Can Intensive Exercise Harm the Heart?
The Benefits of Competitive Endurance Training for Cardiovascular Structure and Function
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Elite athletes are paragons of physical fitness in our society, and an entire sports-industrial complex has developed from playing/watching/marketing sports.1 Although the idiosyncratic example of Pheidippides has been used by some to highlight the dangers of extreme endurance efforts,2 much more ubiquitous is the Greek model of the athlete as physical perfection, allowing vigor through to great age.3
Response by La Gerche and Heidbuchel p 991
The term “athlete’s heart” was originally coined to reflect its similarities to patients with enlarged hearts from disease,4 though it is now recognized to reflect the unique physiological adaptation of the endurance athlete5,6: a heart that is big,7 muscular,8,9 compliant,10 and can pump a lot of blood very fast, to support high rates of aerobic metabolism.11 It is quite clear that prolonged, high-intensity sports training required to compete at an Olympic level is sustainable without adverse effects in young individuals, and does not lead to impairment in cardiovascular structure or function.12,13 It is also clear that there is no epidemiological signal that high-level athletics leads to premature death; indeed quite the opposite. For example, when >15 000 Olympic medalists from 9 different country groups were examined over decades after their first medal, there was a progressive increase in conditional survival (compared with age- and sex-matched controls from the general population in those countries; Figure 1) for the Olympic medalists which was greatest in the participants in endurance sports.14 Although there are many possible explanations for such a finding (such as socioeconomic status, or healthier lifestyles), the concept of increased rather than decreased survival in elite endurance athletes has been demonstrated repeatedly,15–17 and was most recently buttressed by a study of nearly 800 French Tour …