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Clemens von Schacky, Maximilian Kemper, Robert Haslbauer and Martin Halle

The Omega-3 Index is defined as erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and represents an individual’s status in these two marine omega-3 fatty acids. A target range of 8 to 11% has been suggested, because values below predispose to cardiovascular events, especially sudden cardiac death, as well as to suboptimal brain function, like prolonged reaction times or even depression. Compared with the general population, elite athletes have an increased incidence of sudden death. The Omega-3 Index has not yet been investigated in elite athletes. In an exploratory approach, we determined the Omega-3 Index in 106 consecutive German national elite winter endurance athletes presenting for preparticipation screening, using a well-established analytical procedure (HS-Omega-3 Index). Surprisingly, only one athlete had a value within the target range, but all others had values <8%. We conclude that we have identified a deficiency of EPA and DHA in these elite athletes. This deficiency presents a potential option for prevention of cardiovascular events such as sudden cardiac death, and improving aspects of brain function. It will be important to scrutinize our finding by more thorough epidemiologic studies and appropriate intervention trials.

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Thomas Rowland

The two articles in the area of cardiovascular physiology and disease in youth were chosen for commentary because of their exploration of new approaches to the diagnosis and management of cardiovascular derangements in young persons. The first, by Hinds et al., describes the potential clinical importance of detection of cardiovascular changes during exercise testing in adolescent athletes following concussions. This approach might prove useful in establishing safe return-to-play guidelines. The second, a review article by Van De Schoor et al, evaluates the frequency of myocardial scarring in athletes, some of adolescent age, which is a recognized risk factor for sudden cardiac death. These findings support other evidence indicating that sports participation per se might rarely increase the risk of such tragedies. Clearly more research is indicated by the information raised in both of these articles, but their importance to clinical medicine is obvious.

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Seyed Mohsen Hosseini, Mojtaba Azizi, Ali Samadi, Nahid Talebi, Hannes Gatterer and Martin Burtscher

-Arrese A . Cardiac biomarker response to intermittent exercise bouts . Int J Sports Med . 2011 ; 32 ( 5 ): 327 – 31 . PubMed doi:10.1055/s-0030-1263138 10.1055/s-0030-1263138 21547864 6. Ellison SR . Sudden cardiac death in adolescents . Prim Care Clin Office Pract . 2015 ; 42 ( 1 ): 57 – 76

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Susan Sullivan Glenney, Derrick Paul Brockemer, Andy C. Ng, Michael A. Smolewski, Vladimir M. Smolgovskiy and Adam S. Lepley

“working out”[ti] OR “workout”[ti] OR “workouts”[ti] OR firefighter*[ti]) AND (“Sudden cardiac death” OR SCD OR “troponin I” OR “troponin t” OR “troponin complex” OR “p selectin” OR “lipid panel” OR “fasting glucose” OR insulin OR BNP OR fibrinogen OR “cardiorespiratory fitness” OR crp OR “c reactive

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Alis Bonsignore, David Field, Rebecca Speare, Lianne Dolan, Paul Oh and Daniel Santa Mina

Particularly, patients treated with androgen deprivation therapy are at an increased risk of developing cardiovascular comorbidities. For example, Gandaglia et al 7 observed 10-year cardiovascular event rates including coronary artery disease, acute myocardial infarction, or sudden cardiac death of 57.3% in

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Gregory Severino, Marcos Sanchez-Gonzalez, Michelle Walters-Edwards, Michael Nordvall, Oksana Chernykh, Jason Adames and Alexei Wong

.79.3.818 Schwartz , P.J. , La Rovere , M.T. , & Vanoli , E. ( 1992 ). Autonomic nervous system and sudden cardiac death. Experimental basis and clinical observations for post-myocardial infarction risk stratification . Circulation, 85 ( Suppl 1 ), I77 – I91 . PubMed Syme , C , Abrahamowicz , M

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Alexei Wong and Arturo Figueroa

.79.3.818 Schwartz , P.J. , La Rovere , M.T. , & Vanoli , E. ( 1992 ). Autonomic nervous system and sudden cardiac death. Experimental basis and clinical observations for post-myocardial infarction risk stratification . Circulation, 85 ( 1 Suppl. ), I77 – I91 . PubMed ID: 1728509 Tanimoto , M. ( 2005

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Duncan Simpson and Lauren P. Elberty

(approximately 18 deaths per year) with sudden cardiac death (SCD) being the common cause, while other reasons included sleep issues, gunshots, drug abuse, suicide, blunt trauma, sickle cell trait, drowning, and heat stroke. Although 18 deaths per year is a small number given there are over 460,000 NCAA student