Left ventricular volumes and mass in marathon runners and their association with cardiovascular risk factors

Naßenstein, Kai; Breuckmann, Frank; Lehmann, Nils; Schmermund, Axel; Hunold, Peter; Broecker-Preuß, Martina; Sandner, Thilo; Halle, Martin; Mann, Klaus; Jöckel, Karl‐Heinz; Heusch, Gerd; Budde, Thomas; Erbel, Raimund; Barkhausen, Jörg; Möhlenkamp, Stefan

doi:10.1007/s10554-008-9337-x

Cited by 27 publications

(21 citation statements)

References 24 publications

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“…During the postexercise period, the cardiac geometric dimensions are restored, but with this recurrent stretch of the chambers and reestablishment of the chamber geometry, some individuals may be prone to the development of chronic structural changes including chronic dilatation of the RV and RA with patchy myocardial scarring in response to the recurrent volume over- load and excessive cardiac strain. [17][18][19]29,44 These abnormalities are often asymptomatic and probably accrue over many years; they might predispose to serious arrhythmias such as atrial fibrillation and/or ventricular arrhythmias (VAs).…”

Section: Biomarker Evidence For Cardiac Damage With Extreme Endurance Etmentioning

confidence: 99%

“…Although it has been recognized that elite-level endurance athletes commonly have electrocardiographic abnormalities and atrial and ventricular ectopy, 28,44,54 these functional adaptations traditionally have not been thought to predispose to serious arrhythmias or SCD. However, it appears that adverse cardiac remodeling induced by excessive ET can create an arrhythmogenic substrate, and rhythm abnormalities may be the most common CV problems encountered by veteran endurance athletes.…”

Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

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Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

O’Keefe

Patil

Lavie

et al. 2012

Mayo Clinic Proceedings

335

305

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A routine of regular exercise is highly effective for prevention and treatment of many common chronic diseases and improves cardiovascular (CV) health and longevity. However, long-term excessive endurance exercise may induce pathologic structural remodeling of the heart and large arteries. Emerging data suggest that chronic training for and competing in extreme endurance events such as marathons, ultramarathons, ironman distance triathlons, and very long distance bicycle races, can cause transient acute volume overload of the atria and right ventricle, with transient reductions in right ventricular ejection fraction and elevations of cardiac biomarkers, all of which return to normal within 1 week. Over months to years of repetitive injury, this process, in some individuals, may lead to patchy myocardial fibrosis, particularly in the atria, interventricular septum, and right ventricle, creating a substrate for atrial and ventricular arrhythmias. Additionally, long-term excessive sustained exercise may be associated with coronary artery calcification, diastolic dysfunction, and large-artery wall stiffening. However, this concept is still hypothetical and there is some inconsistency in the reported findings. Furthermore, lifelong vigorous exercisers generally have low mortality rates and excellent functional capacity. Notwithstanding, the hypothesis that long-term excessive endurance exercise may induce adverse CV remodeling warrants further investigation to identify at-risk individuals and formulate physical fitness regimens for conferring optimal CV health and longevity.

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Section: Biomarker Evidence For Cardiac Damage With Extreme Endurance Etmentioning

confidence: 99%

Section: Proarrhythmic Effects Of Excessive Endurance Etmentioning

confidence: 99%

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

O’Keefe

Patil

Lavie

et al. 2012

Mayo Clinic Proceedings

335

305

View full text Add to dashboard Cite

show abstract

“…In line with this hypothesis, the investigators of the Heinz Nixdorf Recall Study [38,39] showed that 108 apparently healthy marathon runners (older than 50 years) presented a similar CAC distribution of age-matched controls (median CAC: 36 vs 38 Agatston Units, p = 0.36, respectively) but greater CAC burden than peers matched by the Framingham risk score (median CAC: 36 vs 12 Agatston Units, p = 0.02, respectively) [38]. Of importance, the event-free survival was inversely related to CAC burden during a mean follow-up of 21.3 ± 2.8 months [38], suggesting that CAC portends a poor prognosis and is an early indicator for subclinical cardiac alteration even in this apparently super-healthy population [39,40,41]. …”

Section: Pa and Markers Of Subclinical Atherosclerosis In The Generalmentioning

confidence: 97%

Physical Activity in Chronic Kidney Disease: a Plausible Approach to Vascular Calcification?

Basile

Lomonte²,

Lisi³

et al. 2014

Kidney Blood Press Res

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Vascular calcification (VC) is a prominent feature that affects up to 40 to 80% of Chronic Kidney Disease (CKD) patients depending on the degree of renal impairment. Though etiology and pathogenesis of the different types of VC are far from being elucidated, it is conceivable that an imbalance between promoters and inhibitors represents the condition that triggers VC deposition and progression. In addition to traditional cardiovascular risk factors, several lines of evidence suggest that specific factors may affect the arterial system and prognosis in CKD. Over the last decade, a few pharmacological strategies aimed at controlling different selected risk factors for VC have been investigated yielding conflicting results. In light of the complicated interplay between inhibitors and promoters as well as the fact that VC represents the result of cumulative and prolonged exposure to multiple risk factors, a more comprehensive risk modification approach such as lifestyle modification or physical activity (PA) may represent a valid strategy to attenuate VC deposition and progression.We herein aim at reviewing the rationale and current evidence on the potential for lifestyle modification with a specific focus on PA as a cost-effective strategy for VC treatment.

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“…Both imaging modalities have been shown to play a pivotal role in the accurate evaluation of left ventricular function particularly in patients with ischemic heart disease and different forms of cardiomyopathy [21–36]. These methods are needed to accurately identify and characterize patients with various manifestations of left ventricular hypertrophy (LVH) [37–49].…”

mentioning

confidence: 99%