Relationship between strenuous exercise and cardiac morbimortality: Benefits outweigh the potential risks

Trends in Cardiovascular Medicine

Volumn 26, Issue 3, 2016, Pages 241-244

  Sanchis Gomar, Fabian ^a   Lucia, Alejandro ^a,b   Levine, Benjamin D ^c  

^a Research Institute Hospital 12 de Octubre ^*  (Spain)

^b UNIVERSIDAD EUROPEA DE MADRID   (Spain)

^c UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ATHLETE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; DISEASE ASSOCIATION; EDITORIAL; ENDURANCE TRAINING; HEART DILATATION; HEART LEFT VENTRICLE CONTRACTION; HEART LEFT VENTRICLE FILLING; HEART LEFT VENTRICLE HYPERTROPHY; HEART MUSCLE COMPLIANCE; HEART MUSCLE FIBROSIS; HEART RIGHT VENTRICLE FAILURE; HEART VENTRICLE COMPLIANCE; HEART VENTRICLE SEPTUM; HUMAN; ISCHEMIC HEART DISEASE; MARATHON RUNNER; PRIORITY JOURNAL; STRENUOUS EXERCISE; SUDDEN CARDIAC DEATH; EXERCISE; HEART; RISK;

EXERCISE; HEART; HUMANS; RISK;

EID: 84945571505     PISSN: 10501738     EISSN: 18732615     Source Type: Journal    
DOI: 10.1016/j.tcm.2015.07.008     Document Type: Editorial

References (62)

