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Erschienen in: Sports Medicine 3/2019

11.02.2019 | Leading Article

Is Heat Intolerance State or Trait?

verfasst von: Yuri Hosokawa, Rebecca L. Stearns, Douglas J. Casa

Erschienen in: Sports Medicine | Ausgabe 3/2019

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Abstract

The existing literature suggests two standpoints in defining heat intolerance, which are heat tolerance as state or trait. The former bases its case in the plasticity of human physiology, where one may gain or lose the adaptations associated with heat acclimatization and the ability to tolerate heat is considered transient. This phenomenon is exemplified in the recovery process of exertional heat stroke (EHS) patients in that victims of EHS are able to eventually regain heat tolerance and return to activity without recurrent episodes of EHS. On the other hand, an increasing number of reports imply that genetic predisposition may be associated with one’s vulnerability to heat stress. Individuals who seem to exhibit lower than expected exercise tolerance in moderate heat and those who never regain heat tolerance post EHS fall into this category. However, there is a large area of uncertainty in this debate because a true prospective investigation of factors associated with heat intolerance is methodologically difficult. We conclude from the current literature that both mechanisms of heat intolerance (state and trait) should be considered in interpreting the mechanism and cause of heat intolerance.
Literatur
1.
Zurück zum Zitat Sawka MN, Leon LR, Montain SJ, Sonna LA. Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress. Compr Physiol. 2011;1:1883–928.CrossRefPubMed Sawka MN, Leon LR, Montain SJ, Sonna LA. Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress. Compr Physiol. 2011;1:1883–928.CrossRefPubMed
2.
Zurück zum Zitat Jay O, Kenny GP. The determination of changes in body heat content during exercise using calorimetry and thermometry. J Hum Environ Syst. 2007;10:19–29.CrossRef Jay O, Kenny GP. The determination of changes in body heat content during exercise using calorimetry and thermometry. J Hum Environ Syst. 2007;10:19–29.CrossRef
3.
Zurück zum Zitat Rowell LB. Human cardiovascular adjustments to exercise and thermal stress. Physiol Rev. 1974;54:75–159.CrossRefPubMed Rowell LB. Human cardiovascular adjustments to exercise and thermal stress. Physiol Rev. 1974;54:75–159.CrossRefPubMed
4.
Zurück zum Zitat Nadel ER, Cafarelli E, Roberts MF, Wenger CB. Circulatory regulation during exercise in different ambient temperatures. J Appl Physiol. 1979;46:430–7.CrossRefPubMed Nadel ER, Cafarelli E, Roberts MF, Wenger CB. Circulatory regulation during exercise in different ambient temperatures. J Appl Physiol. 1979;46:430–7.CrossRefPubMed
5.
Zurück zum Zitat Wingo JE, Crandall CG, Kenny GP. Chapter 2 Human Heat Physiology. In: Casa DJ, editor. Sport and physical activity in the heat—maximizing performance and safety. Berlin: Springer; 2018. p. 15–30.CrossRef Wingo JE, Crandall CG, Kenny GP. Chapter 2 Human Heat Physiology. In: Casa DJ, editor. Sport and physical activity in the heat—maximizing performance and safety. Berlin: Springer; 2018. p. 15–30.CrossRef
6.
Zurück zum Zitat Nielsen M. Die Regulation der Körpertemperatur bei Muskelarbeit1. Skand Arch Für Physiol. 1938;79:193–230.CrossRef Nielsen M. Die Regulation der Körpertemperatur bei Muskelarbeit1. Skand Arch Für Physiol. 1938;79:193–230.CrossRef
7.
Zurück zum Zitat Armstrong LE, Maresh CM. The Induction and decay of heat acclimatisation in trained athletes. Sports Med. 1991;12:302–12.CrossRefPubMed Armstrong LE, Maresh CM. The Induction and decay of heat acclimatisation in trained athletes. Sports Med. 1991;12:302–12.CrossRefPubMed
8.
Zurück zum Zitat Cramer MN, Jay O. Explained variance in the thermoregulatory responses to exercise: the independent roles of biophysical and fitness/fatness-related factors. J Appl Physiol Bethesda Md. 1985;2015(119):982–9. Cramer MN, Jay O. Explained variance in the thermoregulatory responses to exercise: the independent roles of biophysical and fitness/fatness-related factors. J Appl Physiol Bethesda Md. 1985;2015(119):982–9.
