Mechanical Stress Effects on the Cardiovascular Adaptations of Peripheral Arterial Calcifications Among Athletes (MediaSport)

• Extent of intra parietal calcification of lower limb arteries [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  Score ranging from 0 to 3
• Inner diameter of the intima-media of the common femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Outer diameter of the intima-media of the common femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Inner diameter of the intima-media of the superficial femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Outer diameter of the intima-media of the superficial femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Inner diameter of the intima-media of the common carotid artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Outer diameter of the intima-media of the common carotid artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Thickness of the intima-media of the common femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Thickness of the intima-media of the superficial femoral artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Thickness of the intima-media of the common carotid artery (mm) [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Local parietal compliance of the superficial femoral artery [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mm^2/mmHg
• Compliance of the carotid artery [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mm^2/mmHg
• Distensibility of the carotid artery [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mmHg^-1*10^-2
• Arterial wave velocity in lower limb [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  m/s
• Arterial wave velocity in upper limb [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  m/s
• Endothelium-dependent vasorelaxation in the femoral artery [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  %
• Postischemic vasomotor response at the (skin) microcirculatory level [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  %
• Systolic pressure index at the ankle [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  relative units
• Systolic pressure index for the big toe [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  relative units
• Cardiac afterload index [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  g/cm^2
• Echocardiographic parameters analyzing systolic function: the stroke volume [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  ml
• Echocardiographic parameters analyzing systolic function: cardiac output [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  l/min
• Echocardiographic parameters analyzing systolic function: peripheral vascular resistance [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  Pa.s/m^3
• Echocardiographic parameters analyzing systolic function: fractional shortening [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  %
• Echocardiographic parameters analyzing systolic function: speed of the S-wave according to tissue Doppler [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  cm.s-1
• Echocardiographic parameters analyzing systolic function: global longitudinal strain [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  %
• Ventricular-arterial coupling [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  relative units
• Echocardiographic parameters analyzing diastolic function: transmitral E wave velocity [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  cm/s
• Echocardiographic parameters analyzing diastolic function: transmitral A wave velocity [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  cm/s
• Echocardiographic parameters analyzing diastolic function: transmitral E wave velocity / transmitral A wave velocity [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  relative units
• Echocardiographic parameters analyzing diastolic function: maximum Em wave velocity according to tissue Doppler [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  cm/s
• Echocardiographic parameters analyzing diastolic function: maximum Am wave velocity according to tissue Doppler [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  cm/s
• Echocardiographic parameters analyzing diastolic function: transmitral E wave velocity / maximum Em wave velocity according to tissue Doppler [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  relative units
• Echocardiographic parameters analyzing diastolic function: early diastolic strain-rate [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  s^-1
• Years of athletic training [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Hours of athletic training per week [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  h/week
• Best performance in the last 6 months [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
• Lower limb muscle mass [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  g
• Bone density [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  g/cm^2
• Dietary protein intake [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  g/day
• Dietary protein intake [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  % calories per day
• Dietary calcium intake [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mg/day
• Serum protein [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  g/l
• Serum calcium [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mmol/l
• Serum phosphorus [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  mmol/l
• Serum parathyroid hormone [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  ng/l
• Serum vitamin D2 [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  µg/l
• Serum vitamin D3 [ Time Frame: Baseline (Day 0; transversal study) ] [ Designated as safety issue: No ]
  µg/l

The main objective of this study is to obtain data for the integrated analysis of morphological, functional and biomechanical parameters pertaining to lower limb arteries in "upper-limb" and "lower-limb" endurance athletes without cardiovascular risk as compared to (each other and to) sedentary controls.

Secondary objectives of this study are:

A. Determine the presence and extent of intima-media calcifications in athletes B. Determine the relationship between these calcifications and the level, length and intensity of sports activity.

C. Determine the relationship between these properties and calcification of the arterial wall D. Analyze the relationship between the type of sports activity and properties of the arterial wall.

E. Examine the relationship between the properties of the arterial wall and peripheral perfusion pressures.

F. Examine the relationship between the properties of the arterial wall, changes in afterload, morphology and systolic heart function.

G. Analyze the relationships between the parameters characterizing the arterial wall and muscle mass of the lower limbs.

H. Analyze the relationship between the presence of intramural calcification and bone density determined by densitometry.

I. Analyze the relationship between the presence of intramural calcification and dietary protein intake and calcium.

J. Compare indices of pressure at the ankle and toe, depending on the extent of calcification.

K. Create a collection of biological samples (serum).

The study population is composed of three groups of healthy volunteers: (1) upper body athletes; (2) lower-body athletes and (3) sedentary volunteers. All volunteers are between the ages of 25 and 40. Upper-body and lower-body athletes are matched according to years of intense athletic training and hours of weekly training. Sedentary volunteers are matched with athletes according to age and sex.

• Upper-body athletes
  This group includes swimmers, rowers or kayakers with a history of at least 10 years of intense training, and performance in regional competitions for the past five years.
• Lower-body athletes
  This group includes runners (marathon or trail) and cyclists with a history of at least 10 years of intense training, and performance in regional competitions for the past five years.
• Sedentary volunteers
  This group of healthy volunteers does not participate in athletic activity for more than two hours per week. They are matched by age and sex with the athletic groups.

Inclusion Criteria for athletic and sedentary volunteers:

• The volunteer must have given his/her informed and signed consent
• The volunteer must be insured or beneficiary of a health insurance plan
• Volunteers without cardiovascular disease, glucose regulation disorders or known renal disease

Inclusion Criteria for athletic volunteers only:

• Ongoing athletic activity for the past 10 years
• Athletic activity at the regional level for the past 5 years
• Practices one of the four following sports: marathon or trail running; cycling; swimming; rowing/kayaking

Exclusion Criteria for athletic and sedentary volunteers:

• The volunteer is participating in another study
• The volunteer is in an exclusion period determined by a previous study
• The volunteer is under judicial protection, under tutorship or curatorship
• The volunteer refuses to sign the consent
• It is impossible to correctly inform the volunteer
• The volunteer is pregnant, parturient, or breastfeeding
• Tobacco use
• Contraindications for the practice of physical activity (joint, heart or other)
• Intercurrent pathology
• First degree family history of cardiovascular disease
• Known dyslipidemia (including cholesterol)
• Glucose tolerance abnormalities (prediabetes or diabetes)
• Treatment with certain drugs used for treating erectile dysfunction: Sildefanil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra) and yohimbine (Yohimbine Houde and Yocoral)

Exclusion Criteria for sedentary volunteers only:

• More than two hours of athletic activity per week
• History of intense athletic training
• Body mass index >= 25 kg/m^2