April 2, 2015European Heart Journal
Exercise and the heart: the good, the bad, and the ugly
Design
Review
Authors
Discussion
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Implication
Exercise advice should remain individualized; leaves open net outcomes of vigorous endurance remodeling.
Key Points
- To review the spectrum of cardiovascular outcomes associated with physical activity, contrasting the clear systemic health benefits of moderate exercise with the potential structural and electrical pathologies linked to extreme athletic endurance.
- Narrative review of clinical and physiological evidence evaluating cardiac adaptations to exercise across different intensity levels.
- Analysis of diagnostic overlap between athlete's heart adaptations and primary cardiomyopathies, as well as cardiac risks associated with performance-enhancing substances.
- Regular moderate exercise halves the risk of myocardial infarction (50% reduction) and enhances longevity while lowering risks for dementia and select malignancies.
- Extreme endurance training produces a 10% to 20% physiological increase in cardiac dimensions that can mimic mild cardiomyopathy phenotypes or provoke arrhythmogenic sudden cardiac death in athletes with silent underlying disease.
- Chronic vigorous exertion is increasingly associated with maladaptive electrical and structural cardiac remodeling in structurally normal hearts, compounded by cardiotoxicity from performance-enhancing drug abuse.
Cite This Study
Sharma et al. (2015) studied this question.