9.
Zurück zum Zitat Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014;4:257–85.CrossRefPubMed Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014;4:257–85.CrossRefPubMed
10.
Zurück zum Zitat Racinais S, Alonso JM, Coutts AJ, Flouris AD, Girard O, González-Alonso J, et al. Consensus recommendations on training and competing in the heat. Br J Sports Med. 2015;49:1164–73.CrossRefPubMedPubMedCentral Racinais S, Alonso JM, Coutts AJ, Flouris AD, Girard O, González-Alonso J, et al. Consensus recommendations on training and competing in the heat. Br J Sports Med. 2015;49:1164–73.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Casadio JR, Kilding AE, Cotter JD, Laursen PB. From lab to real world: heat acclimation considerations for elite athletes. Sports Med Auckl NZ. 2017;47:1467–76.CrossRef Casadio JR, Kilding AE, Cotter JD, Laursen PB. From lab to real world: heat acclimation considerations for elite athletes. Sports Med Auckl NZ. 2017;47:1467–76.CrossRef
12.
Zurück zum Zitat Casa DJ, DeMartini JK, Bergeron MF, Csillan D, Eichner ER, Lopez RM, et al. National Athletic Trainers’ Association position statement: exertional heat illnesses. J Athl Train. 2015;50:986–1000.CrossRefPubMedPubMedCentral Casa DJ, DeMartini JK, Bergeron MF, Csillan D, Eichner ER, Lopez RM, et al. National Athletic Trainers’ Association position statement: exertional heat illnesses. J Athl Train. 2015;50:986–1000.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Belding HS, Kamon E. Evaporative coefficients for prediction of safe limits in prolonged exposures to work under hot conditions. Fed Proc. 1973;32:1598–601.PubMed Belding HS, Kamon E. Evaporative coefficients for prediction of safe limits in prolonged exposures to work under hot conditions. Fed Proc. 1973;32:1598–601.PubMed
15.
Zurück zum Zitat Shapiro Y, Magazanik A, Udassin R, Ben-Baruch G, Shvartz E, Shoenfeld Y. Heat intolerance in former heatstroke patients. Ann Intern Med. 1979;90:913–6.CrossRefPubMed Shapiro Y, Magazanik A, Udassin R, Ben-Baruch G, Shvartz E, Shoenfeld Y. Heat intolerance in former heatstroke patients. Ann Intern Med. 1979;90:913–6.CrossRefPubMed
16.
Zurück zum Zitat Stearns RL, Deuster PA, Kazman JB, Heled Y, O’Connor FG. Chapter 12 heat tolerance testing. In: Casa DJ, editor. Sport and physical activity in the heat—maximizing performance and safety. Berlin: Springer; 2018. p. 213–27.CrossRef Stearns RL, Deuster PA, Kazman JB, Heled Y, O’Connor FG. Chapter 12 heat tolerance testing. In: Casa DJ, editor. Sport and physical activity in the heat—maximizing performance and safety. Berlin: Springer; 2018. p. 213–27.CrossRef
17.
Zurück zum Zitat Fiszer D, Shaw M-A, Fisher NA, Carr IM, Gupta PK, Watkins EJ, et al. Next-generation sequencing of RYR1 and CACNA1S in malignant hyperthermia and exertional heat illness. Anesthesiology. 2015;122:1033–46.CrossRefPubMedPubMedCentral Fiszer D, Shaw M-A, Fisher NA, Carr IM, Gupta PK, Watkins EJ, et al. Next-generation sequencing of RYR1 and CACNA1S in malignant hyperthermia and exertional heat illness. Anesthesiology. 2015;122:1033–46.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Potts LE, Longwell JJ, Bedocs P, Sambuughin N, Bina S, Cooper PB, et al. Improving awareness of nonanesthesia-related malignant hyperthermia presentations: a tale of two brothers. Case Rep. 2014;3:23–6. Potts LE, Longwell JJ, Bedocs P, Sambuughin N, Bina S, Cooper PB, et al. Improving awareness of nonanesthesia-related malignant hyperthermia presentations: a tale of two brothers. Case Rep. 2014;3:23–6.
19.
Zurück zum Zitat Muldoon S, Deuster P, Voelkel M, Capacchione J, Bunger R. Exertional heat illness, exertional rhabdomyolysis, and malignant hyperthermia: is there a link? Curr Sports Med Rep. 2008;7:74–80.CrossRefPubMed Muldoon S, Deuster P, Voelkel M, Capacchione J, Bunger R. Exertional heat illness, exertional rhabdomyolysis, and malignant hyperthermia: is there a link? Curr Sports Med Rep. 2008;7:74–80.CrossRefPubMed
