how best to achieve them. " In VO2 ma x testing, we mea sure athletes' peak performance," Dr. Jafar says. " We measure their target zones. We then optimize a regimen depending on what their race or competition is to let them know at what level they should train. Equally important, we perform a measurement before they begin training, and then we perform multiple parameter measurements after training to see what performance they're improving and to show the point at which the heart is most efficient — their aerobic base." The aerobic base should be close to the anaerobic threshold, Dr. Jafar explains. That way, the athlete can identify the point at which he or she performs best while using energy most efficiently. "Your anaerobic threshold is your upper limit, or your redline," Dr. Jafar says. "We want to help an athlete move the aerobic base as close to the redline as possible because that gives him or her greater effi- ciency at a higher heart rate." In some cases, athletes wear monitors to help them track where they're most efficient, and that data can help sports cardiologists evaluate their performance and advise them. Specially trained teams of cardiologists and exercise physiologists work with each patient. "We have options for the college athlete and others for people who have varying amounts of time to work out — anything from five to 20 hours a week," Dr. Jafar says. "Everybody is unique, so no one will run the same program exactly the same way every time." SAFETY FOR ATHLETES YOUNG AND OLD W hile performance optimization for advanced athletes is a crucial component of the sports cardiology program, the primary goal is to keep athletes safe. "For athletes who are older and doing longer endurance events, such as triath- lons, marathons and ultramarathons, we aim to mitigate underlying risk factors they may experience as weekend warriors or serious amateurs," Dr. Jafar says. "In younger athletes, we look for any congeni- tal abnormalities that put them at risk." The movement of middle-age and senior adults into endurance sports is noth- ing new; in fact, in many long-distance events, the age of record-holders has nudged upward in recent decades, though Dr. Haleem notes that no physiological basis for this trend has been established. Winners of races up to 100 miles long or run over severa l days tend to have a n age spread from the late 20s to the 50s. A s ol der p e ople lo ok t o i mpr o v e t hei r endura nce w it h longer event s, The Hea r t Center 's ca rdiolog ists ca n address a ny ca rdiac condition prior to such events. "Athletes eventua lly enter the age at which they may develop hea r t disease, leading to the potentia lly deadly combi- nation of elevated disease risk combined with putting the hea r t under stress by running a g reater dista nce," Dr. Ja fa r says. " You wa nt to ensure the athlete is doing what is sa fe for his or her hea r t." Sp or t s c a rd iolog i s t s ba l a nc e t he risk of a n older ath lete ex periencing a hea r t attack or stroke while working out w it h t he potentia l of exercise to m itigate hea r t disea se r isk a nd pro- mote longevit y. 0 8 0 8❱❱❱❱❱ C O V E R F E A T U R E

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