How will Meldonium work on the "sports" heart?

I will start here with what, in fact, is the physiological purpose of the heart in General.

All the tissues of our body constantly need oxygen, nutrients and the removal of harmful substances formed as a result of work. The circulatory system fulfills these needs. The "pump" that "pumps" blood into the tissues is our heart. If the heart is in good condition and the circulatory system is functioning normally, then the entire body with all its systems is also working normally. When the heart begins to fail, it will suffer not only the heart, but all the systems of the body. Therefore, we are talking about the heart as the most important part of the human body. This is true both for everyday life and for sports, because sports require many times more tension and more intensive work of the circulatory system.

Disorders in the heart are caused primarily by a lack of oxygen coming to it in comparison with its needs. With a constant decrease in oxygen concentration, oxygen starvation turns into energy starvation. (R. D. Seifulla, Z. G. Ordzhonikidze, 2003)

Without sufficient energy (ATP) for its work, the heart can not perform it in full, especially in a situation of shock work. This results in so-called cardiac overstrain, which is expressed in the following symptoms:

sudden drop in performance,
excessive sweating, General weakness,
lack of oxygen, cough, shortness of breath,
tachycardia, heart rate abnormalities,
pain and stiffness in the chest, nausea, vomiting.
This situation of lack of oxygen is called hypoxia. Cardiac hypoxia occurs for a variety of reasons. One of the most common causes is coronary heart disease, which develops due to atherosclerosis of the arteries, which causes narrowing of their lumen and a decrease in the flow of blood that feeds the heart muscle.

In sports, hypoxia of the heart occurs due to the increasing needs of the muscles for oxygen supply. And the heart also begins to experience a lack of oxygen, which seriously changes the work of the heart.

First, as mentioned above, the production of ATP in the heart muscle decreases. To offset this decrease, the heart rate begins to increase. As a result, blood flow increases and the amount of oxygen delivered to the tissues increases. But the heart rate can not increase indefinitely, for strong and young trained athletes, its maximum value is 200 beats per minute, and for other categories of people it is lower. The heart rate level close to the maximum means that the heart is working with an overload and this condition must be controlled so that there are no pathological changes in the heart tissues. This should be remembered by all athletes of all ages and any level of training.

Secondly, due to the inadequate supply of oxygen to the tissues, there will be a violation of the mitochondria, which is manifested by phase fluctuations in the activity of mitochondrial enzyme complexes. This causes inhibition of the aerobic process of ATP production. Free radicals (SR) will be formed much faster, and the ability of many parts of the antioxidant system will significantly decrease. [3] an Increase in the number of CP will cause oxidative stress, provoking various pathologies of the heart and blood vessels.

The longer this situation of heart overstrain continues and the more often it is repeated, the more irreversible changes occur in the heart tissues:

DILATION of the HEART CHAMBERS is an increase in the volume of the chambers without corresponding thickening of the walls, i.e. actually stretching the walls of the heart. [3] Dilatation of the left atrium is usually caused by regularly increased pressure in the vessels of the large circle of blood circulation as a result of regular hard work. Dilation becomes an important factor in heart failure, since the volume of ejection is reduced due to the weakening of the stretched walls.

MYOCARDIAL HYPERTROPHY is an overgrowth of muscle tissue in certain areas of the heart. Usually hypertrophy affects the left ventricle. This pathology develops in some athletes as an inadequate response to prolonged intense loads – hyperfunction of the heart muscle. [3] in this case, there is also a decrease in the ejection fraction, but due to a decrease in the volume of the heart chambers due to the growing and thickening wall. In addition, there is the problem of the deteriorating supply of food and oxygen to the myocardium due to the increase in its size and insufficient number of capillaries (growing much slower than muscle tissue). The time of oxygen diffusion from the capillaries to the center of the muscle fibers in this case also increases, contributing to the deterioration of oxygen absorption of the enlarged heart muscle. Hypoxia of the heart here leads to heart failure, arrhythmia and overstrain.

A significant part of sudden deaths in sports is caused by myocardial hypertrophy – 33 %, and from all causes, including extra-cardiac (!). [3] Statistics show 17 times more common myocardial hypertrophy in deceased athletes than in living ones. [3]

ARRHYTHMIA. Normally, the heart beats in a certain rhythm, having in its cycle a consistent contraction and relaxation of the Atria and ventricles. If the frequency, rhythm, or sequence of excitation and contraction of the heart is disturbed, then this is a state of cardiac dysfunction, and it is called arrhythmia. 15% of deaths due to cardiac dysfunction are associated with arrhythmia.

For more information about heart strain in sports and its prevention, see the article on this topic
Sports pharmacology has a fairly extensive range of medications and dietary Supplements that optimize heart function. Such drugs are referred to as cardioprotectors. Meldonium is one of these remedies. It, as mentioned above, optimizes the process of ATP energy formation, reduces the heart's need for oxygen (which is important for hypoxia overloading), thereby resisting the processes of cardiac overstrain. Not in all types of sports load, however, its reception will be equally justified and in addition, its property of "switching off" from fat metabolism in some cases of physical activity can create certain problems. Therefore, in order to justify in which cases of physical activity the use of Meldonium can be rational, I propose to take as a basis the division of exercises into zones of power (classification of V. S. Farfel) [1] and consider different types of physical activity. According to the classification of V. S. Farfel, physical exercises are divided into the following zones: maximum, submaximal, large and moderate power. The requirements for the functioning of the cardiovascular system (CVS) and, accordingly, the reception of Meldonium, will depend mainly on two parameters - the power of the effort performed and the time that this effort can be maintained. Moreover, these parameters are inversely dependent. I.e., the more powerful the force, the less time it can be "held". So,

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