20.
Zurück zum Zitat Hosokawa Y, Casa DJ, Rosenberg H, Capacchione JF, Sagui E, Riazi S, et al. Round table on malignant hyperthermia in physically active populations: meeting proceedings. J Athl Train. 2017;52:377–83.CrossRefPubMedPubMedCentral Hosokawa Y, Casa DJ, Rosenberg H, Capacchione JF, Sagui E, Riazi S, et al. Round table on malignant hyperthermia in physically active populations: meeting proceedings. J Athl Train. 2017;52:377–83.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Keren G, Epstein Y, Magazanik A. Temporary heat intolerance in a heatstroke patient. Aviat Sp Environ Med. 1981;52:116–7. Keren G, Epstein Y, Magazanik A. Temporary heat intolerance in a heatstroke patient. Aviat Sp Environ Med. 1981;52:116–7.
22.
Zurück zum Zitat Druyan A, Yanovich R, Heled Y. Misdiagnosis of exertional heat stroke and improper medical treatment. Mil Med. 2011;176:1278–80.CrossRefPubMed Druyan A, Yanovich R, Heled Y. Misdiagnosis of exertional heat stroke and improper medical treatment. Mil Med. 2011;176:1278–80.CrossRefPubMed
23.
Zurück zum Zitat Adams WM, Hosokawa Y, Huggins RA, Mazerolle SM, Casa DJ. An exertional heat stroke survivor’s return to running: an integrated approach on the treatment, recovery, and return to activity. J Sport Rehabil. 2016;25:280–7.CrossRefPubMed Adams WM, Hosokawa Y, Huggins RA, Mazerolle SM, Casa DJ. An exertional heat stroke survivor’s return to running: an integrated approach on the treatment, recovery, and return to activity. J Sport Rehabil. 2016;25:280–7.CrossRefPubMed
24.
Zurück zum Zitat Chen S-H, Lin M-T, Chang C-P. Ischemic and oxidative damage to the hypothalamus may be responsible for heat stroke. Curr Neuropharmacol. 2013;11:129–40.CrossRefPubMedPubMedCentral Chen S-H, Lin M-T, Chang C-P. Ischemic and oxidative damage to the hypothalamus may be responsible for heat stroke. Curr Neuropharmacol. 2013;11:129–40.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Moran DS, Erlich T, Epstein Y. The heat tolerance test: an efficient screening tool for evaluating susceptibility to heat. J Sport Rehabil. 2007;16:215–21.CrossRefPubMed Moran DS, Erlich T, Epstein Y. The heat tolerance test: an efficient screening tool for evaluating susceptibility to heat. J Sport Rehabil. 2007;16:215–21.CrossRefPubMed
27.
Zurück zum Zitat Mee JA, Doust J, Maxwell NS. Repeatability of a running heat tolerance test. J Therm Biol. 2015;49–50:91–7.CrossRefPubMed Mee JA, Doust J, Maxwell NS. Repeatability of a running heat tolerance test. J Therm Biol. 2015;49–50:91–7.CrossRefPubMed
28.
Zurück zum Zitat Stearns RL. True Story #4……. returning a complicated exertional heat stroke case to activity. In: Gorse K, Feld F, Blanc R, editors. True stories Athl Train Room. Thorofare: SLACK Inc; 2018. Stearns RL. True Story #4……. returning a complicated exertional heat stroke case to activity. In: Gorse K, Feld F, Blanc R, editors. True stories Athl Train Room. Thorofare: SLACK Inc; 2018.
29.
Zurück zum Zitat Kenney WL. A review of comparative responses of men and women to heat stress. Environ Res. 1985;37:1–11.CrossRefPubMed Kenney WL. A review of comparative responses of men and women to heat stress. Environ Res. 1985;37:1–11.CrossRefPubMed
30.
Zurück zum Zitat Kenney WL. Physiological correlates of heat intolerance. Sports Med Auckl NZ. 1985;2:279–86.CrossRef Kenney WL. Physiological correlates of heat intolerance. Sports Med Auckl NZ. 1985;2:279–86.CrossRef
31.
Zurück zum Zitat Druyan A, Amit D, Makranz C, Moran D, Yanovich R, Epstein Y, et al. Heat tolerance in women—reconsidering the criteria. Aviat Sp Environ Med. 2012;83:58–60.CrossRef Druyan A, Amit D, Makranz C, Moran D, Yanovich R, Epstein Y, et al. Heat tolerance in women—reconsidering the criteria. Aviat Sp Environ Med. 2012;83:58–60.CrossRef
32.
