T he most current discoveries about Russian figure skater Kamila Valieva’s doping case raise more concerns about the compounds discovered in her sample– and the reasons why the 15- year-old might have stopped working the drug test TIME asked leading specialists to assist make sense of the claims, which have upended the women’s figure skating competition at the Beijing Olympics and cast a larger pall over the sport.

At the hearing held on Sunday by the Court of Arbitration for Sport (CAS), anti-doping authorities exposed that Valieva tested positive for 3 heart treatment drugs, among which is banned as a performance-enhancer by the World Anti-Doping Agency.

In addition to trimetazidine (TMZ), the prohibited substance, the New York City Times reported that Valieva’s sample also consisted of hypoxen and L-carnatine, a supplement. All 3 are utilized for patients with angina, to improve blood circulation and enhance function of the heart when it lacks oxygen.

To explain the existence of the forbidden drug, TMZ, Valieva’s legal representative argued that she was “infected” with the medication, potentially by means of contact with her grandfather, who appeared by video to state that he takes the medication. The Fight Over Her Drug Test Is Simply Starting

Russian paper Pravda reported that Valieva’s attorneys argued throughout the hearing, “There can be completely different methods how it got into her body.

Can the drug pass that easily from one person to another, and if so, would it appear in the recipient’s urine sample, as Valieva’s legal representative is claiming?

Valieva’s attorney also declared she might have come into contact with the medication on a surface and then in some way consumed it. Dr. Donald Lloyd-Jones, president of the American Heart Association and chair of preventive medicine at Northwestern University’s Feinberg School of Medicine states, “I’ve seen no evidence it gets soaked up through the skin.” He admits he doesn’t understand just how much of the drug was discovered in the athlete’s sample, which would notify whether a short contact with a small amount of the drug might describe her positive test.

Lloyd-Jones likewise mentions clients have to take TMZ 3 times a day, due to the fact that it is metabolized by the body and excreted reasonably rapidly. Taken at the approved dosage, the drug would reach its peak levels in the blood in anywhere from two to six hours, and the majority would be cleared within 24 hours. “It would appear implausible that a little bit on a glass or on her skin would have resulted in a positive test unless it happened to be right before she offered the sample,” he says. “One can draw reasonings that either the direct exposure was extremely current, very shortly prior to her test, or that she was exposed more chronically.”

Preferably, a performance-enhancing drug has the exact same function. “The perfect performance-enhancing compounds get in to enhance performance, then go out without leaving a trace,” states Lloyd-Jones.

FIND OUT MORE: Olympians Let Loose on Kamila Valieva and Russian Doping Debate

While TMZ is not available in the U.S., Nissen states there is a comparable drug, ranolazine, that is approved by the Food and Drug Administration. That drug likewise shifts the energy source that heart cells use from fatty acids to glucose, which is more effective. “That’s why it works for angina,” says Nissen. “It permits individuals to do more with less blood circulation. Possibly for an athlete, it would have similar benefit and would make the heart work more effectively and give them a little edge.”

Lloyd-Jones states this metabolic pathway likewise leads to less accumulation of lactic acid, which can cause muscle fatigue. “There are data from little trials in clients who have heart failure that appear to suggest better heart efficiency for those who have a failing pump,” he says. “But whether that equates into the same advantage in a young, healthy person– I don’t think we understand.”

It’s likewise unclear what the effects are of taking these substances while the body is more youthful. “It’s certainly worrying, specifically in a young person whose body is still developing,” says Lloyd-Jones. “We actually don’t comprehend the long term results of altering someone’s physiology at this age.”

While the Court of Arbitration for Sport determined Valieva might complete in Beijing, her doping offense case remains unsolved, pending more examination. That means the gold she and her colleagues won in the group event, and any medal she wins in the females’s occasion might possibly be removed if anti-doping officials conclude she doped and took on an unfair benefit.

That will hinge on additional testing of a 2nd sample, offered from the same urine as her first, that will be examined to validate the favorable results from the first sample.


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