1. Guasch E., Mont L. Exercise and the heart: unmasking Mr Hyde. Heart 2014, 100:999-1000.
2. O'Keefe J.H., Franklin B., Lavie C.J. Exercising for health and longevity vs peak performance: different regimens for different goals. Mayo Clin Proc 2014, 89:1171-1175.
3. Merghani A., Malhotra A., Sharma S. The U-shaped relationship between exercise and cardiac morbidity. Trends Cardiovasc Med 2015, http://dx.doi.org/10.1016/j.tcm.2015.06.005 [in press].
4. Galderisi M., Cardim N., D'Andrea A., Bruder O., Cosyns B., Davin L., et al. The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015, 16:353.
5. Pelliccia A., Maron B.J., Spataro A., Proschan M.A., Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991, 324:295-301.
6. Fagard R., Van den Broeke C., Amery A. Left ventricular dynamics during exercise in elite marathon runners. J Am Coll Cardiol 1989, 14:112-118.
7. Fagard R.H. Impact of different sports and training on cardiac structure and function. Cardiol Clin 1997, 15:397-412.
8. Levine B.D. Can intensive exercise harm the heart? The benefits of competitive endurance training for cardiovascular structure and function. Circulation 2014, 130:987-991.
9. Levine B.D., Lane L.D., Buckey J.C., Friedman D.B., Blomqvist C.G. Left ventricular pressure-volume and Frank-Starling relations in endurance athletes. Implications for orthostatic tolerance and exercise performance. Circulation 1991, 84:1016-1023.
10. Maron B.J., Pelliccia A., Spataro A., Granata M. Reduction in left ventricular wall thickness after deconditioning in highly trained Olympic athletes. Br Heart J 1993, 69:125-128.
11. Pelliccia A., Maron B.J., De Luca R., Di Paolo F.M., Spataro A., Culasso F. Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation 2002, 105:944-949.
12. Urhausen A., Albers T., Kindermann W. Are the cardiac effects of anabolic steroid abuse in strength athletes reversible?. Heart 2004, 90:496-501.
13. Pelliccia A., Culasso F., Di Paolo F.M., Maron B.J. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med 1999, 130:23-31.
14. Morganroth J., Maron B.J., Henry W.L., Epstein S.E. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975, 82:521-524.
15. D'Andrea A., Limongelli G., Caso P., Sarubbi B., Della Pietra A., Brancaccio P., et al. Association between left ventricular structure and cardiac performance during effort in two morphological forms of athlete's heart. Int J Cardiol 2002, 86:177-184.
16. George K.P., Warburton D.E., Oxborough D., Scott J.M., Esch B.T., Williams K., et al. Upper limits of physiological cardiac adaptation in ultramarathon runners. J Am Coll Cardiol 2011, 57:754-755.
17. Arbab-Zadeh A., Perhonen M., Howden E., Peshock R.M., Zhang R., Adams-Huet B., et al. Cardiac remodeling in response to 1 year of intensive endurance training. Circulation 2014, 130:2152-2161.
18. La Gerche A., Claessen G. Is exercise good for the right ventricle? Concepts for health and disease. Can J Cardiol 2015, 31:502-508.
19. La Gerche A., Heidbuchel H. Can intensive exercise harm the heart? You can get too much of a good thing. Circulation 2014, 130:992-1002.
20. Utomi V., Oxborough D., Ashley E., Lord R., Fletcher S., Stembridge M., et al. Predominance of normal left ventricular geometry in the male "athlete's heart". Heart 2014, 100:1264-1271.
21. Rimensberger C., Carlen F., Brugger N., Seiler C., Wilhelm M. Right ventricular adaptations and arrhythmias in amateur ultra-endurance athletes. Br J Sports Med 2014, 48:1179-1184.
22. Sanchis-Gomar F., Garatachea N., Catalan P., Lopez M., Lucia A., Serrano-Ostariz E. Strenuous endurance exercise and right ventricular systolic function: no evidence of long-term sequelae. Int J Cardiol 2015, 179:297-298.
23. La Gerche A., Connelly K.A., Mooney D.J., MacIsaac A.I., Prior D.L. Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise. Heart 2008, 94:860-866.
24. La Gerche A., Heidbuchel H., Burns A.T., Mooney D.J., Taylor A.J., Pfluger H.B., et al. Disproportionate exercise load and remodeling of the athlete's right ventricle. Med Sci Sports Exerc 2011, 43:974-981.
25. Scharhag J., Schneider G., Urhausen A., Rochette V., Kramann B., Kindermann W. Athlete's heart: right and left ventricular mass and function in male endurance athletes and untrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol 2002, 40:1856-1863.
26. Garatachea N, Santos-Lozano A, Sanchis-Gomar F, Fiuza-Luces C, Pareja-Galeano H, Emanuele E., et al. Elite athletes live longer than the general population: a meta-analysis. Mayo Clin Proc 2014, 89:1195-1200.
27. Kujala U.M., Sarna S., Kaprio J. Use of medications and dietary supplements in later years among male former top-level athletes. Arch Intern Med 2003, 163:1064-1068.
28. Farahmand B.Y., Ahlbom A., Ekblom O., Ekblom B., Hallmarker U., Aronson D., et al. Mortality amongst participants in Vasaloppet: a classical long-distance ski race in Sweden. J Intern Med 2003, 253:276-283.
29. Marijon E., Tafflet M., Antero-Jacquemin J., El Helou N., Berthelot G., Celermajer D.S., et al. Mortality of French participants in the Tour de France (1947-2012). Eur Heart J 2013, 34:3145-3150.
30. Sofi F., Capalbo A., Cesari F., Abbate R., Gensini G.F. Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil 2008, 15:247-257.