Zurück zum Zitat Smoljanić J, Morris NB, Dervis S, Jay O. Running economy, not aerobic fitness, independently alters thermoregulatory responses during treadmill running. J Appl Physiol Bethesda Md. 1985;2014(117):1451–9. Smoljanić J, Morris NB, Dervis S, Jay O. Running economy, not aerobic fitness, independently alters thermoregulatory responses during treadmill running. J Appl Physiol Bethesda Md. 1985;2014(117):1451–9.
33.
Zurück zum Zitat Cramer MN, Jay O. Selecting the correct exercise intensity for unbiased comparisons of thermoregulatory responses between groups of different mass and surface area. J Appl Physiol Bethesda Md. 1985;2014(116):1123–32. Cramer MN, Jay O. Selecting the correct exercise intensity for unbiased comparisons of thermoregulatory responses between groups of different mass and surface area. J Appl Physiol Bethesda Md. 1985;2014(116):1123–32.
34.
Zurück zum Zitat Nelson DA, Deuster PA, O’Connor FG, Kurina LM. Timing and predictors of mild and severe heat illness among new military enlistees. Med Sci Sports Exerc. 2018;50:1603–12.CrossRefPubMedPubMedCentral Nelson DA, Deuster PA, O’Connor FG, Kurina LM. Timing and predictors of mild and severe heat illness among new military enlistees. Med Sci Sports Exerc. 2018;50:1603–12.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Stearns RL, Hosokawa Y, Adams WM, Belval LN, Huggins RA, Jardine JF, et al. Repeated exertional heat stroke incidence in a warm-weather road race. J Athl Train. 2017;52:S106. Stearns RL, Hosokawa Y, Adams WM, Belval LN, Huggins RA, Jardine JF, et al. Repeated exertional heat stroke incidence in a warm-weather road race. J Athl Train. 2017;52:S106.
36.
Zurück zum Zitat Abriat A, Brosset C, Brégigeon M, Sagui E. Report of 182 cases of exertional heatstroke in the French Armed Forces. Mil Med. 2014;179:309–14.CrossRefPubMed Abriat A, Brosset C, Brégigeon M, Sagui E. Report of 182 cases of exertional heatstroke in the French Armed Forces. Mil Med. 2014;179:309–14.CrossRefPubMed
37.
Zurück zum Zitat Sagui E. Malignant hyperthermia, exertional heat illness, and RYR1 variants: the muscle may not be the brain. Anesthesiology. 2016;124:510.CrossRefPubMed Sagui E. Malignant hyperthermia, exertional heat illness, and RYR1 variants: the muscle may not be the brain. Anesthesiology. 2016;124:510.CrossRefPubMed
38.
Zurück zum Zitat Smith R, Jones N, Martin D, Kipps C. “Too much of a coincidence”: identical twins with exertional heatstroke in the same race. BMJ Case Rep. 2016;2016:bcr2015212592.CrossRefPubMedPubMedCentral Smith R, Jones N, Martin D, Kipps C. “Too much of a coincidence”: identical twins with exertional heatstroke in the same race. BMJ Case Rep. 2016;2016:bcr2015212592.CrossRefPubMedPubMedCentral
40.
41.
Zurück zum Zitat Heled Y, Fleischmann C, Epstein Y. Cytokines and their role in hyperthermia and heat stroke. J Basic Clin Physiol Pharmacol. 2013;24:85–96.PubMed Heled Y, Fleischmann C, Epstein Y. Cytokines and their role in hyperthermia and heat stroke. J Basic Clin Physiol Pharmacol. 2013;24:85–96.PubMed
42.
Zurück zum Zitat Horowitz M. Heat acclimation, epigenetics, and cytoprotection memory. Compr Physiol. 2014;4:199–230.CrossRefPubMed Horowitz M. Heat acclimation, epigenetics, and cytoprotection memory. Compr Physiol. 2014;4:199–230.CrossRefPubMed
43.
Zurück zum Zitat Stearns RL, Casa DJ, O’Connor FG, Lopez RM. A tale of two heat strokes: a comparative case study. Curr Sports Med Rep. 2016;15:94–7.CrossRefPubMed Stearns RL, Casa DJ, O’Connor FG, Lopez RM. A tale of two heat strokes: a comparative case study. Curr Sports Med Rep. 2016;15:94–7.CrossRefPubMed
44.
Zurück zum Zitat Casa DJ. Don’t gamble: complex considerations for return to play following exertional heat stroke. J Sport Rehabil. 2007;16:161–2.CrossRef Casa DJ. Don’t gamble: complex considerations for return to play following exertional heat stroke. J Sport Rehabil. 2007;16:161–2.CrossRef
Metadaten
Titel
Is Heat Intolerance State or Trait?
verfasst von
Yuri Hosokawa
Rebecca L. Stearns
Douglas J. Casa
Publikationsdatum
11.02.2019
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 3/2019
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-019-01067-z

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