The U-shaped relationship between exercise and cardiac morbidity

Merghani, Ahmed; Malhotra, Aneil; Sharma, Sanjay

doi:10.1016/j.tcm.2015.06.005

Cited by 125 publications

(97 citation statements)

References 65 publications

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“…While compelling evidence indicate that regular and moderate exercise is favorable in healthy subjects and those with CVD, recent data suggest that higher doses of physical and athletic activity are associated with adverse cardiovascular outcomes 33. Intense and strenuous exercise may have adverse effects in individuals with underlying CV abnormalities34 and on those with otherwise normal heart 35. Our results confirm that indeed higher physical activity is associated with increased risk of CVD in women.…”

Section: Discussionsupporting

confidence: 75%

Association of Gender-Specific Risk Factors in Metabolic and Cardiovascular Diseases: An NHANES-Based Cross-Sectional Study

Zhang

Cheng

Wang

et al. 2018

Journal of Investigative Medicine

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In the present cross-sectional study, based on National Health and Nutrition Examination Survey (NHANES, 2007-2010) cohorts, various risk factors for metabolic syndrome (MetS) and cardiovascular diseases (CVDs) were analyzed (n=12,153). The variables analyzed include, demographics, comorbidities associated with MetS or CVD, behavioral and dietary factors, while the primary endpoints were the prevalence of MetS and CVD. The prevalence of MetS and CVD was slightly higher in males as compared with females (42.50% and 7.65% vs 41.29% and 4.13%, respectively). After controlling for confounding factors, advanced age, family history of diabetes mellitus (DM), overweight, and obesity were significantly associated with the likelihood of MetS, irrespective of gender differences. In males, the diagnosis of prostate cancer and regular smoking were additional risk factors of MetS, whereas, advanced age, family history of heart attack or angina, health insurance coverage, diagnosis of rheumatoid arthritis or depression, obesity and low calorie intake were identified as risk factors for CVD. In addition to the above risk factors, higher physical activity and vitamin D insufficiency were also found to increase the risk of CVD in females. Furthermore, obesity was a higher risk factor for MetS than CVD. Emerging risk factors for CVD identified in this study has major clinical implications. Of interest is the correlation of higher physical activity and the risk of CVD in women and the role of depression and lower calorie intake in general population.

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Section: Discussionsupporting

confidence: 75%

Association of Gender-Specific Risk Factors in Metabolic and Cardiovascular Diseases: An NHANES-Based Cross-Sectional Study

Zhang

Cheng

Wang

et al. 2018

Journal of Investigative Medicine

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“…The benefits of moderate exercise are indisputable, and physical activity should be encouraged in all individuals including those with chronic cardiac disease. However, although the analysis of the cardiovascular consequences of different intensity of endurance exercise was beyond the scope of the present study, the discrepancies found among the arrhythmic effects of different endurance disciplines may support the theory that more extreme endurance exercise may be associated with an excess of arrhythmias contrary to the plethora of beneficial effects offered by moderate endurance training …”

Section: Discussionsupporting

confidence: 61%

“…However, although the analysis of the cardiovascular consequences of different intensity of endurance exercise was beyond the scope of the present study, the discrepancies found among the arrhythmic effects of different endurance disciplines may support the theory that more extreme endurance exercise may be associated with an excess of arrhythmias contrary to the plethora of beneficial effects offered by moderate endurance training. 34,35 Finally, in our study we also observed greater T-wave amplitude at the finish-line evaluation as compared with ECG data collected the day before the competition, in absence of relevant differences between men and women. 36 During exercise T-wave magnitude tends to lessen, showing a marked increase in the first minutes of recovery.…”

supporting

confidence: 61%

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

D’Ascenzi

Anselmi

Ceccon

et al. 2019

Scandinavian Med Sci Sports

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Background Some concerns exist about possible detrimental effects on cardiac function of ultra‐endurance competitions. The aim of this study was to evaluate the acute effects of an ultramarathon by comparing pre‐ and post‐race 12‐lead ECG features. Methods A total of 301 competitive athletes (mean age: 48 ± 9 years) running a 50‐km ultramarathon were analyzed. Twelve‐lead ECG was collected the day before the race and immediately at the finish line. According to the Italian law, athletes could have participated only after undergoing pre‐participation screening that ruled out the presence of an underlying heart disease. Results After the race a significant increase in P‐wave voltage (P < .001) and P‐wave duration (P < .001) was found as compared to pre‐race data with a higher percentage of athletes fulfilling the ECG criteria for right atrial enlargement (RAE; from 3% to 17%, P < .001). The presence of RAE post‐race significantly correlated with age, hours of training/week, and years of training and inversely with time at the finish line and the final position in the ranking. T‐wave and R‐wave amplitude (P < .001) and QTc‐interval duration (P < .001) significantly increased after the race. No significant differences in terms of supraventricular or ventricular arrhythmias were found. Conclusions A sizeable proportion of athletes running a 50‐km ultramarathon demonstrated post‐race ECG signs of right heart overload but no arrhythmias. This finding supports the hypothesis that ultra‐endurance races may induce transient right heart overload.

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“…Regular physical activity has been shown to lower the risk of developing AF in older adults [78] even though excessive endurance exercise increases the risk for AF in younger adults [86,87]. There are three forms of AF; paroxysmal-, persistent-and permanent AF.…”

Section: Atrial Fibrillation and Elderlymentioning

confidence: 99%

Cardiovascular risk factors in elderly : With special emphasis on atrial fibrillation, hypertension and diabetes

Rådholm¹

2015

Linköping University Medical Dissertations

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The U-shaped relationship between exercise and cardiac morbidity

Cited by 125 publications

References 65 publications

Association of Gender-Specific Risk Factors in Metabolic and Cardiovascular Diseases: An NHANES-Based Cross-Sectional Study

Association of Gender-Specific Risk Factors in Metabolic and Cardiovascular Diseases: An NHANES-Based Cross-Sectional Study

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

Cardiovascular risk factors in elderly : With special emphasis on atrial fibrillation, hypertension and diabetes

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