31. Lollgen H., Bockenhoff A., Knapp G. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med 2009, 30:213-224.
32. Samitz G., Egger M., Zwahlen M. Domains of physical activity and all-cause mortality: systematic review and dose-response meta-analysis of cohort studies. Int J Epidemiol 2011, 40:1382-1400.
33. Nocon M., Hiemann T., Muller-Riemenschneider F., Thalau F., Roll S., Willich S.N. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2008, 15:239-246.
34. Sattelmair J., Pertman J., Ding E.L., Kohl H.W., Haskell W., Lee I.M. Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation 2011, 124:789-795.
35. Moore S.C., Patel A.V., Matthews C.E., Berrington de Gonzalez A., Park Y., Katki H.A., et al. Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis. PLoS Med 2012, 9:e1001335.
36. Lee D.C., Pate R.R., Lavie C.J., Sui X., Church T.S., Blair S.N. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol 2014, 64:472-481.
37. Schnohr P., Marott J.L., Lange P., Jensen G.B. Longevity in male and female joggers: the Copenhagen City Heart Study. Am J Epidemiol 2013, 177:683-689.
38. Wen C.P., Wai J.P., Tsai M.K., Yang Y.C., Cheng T.Y., Lee M.C., et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 2011, 378:1244-1253.
39. Chakravarty E.F., Hubert H.B., Lingala V.B., Fries J.F. Reduced disability and mortality among aging runners: a 21-year longitudinal study. Arch Intern Med 2008, 168:1638-1646.
40. Williams P.T. Reductions in incident coronary heart disease risk above guideline physical activity levels in men. Atherosclerosis 2009, 209:524-527.
41. Chomistek A.K., Cook N.R., Flint A.J., Rimm E.B. Vigorous-intensity leisure-time physical activity and risk of major chronic disease in men. Med Sci Sports Exerc 2012, 44:1898-1905.
42. Albert C.M., Mittleman M.A., Chae C.U., Lee I.M., Hennekens C.H., Manson J.E. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000, 343:1355-1361.
43. Kim J.H., Malhotra R., Chiampas G., d'Hemecourt P., Troyanos C., Cianca J., et al. Cardiac arrest during long-distance running races. N Engl J Med 2012, 366:130-140.
44. Mathews S.C., Narotsky D.L., Bernholt D.L., Vogt M., Hsieh Y.H., Pronovost P.J., et al. Mortality among marathon runners in the United States, 2000-2009. Am J Sports Med 2012, 40:1495-1500.
45. Harris K.M., Henry J.T., Rohman E., Haas T.S., Maron B.J. Sudden death during the triathlon. J Am Med Assoc 2010, 303:1255-1257.
46. Guasch E., Benito B., Qi X., Cifelli C., Naud P., Shi Y., et al. Atrial fibrillation promotion by endurance exercise: demonstration and mechanistic exploration in an animal model. J Am Coll Cardiol 2013, 62:68-77.
47. Wilhelm M., Roten L., Tanner H., Wilhelm I., Schmid J.P., Saner H. Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes. Am J Cardiol 2011, 108:580-585.
48. Turagam M.K., Velagapudi P., Kocheril A.G. Atrial fibrillation in athletes. Am J Cardiol 2012, 109:296-302.
49. Turagam MK, Velagapudi P, Alpert MA. Does exercise cause atrial fibrillation. Int J Cardiol 2014, 181:245-246.
50. Mozaffarian D., Furberg C.D., Psaty B.M., Siscovick D. Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study. Circulation 2008, 118:800-807.
51. Kwok C.S., Anderson S.G., Myint P.K., Mamas M.A., Loke Y.K. Physical activity and incidence of atrial fibrillation: a systematic review and meta-analysis. Int J Cardiol 2014, 177:467-476.
52. Drca N., Wolk A., Jensen-Urstad M., Larsson S.C. Atrial fibrillation is associated with different levels of physical activity levels at different ages in men. Heart 2014, 100:1037-1042.
53. Aizer A., Gaziano J.M., Cook N.R., Manson J.E., Buring J.E., Albert C.M. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol 2009, 103:1572-1577.
54. Elosua R., Arquer A., Mont L., Sambola A., Molina L., Garcia-Moran E., et al. Sport practice and the risk of lone atrial fibrillation: a case-control study. Int J Cardiol 2006, 108:332-337.
55. Molina L., Mont L., Marrugat J., Berruezo A., Brugada J., Bruguera J., et al. Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study. Europace 2008, 10:618-623.
56. Mont L., Sambola A., Brugada J., Vacca M., Marrugat J., Elosua R., et al. Long-lasting sport practice and lone atrial fibrillation. Eur Heart J 2002, 23:477-482.
57. Furlanello F., Bertoldi A., Dallago M., Galassi A., Fernando F., Biffi A., et al. Atrial fibrillation in elite athletes. J Cardiovasc Electrophysiol 1998, 9:S63-S68.
58. Pelliccia A., Maron B.J., Di Paolo F.M., Biffi A., Quattrini F.M., Pisicchio C., et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol 2005, 46:690-696.
59. Shibata S., Levine B.D. Biological aortic age derived from the arterial pressure waveform. J Appl Physiol 2011, 110:981-987.
60. Arbab-Zadeh A., Dijk E., Prasad A., Fu Q., Torres P., Zhang R., et al. Effect of aging and physical activity on left ventricular compliance. Circulation 2004, 110:1799-1805.
61. Bhella P.S., Hastings J.L., Fujimoto N., Shibata S., Carrick-Ranson G., Palmer M.D., et al. Impact of lifelong exercise "dose" on left ventricular compliance and distensibility. J Am Coll Cardiol 2014, 64:1257-1266.
62. Shibata S., Hastings J.L., Prasad A., Fu Q., Okazaki K., Palmer M.D., et al. 'Dynamic' Starling mechanism: effects of ageing and physical fitness on ventricular-arterial coupling. J Physiol 2008, 586:1951-1962.