Does high-volume and/or high-intensity long-term exercise training cause adverse cardiovascular manifestations in endurance athletes?
High-volume and high-intensity long-term exercise may be associated with adverse cardiovascular manifestations such as coronary calcification, myocardial fibrosis, and arrhythmias in some veteran endurance athletes.
Emerging evidence from epidemiological studies and observations in cohorts of endurance athletes suggest that potentially adverse cardiovascular manifestations may occur following high-volume and/or high-intensity long-term exercise training, which may attenuate the health benefits of a physically active lifestyle. Accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, atrial fibrillation, and even higher risk of sudden cardiac death have been reported in athletes. There is primarily circumstantial evidence that supports the "Extreme Exercise Hypothesis." Subclinical and atherosclerotic coronary artery disease (CAD) as well as structural cardiovascular abnormalities and arrhythmias are present in some of the most active veteran endurance athletes and need appropriate clinical follow-up to reduce the risk for adverse cardiovascular outcomes. Future studies are warranted to establish the long-term cardiovascular health effects of these findings in veteran endurance athletes.
Eijsvogels et al. (Tue,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: