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Tyrrell T, Pavlock J, Bramwell S, Cortis C, Doberstein ST, Fusco A, Porcari JP, Foster C. Functional Translation of Exercise Responses from Exercise Testing to Exercise Training: The Test of a Model. J Funct Morphol Kinesiol 2021; 6:66. [PMID: 34449668 PMCID: PMC8395770 DOI: 10.3390/jfmk6030066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.
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Affiliation(s)
- Tristan Tyrrell
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
| | - Jessica Pavlock
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
| | - Susan Bramwell
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy; (C.C.); (A.F.)
| | - Scott T. Doberstein
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy; (C.C.); (A.F.)
| | - John P. Porcari
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (T.T.); (J.P.); (S.B.); (S.T.D.); (J.P.P.)
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Schultz KL, Foster C, Radtke K, Bramwell S, Cortis C, Fusco A, Porcari JP. Workload Accomplished in Phase III Cardiac Rehabilitation. J Funct Morphol Kinesiol 2021; 6:jfmk6020047. [PMID: 34071525 PMCID: PMC8167778 DOI: 10.3390/jfmk6020047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 05/26/2021] [Indexed: 01/02/2023] Open
Abstract
Exercise training is an important component of clinical exercise programs. Although there are recognized guidelines for the amount of exercise to be accomplished (≥70,000 steps per week or ≥150 min per week at moderate intensity), there is virtually no documentation of how much exercise is actually accomplished in contemporary exercise programs. Having guidelines without evidence of whether they are being met is of limited value. We analyzed both the weekly step count and the session rating of perceived exertion (sRPE) of patients (n = 26) enrolled in a community clinical exercise (e.g., Phase III) program over a 3-week reference period. Step counts averaged 39,818 ± 18,612 per week, with 18% of the steps accomplished in the program and 82% of steps accomplished outside the program. Using the sRPE method, inside the program, the patients averaged 162.4 ± 93.1 min per week, at a sRPE of 12.5 ± 1.9 and a frequency of 1.8 ± 0.7 times per week, for a calculated exercise load of 2042.5 ± 1244.9 AU. Outside the program, the patients averaged 144.9 ± 126.4 min, at a sRPE of 11.8 ± 5.8 and a frequency of 2.4 ± 1.5 times per week, for a calculated exercise load of 1723.9 ± 1526.2 AU. The total exercise load using sRPE was 266.4 ± 170.8 min per week, at a sRPE of 12.6 ± 3.8, and frequency of 4.2 ± 1.1 times per week, for a calculated exercise load of 3359.8 ± 2145.9 AU. There was a non-linear relationship between steps per week and the sRPE derived training load, apparently attributable to the amount of non-walking exercise accomplished in the program. The results suggest that patients in a community clinical exercise program are achieving American College of Sports Medicine guidelines, based on the sRPE method, but are accomplishing less steps than recommended by guidelines.
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Affiliation(s)
- Katrina L. Schultz
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (K.L.S.); (K.R.); (S.B.); (J.P.P.)
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (K.L.S.); (K.R.); (S.B.); (J.P.P.)
- Correspondence:
| | - Kimberley Radtke
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (K.L.S.); (K.R.); (S.B.); (J.P.P.)
| | - Susan Bramwell
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (K.L.S.); (K.R.); (S.B.); (J.P.P.)
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy; (C.C.); (A.F.)
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy; (C.C.); (A.F.)
| | - John P. Porcari
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA; (K.L.S.); (K.R.); (S.B.); (J.P.P.)
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Rubio-Arias JÁ, Andreu L, Martínez-Aranda LM, Martínez-Rodríguez A, Manonelles P, Ramos-Campo DJ. Effects of medium- and long-distance running on cardiac damage markers in amateur runners: a systematic review, meta-analysis, and metaregression. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:192-200. [PMID: 33742602 PMCID: PMC7987568 DOI: 10.1016/j.jshs.2019.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/03/2019] [Accepted: 10/28/2019] [Indexed: 06/12/2023]
Abstract
BACKGROUND To finish an endurance race, athletes perform a vigorous effort that induces the release of cardiac damage markers. There are several factors that can affect the total number of these markers, so the aim of this review was to analyze the effect of endurance running races on cardiac damage markers and to identify the factors that modify the levels of segregation of these cardiac damage markers. METHODS A systematic search of PubMed, Web of Science, and the Cochrane Library databases was performed. This analysis included studies where the acute effects of running races on cardiac damage markers (troponin I and troponin T) were analyzed, assessing the levels of these markers before and after the races. RESULTS The effects of running races on troponin I (mean difference = 0.0381 ng/mL) and troponin T (mean difference = 0.0256 ng/mL) levels were significant. The ages (R2 = 14.4%, p = 0.033) and body mass indexes (R2 = 14.5%, p = 0.045) of the athletes had a significant interaction with troponin I. In addition, gender, mean speed, time to finish the race, and type of race can affect the level of cardiac damage markers. CONCLUSION Endurance running races induce the release of cardiac-damage markers that remain elevated for at least 24 h after the races. In addition, young male athletes with high body mass indexes who perform races combining long duration and moderate intensity (i.e., marathons) release the highest levels of cardiac damage markers. Physicians should take into consideration these results in the diagnosis and treatment of patients admitted to the hospital days after finishing endurance running races.
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Affiliation(s)
- Jacobo Á Rubio-Arias
- Faculty of Sport, Catholic University of San Antonio (UCAM), Murcia 30107, Spain; LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid 28040, Spain.
| | - Luis Andreu
- International Chair of Sports Medicine, Catholic University of San Antonio (UCAM), Murcia 30107, Spain
| | - Luis Manuel Martínez-Aranda
- Faculty of Sport, Catholic University of San Antonio (UCAM), Murcia 30107, Spain; Neuroscience of Human Movement Research Group (Neuromove), Catholic University of San Antonio (UCAM), Murcia 30107, Spain
| | | | - Pedro Manonelles
- International Chair of Sports Medicine, Catholic University of San Antonio (UCAM), Murcia 30107, Spain
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Runacres A, Mackintosh KA, McNarry MA. Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes. Sports Med 2021; 51:289-301. [PMID: 33368029 PMCID: PMC7846545 DOI: 10.1007/s40279-020-01379-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be 'J' shaped; with elite athlete's likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes. METHODS 38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio's (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis. RESULTS Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61-0.78]; female SMR 0.51 [95% CI 0.40-0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91-1.12]). Although male athlete's CVD (SMR 0.73 [95% CI 0.62-0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63-0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86-1.40]) or END athletes cancer mortality (SMR 0.73 [0.50-1.07]). There was insufficient data to calculate female sport-specific SMR's. DISCUSSION Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the 'J' shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).
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Affiliation(s)
- Adam Runacres
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK.
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
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Generalized Approach to Translating Exercise Tests and Prescribing Exercise. J Funct Morphol Kinesiol 2020; 5:jfmk5030063. [PMID: 33467278 PMCID: PMC7739260 DOI: 10.3390/jfmk5030063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 01/24/2023] Open
Abstract
Although there is evidence supporting the benefit of regular exercise, and recommendations about exercise and physical activity, the process of individually prescribing exercise following exercise testing is more difficult. Guidelines like % heart rate (HR) reserve (HRR) require an anchoring maximal test and do not always provide a homogenous training experience. When prescribing HR on the basis of % HRR, rating of perceived exertion or Talk Test, cardiovascular/perceptual drift during sustained exercise makes prescription of the actual workload difficult. To overcome this issue, we have demonstrated a strategy for "translating" exercise test responses to steady state exercise training on the basis of % HRR or the Talk Test that appeared adequate for individuals ranging from cardiac patients to athletes. However, these methods depended on the nature of the exercise test details. In this viewpoint, we combine these data with workload expressed as Metabolic Equivalent Task (METs). We demonstrate that there is a regular stepdown between the METs during training to achieve the same degree of homeostatic disturbance during testing. The relationship was linear, was highly-correlated (r = 0.89), and averaged 71.8% (Training METs/Test METs). We conclude that it appears possible to generate a generalized approach to correctly translate exercise test responses to exercise training.
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The relationship between left ventricular structure and function in the elite rugby football league athlete as determined by conventional echocardiography and myocardial strain imaging. Int J Cardiol 2018; 261:211-217. [PMID: 29657045 DOI: 10.1016/j.ijcard.2018.01.140] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/11/2018] [Accepted: 01/31/2018] [Indexed: 12/30/2022]
Abstract
AIMS The aims of this study were to establish the left ventricular (LV) phenotype in rugby football league (RFL) athletes and to mathematically model the association between LV size, strain (ɛ) and ejection fraction (EF). METHODS AND RESULTS 139 male athletes underwent echocardiographic LV evaluation including ɛ imaging. Non-athletic males were used for comparison. All absolute and scaled structural indices were significantly larger (P < 0.05) in athletes with a predominance for normal LV geometry. EF and global ɛ were similar between groups but strain rates (SR) were significantly lower (P < 0.05) in athletes. Lower apical rotation (P < 0.001) and twist (P = 0.010) were exhibited in athletes. CONCLUSION Normal EF is explained by divergent effects of LV internal diastolic dimension (LVIDd) and mean wall thickness (MWT) on LV function. Reductions in SR and twist may be part of normal physiological LV adaptation in RFL athletes.
