When the athletic heart falters

For Pierre Lavoie, the first shock came in 2013, when his best friend died suddenly.

“Philippe Boivin was a great cyclist, we did everything together, we trained, we ate together, we traveled together. He never abused, never smoked, didn’t even drink coffee. He was 51 years old. ”

At the end of a trivial hike in Chicoutimi, a passerby saw him pull over on the shoulder, lean over, then fall. A fatal heart incident.

In 2016, Donald Farley, two-time Olympian, considered the best cross-country skier of his generation, also died suddenly while training a bicycle. He was 46 years old. Cardiac arrest.

“Donald, he was an exceptional athlete. We couldn’t get over it. ”

Jean Gagnon, another relative in his fifties, “who bought me my cross-country skis every year”, also fell in battle.

Last summer, director Philippe Belley died in training, two days before the scheduled date of his crossing of Lac Saint-Jean, which he was to do with his daughter, and which he was documenting for a film. The training had been long and rigorous for this 26 km event. He was in great shape. He was 39 years old. “We formed teams and we crossed the lake in a relay with our daughter. It was extremely moving. ”

Then, two weeks ago, Jean-Arthur Tremblay, another close to Pierre Lavoie, died at the age of 63 from what looks like cardiac arrest. “Jean-Arthur was a leader, a guy I gave as an example, a model. He was a top athlete, a guy who had run before [en] 2 h 29 min [un] marathon, one of the best cross-country skiers in Quebec. ”

It was of all the most extreme challenges – ultramarathons, raids of all kinds – in winter and summer.

It was starting to cause a lot of accidents near him …

Adding to the sadness of losing friends was a worry for his own health after decades of hard training.

Not to mention that, for a great promoter of physical activity, these sudden deaths very close to him make a mess. It’s kind of what he does for a living: telling people to play sports.

Lavoie, 57, doesn’t train as much as he did during the not-so-distant days when he was Ironman World Champion in his age category. Nonetheless: his body does not know much about rest. Cycling, running, swimming, cross-country skiing: it’s at least 10 hours a week. Then, at the end of March, he begins his intensive training for his Big Challenge. In 10 weeks, it swallowed 6000 km, whether it was hailing, snowing or raining.

He called cardiologists, including Martin Juneau, director of research at the Montreal Heart Institute.

“I told him: ‘Stop collecting files, do what! What are your recommendations? ” “

The D^r Juneau jumped at the idea. Last week he decided to undertake an in-depth study of the hearts of long-career endurance athletes.

“We have so many problems with a sedentary lifestyle, so when I go to doctors to talk about exercise, I mostly talk about the benefits of exercise. I don’t dwell too much on the problems of excess, says the D^r Juneau. But we know they exist. ”

“Up to 90 minutes of walking a day, or 40 minutes of running, the benefits are huge. Beyond that, it peaks, and at very, very high volume, it goes down again. ”

What is a high volume? He talks more than 20 hours a week. But that too must be clarified.

“We have documented more frequent cases of fibrillation [battements cardiaques irréguliers] in great aerobic type athletes [ski de fond, vélo, course de fond]. Scandinavian researchers have observed rates four to five times higher among top cross-country skiers than among the average population of the same age. It is not necessarily fatal, but it can create pulmonary embolisms.

“It’s a bit worrying. We studied the mechanisms here in rats that were trained to run very regularly. The left atrium grows larger, disrupts electrical conduction, and causes more fibrillation.

“Among the students, there are several amateurs ofultra-trail. It is a fashion that is gaining momentum. I tell them, “If you’re passionate about it, do it, but don’t think it’s going to improve your health.” ”

Athletes’ hearts

For a year, his young colleague, D^r François Simard, spent his days examining the hearts of FC Barcelona players and Spanish Olympic athletes.

This specialist in sports cardiology recently joined the Institute and will participate in this research.

“The problem is defining what is excessive. There has been a big movement in running and extreme endurance sports in recent years. We are barely starting to get answers to our questions.

“What is known is that training [de] high level changes the heart, and not just for the better. The left atrium is growing, as are the arteries, in addition to presenting more calcification. This is not necessarily deleterious, in that it helps stabilize cholesterol plaques. It is nonetheless an irreversible change.

“We often see fibrillation in high performance athletes. It’s not necessarily dangerous, it’s treatable. ”

There is also more “fibrosis”, a kind of scarring on the heart, in endurance athletes.

It is not yet known whether there is a link between these changes and the sudden deaths that we observe from time to time. They may change the electrical connections in the heart and this may be the cause of the arrhythmia.

It is also not known at what level the athletes victims of these fatal cardiac arrests were afflicted with these problems, which are not found in all athletes.

Not to mention that long-term deaths can have many causes.

“I’m not sure Maradona’s heart stopped because of overtraining”, slips the D^r Simard.

In short, there is something to dig.

While waiting for the defibrillators

The D^r Paul Poirier, of the Quebec Heart Institute, will not wait for the results of these studies. For him, the fight is simple: to equip Quebec with defibrillators. And criticize the “extremes”.

“Sudden death, by definition, you can’t predict that,” says Dr.^r Pear tree. We do screenings in the major European soccer clubs, and that does not change anything. ”

Danish soccer player Christian Eriksen would have been given all imaginable tests the day before his cardiac arrest in the middle of the Euro last summer that nothing would have been detected, opines the cardiologist.

“What saved him was the defibrillator. This is what we have to work on. In Ontario, all public places are required by law to have a defibrillator [un appareil qui coûte 1000 $]. In Quebec, there are thousands of them missing. A child of 5^e year can be trained to operate this. Every school should have it, not for the kids, but for the morons like me who go to play ball hockey in the gymnasiums. ”

An athlete is someone who trains more than 10 hours a week, he says.

“Athletes are used to suffering. They deny their symptoms and, on top of that, they often have bastard symptoms: it doesn’t look like in the book. They complain that they have no legs, that their right shoulder hurts, etc.

“We have to respect what our body is made for. We’re not meant to do what Shea Weber does. When I see people running at midday at 40 ° C, I stop and I say to them: “You are going to make a good donor. [d’organes] ! ”

“Extremes are never good. Sedentary people like triathletes: we are not made for that. But it’s as hard to moderate an athlete as it is to move a beluga stranded on a Florida beach in a white Speedo. Him [le béluga], if I tell him to exercise 150 minutes a week, that will put him off. If I tell the jerks who do ultramarathons to stop, they won’t listen to me. You dilate them on Friday, they go back to train on Monday.

– What is the definition of “crinqué”?

– Do you run marathons in more or less than 3 h 30 min?

– Uh, not much less …

– You’re a jerk.

– But doctor …

– What I say to crinquents, it is not to stop, it is to consult if they have symptoms. Pain on exertion, even atypical? Get examined. ”