Heart experts question claims Russian skater’s drug test was contaminated by her grandfather’s drug

The latest revelations about Russian figure skater Kamila Valieva’s doping case raise more questions about the substances found in her sample — and the reasons the 15-year-old may have failed the drug test. TIME asked leading experts to help understand the claims that have turned the women’s figure skating competition at the Beijing Olympics on its head and put a greater damper on the sport.

During Sunday’s hearing by the Court of Arbitration for Sport (CAS), anti-doping authorities revealed that Valieva tested positive for three heart treatment drugs, one of which has been banned by the World Anti-Doping Agency as a performance-enhancing drug.
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In addition to trimetazidine (TMZ), the banned substance, the New York Times reported that Valieva’s sample also contained hypoxes and L-carnatine, a supplement. All three are used for patients with angina, to improve blood flow and improve the function of the heart when it is lacking oxygen.

When she submitted a sample for testing in December, Valieva stated that she was taking hypoxes and L-carnatine, along with another compound, supradyn, a supplement that boosts immunity, according to documents reviewed by the Times. All three of those substances are allowed.

To explain the presence of the banned drug, TMZ, Valieva’s lawyer argued that she was “contaminated” with the medication, possibly through contact with her grandfather, who appeared on video to say he was taking the medication. TMZ is prescribed to treat angina because it can help increase blood flow to the heart and make the heart work more efficiently. It is not approved in the US but has been approved by the European Medicines Agency and other regulatory authorities.

READ MORE: Kamila Valieva gets to skate. The battle for her drug test has only just begun

The Russian newspaper Pravda reported that Valieva’s lawyers argued during the hearing: “There could be completely different ways how it got into her body. For example, Grandpa drank something from a glass, it got salvia in it, this glass was later mixed in some way. way used by an athlete. Either the drug was on a surface, traces were left behind, the drug was on this surface, which the athlete then drank.”

Can the drug pass from one person to another so easily, and if so, would it show up in the recipient’s urine sample, as Valieva’s lawyer claims? “It reminds me of kids I knew who said they got venereal disease from the toilet seat,” said Dr. Steven Nissen, a cardiologist at the Cleveland Clinic.

Nissen says he is not familiar with the sensitivity of the tests, a scientific measurement procedure used by the WADA lab, but says testing positive for a substance by drinking from the same glass as someone taking it is “very far-fetched.” “is.

“It’s hard to be definitive without knowing the test” [test] sensitivity, but it seems very, very unlikely,” he says.

Valieva’s lawyer also claimed that she may have come into contact with the drug on a surface and then somehow ingested it. dr. Donald Lloyd-Jones, president of the American Heart Association and chair of preventive medicine at Northwestern University’s Feinberg School of Medicine, says, “I haven’t seen any evidence of it being absorbed through the skin.” He admits he doesn’t know how much of the drug was detected in the athlete’s sample, which would indicate whether brief contact with a small amount of the drug could explain her positive test.

Lloyd-Jones also points out that patients should take TMZ three times a day because it is metabolized by the body and excreted relatively quickly. At the approved dose, the drug would reach its peak levels in the blood within two to six hours, with the majority clearing within 24 hours. “It seems unlikely that a little bit on a glass or on her skin would have resulted in a positive test unless it happened just before she delivered the sample,” he says. “One can draw conclusions that the exposure was very recent, very shortly before her test, or she was exposed more chronically.”

Ideally, a performance-enhancing drug has the same characteristic. “The ideal performance-enhancing compounds come in to improve performance and then go out without a trace,” says Lloyd-Jones.

READ MORE: Olympians Unleash on Kamila Valieva and Russian Doping Controversy

Although TMZ is not available in the US, Nissen says there is a similar drug, ranolazine, which has been approved by the Food and Drug Administration. That drug also shifts the energy source that heart cells use from fatty acids to glucose, which is more efficient. “That’s why it works for angina,” says Nissen. “It allows people to do more with less blood flow. It’s conceivable for an athlete that it would have a similar advantage and make the heart work more efficiently and give them a little head start.”

Lloyd-Jones says this metabolic pathway also results in less buildup of lactic acid, which can cause muscle fatigue. “There is data from small studies in patients with heart failure that seem to indicate better heart performance for those with a failed pump,” he says. “But whether that translates to the same benefit in a young, healthy person — I don’t think we know.”

It is also unclear what the effects are of taking these compounds while the body is younger. “It’s certainly concerning, especially in a young person whose body is still developing,” Lloyd-Jones says. “We really don’t understand the long-term effects of changing a person’s physiology at this age.”

Although the Court of Arbitration for Sport has ruled that Valieva could participate in Beijing, her doping case remains unsolved pending further investigation. That means the gold she and her teammates won in the team event, and any medal she wins in the women’s event could potentially be stripped if anti-doping officials conclude she’s been doping and competing with an unfair advantage.

That will depend on additional testing of a second sample, supplied from the same urine as her first, which will be analyzed to confirm positive results from the first sample.

This post Heart experts question claims Russian skater’s drug test was contaminated by her grandfather’s drug

was original published at “https://time.com/6148528/russian-skater-kamila-valieva-contamination/”