Running, esophageal acid reflux, and atrial fibrillation: A chain of events linked by evidence from separate medical literatures
Section snippets
1. Introduction
An earlier analysis of atrial fibrillation (AF) in athletes combined arguments from separate medical literatures, one literature providing evidence that athletic overtraining can induce chronic systemic inflammation, and the other showing that inflammation may be important in the pathogenesis of AF [1]. The two arguments together suggest that inflammation as a mechanism might explain an unexpected susceptibility of athletes to AF, unexpected because the typical AF patient is much older (median
2.1. Finding novel connections between complementary literatures
The approach described here is based on the idea that two scientific articles, or two non-overlapping sets of articles, can be complementary, in that, taken together, they suggest new information not apparent in either set alone. To find such pairs of complementary literatures depends in general on finding pairs of statements from different articles that are linked by key words or phrases that they have in common. Sets of articles are identified by exploratory searching of Medline, and key
3.1. Results of Arrowsmith search
Among the top seven B-terms, “proton pump” is immediately of interest because of its possible clinical relevance. It is linked to an output display of the following two titles, each containing the phrase “proton pump inhibit––”.
A-title: Proton pump inhibition prevents gastrointestinal bleeding in ultramarathon runners: a randomized, double blinded, placebo controlled study [3].
C-title: Case of paroxysmal atrial fibrillation improved after the administration of proton pump inhibitor for
4. Discussion
The purpose of this article is not only to call attention to a perhaps previously unnoticed connection between running and AF via GER, as a basis for stimulating a new medical hypothesis, but also to suggest an approach to testing the hypothesis, particularly with respect to a suitable population of subjects and a clinical endpoint.
Acknowledgments
I thank Neil Smalheiser and Vetle Torvik for valuable suggestions. This work was supported in part by a subgrant from the University of Illinois at Chicago (PI Neil R. Smalheiser, M.D., Ph.D.) R01 LM007292-05, Arrowsmith data-mining techniques in neuro-informatics, co-sponsored by NLM and NIMH, 15/6/01–31/5/06. The contents of this article are solely the responsibility of the author and do not necessarily represent the views of NIH.
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2012, American Journal of CardiologyCitation Excerpt :Baldesberger et al15 did not find an increased incidence of atrial ectopy, despite increases in ventricular ectopy in former professional cyclists. A review by Swanson19 showed that excessive endurance exercise can lead to chronic systemic inflammation which can modify the atrial substrate to favoring the onset and maintenance of AF. Another case-control study by Lindsay and Dunn20 involving 45 veteran athletes showed biochemical evidence of disruption of the collagen equilibrium that would favor fibrosis and increase in 3 collagen markers (plasma procollagen type I carboxy-terminal propeptide, C-telopeptide for type I collagen, and tissue inhibitor of metalloproteinase–1) compared to sedentary controls.
Atrial fibrillation in athletes: Prevalence, diagnosis, and treatment
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