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Cavalcante PAM, Gregnani MF, Henrique JS, Ornellas FH, Araújo RC. Aerobic but not Resistance Exercise Can Induce Inflammatory Pathways via Toll-Like 2 and 4: a Systematic Review. SPORTS MEDICINE - OPEN 2017; 3:42. [PMID: 29185059 PMCID: PMC5705532 DOI: 10.1186/s40798-017-0111-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/15/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Only a few studies have addressed the relationship between toll-like receptors 2 and 4 (TLR2 and TLR4) and the production of local and systemic cytokines in response to physical exercise, and they have produced conflicting results. We aimed to determine whether acute and chronic exercise outcomes are associated with changes in TLR2 and TLR4 expression and signaling and if so, the mechanisms that connect them. METHODS PubMed database were consulted. This systematic review selected 39 articles, 26 involving humans and 13 based on rodents. RESULTS In acute resistance exercise studies, 75% reported a decrease in TLR4 or TLR2 expression and 25% did not find differences. For chronic resistance exercise studies, 67% reported a reduction of expression and 33% did not find differences. Studies of both types reported reductions in pro-inflammatory cytokines. In acute aerobic exercise studies, 40% revealed a decline in the expression of the receptors, 7% reported no significant difference, 40% showed an increase, and 13% did not evaluate their expression. Fifty-eight percent of studies of chronic aerobic exercise revealed a reduction in expression, 17% did not find a difference, and 25% reported increases; they also suggested that the expression of the receptors might be correlated with that of inflammatory cytokines. In studies on combined exercise, 50% reported a decline in receptors expression and 50% did not find a difference. CONCLUSIONS The majority of the articles (54%) link different types of exercise to a decline in TLR4 and TLR2 expression. However, aerobic exercise may induce inflammations through its influence on these receptor pathways. Higher levels of inflammation were seen in acute sessions (40%) than regular sessions (25%).
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Affiliation(s)
- Paula Andréa Malveira Cavalcante
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
- , Rua Pedro de Toledo, 669/9and., 04039-032, São Paulo, SP, Brazil.
| | - Marcos Fernandes Gregnani
- Molecular Biology Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jessica Salles Henrique
- Neurology/Neuroscience Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Exercise Neurophysiology Laboratory, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Fábio Henrique Ornellas
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ronaldo Carvalho Araújo
- Medicine (Nephrology) Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Molecular Biology Program, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Exercise Genetics and Metabolism, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Department of Biophysics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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Kleiven Ø, Bjørkavoll-Bergseth M, Melberg T, Skadberg Ø, Bergseth R, Selvåg J, Auestad B, Aukrust P, Aarsland T, Ørn S. High physical fitness is associated with reduction in basal- and exercise-induced inflammation. Scand J Med Sci Sports 2017; 28:172-179. [PMID: 28314078 DOI: 10.1111/sms.12878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/29/2022]
Abstract
C-reactive protein (CRP) increases after strenuous exercise. It has been a concern that prolonged strenuous exercise may be harmful and induce a deleterious inflammatory response. The purpose of this study was to (a) assess and quantify the magnitude of CRP response following an endurance cycling competition in healthy middle-aged recreational cyclists. (b) Identify important determinants of this response. (c) Identify the relationship between CRP, myocardial damage (cardiac Troponin I (cTnI)), and myocardial strain (B-type natriuretic peptide [BNP]). (d) Identify the relationship between CRP and clinical events, defined as utilization of healthcare services or self-reported unusual discomfort. Race time was used as a measure of physical fitness. A total of 97 individuals (43±10 years of age, 74 [76%] males) were assessed prior to and 0, 3, and 24 hours following the 91-km mountain bike race "Nordsjørittet" (Sandnes, Norway, June 2013). There was a highly significant increase in CRP from baseline to 24 hours (0.9 (0.5-1.8) mg/L vs. 11.6 (6.0-17.5) mg/L (median[IQR]), P<.001), with no correlation of CRP to cTnI and BNP at any time-point. CRP was strongly correlated to race time at baseline (r=.38, P<.001) and at 24 hours following the race (r=.43, P<.001), In multivariate models, race time was an independent predictor of CRP both at baseline and at 24 hours (P<.01). There was no relationship between CRP levels and clinical events. In conclusion, high physical fitness was associated with reduction in both basal- and exercise-induced CRP. No adverse relationship was found between high intensity physical exercise, CRP levels, and outcomes.
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Affiliation(s)
- Ø Kleiven
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway
| | | | - T Melberg
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway
| | - Ø Skadberg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - R Bergseth
- Senior medical officer, North Sea Race, Sandnes, Norway
| | - J Selvåg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - B Auestad
- Research Department, Stavanger University Hospital, Stavanger, Norway.,Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway
| | - P Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - T Aarsland
- Research Department, Stavanger University Hospital, Stavanger, Norway
| | - S Ørn
- Cardiology Department, Stavanger University Hospital, Stavanger, Norway.,Department of Electrical Engineering and Computer Science, University of Stavanger, Kjell Arholms Gate 41, Stavanger 4036, Norway
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Sanchis-Gomar F, Pérez LM, Joyner MJ, Löllgen H, Lucia A. Endurance Exercise and the Heart: Friend or Foe? Sports Med 2016; 46:459-66. [PMID: 26586557 DOI: 10.1007/s40279-015-0434-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although low- to moderate-intensity exercise has well-known cardiovascular benefits, it has been increasingly suggested that prolonged strenuous endurance exercise (SEE) could have potential deleterious cardiac effects. In effect, the term 'cardiac overuse injury' (or 'over-exercise') has been recently reported to group all the possible deleterious cardiac consequences of repeated exposure to SEE or 'over-exercise'. In this article, we provide a balanced overview of the current state of knowledge regarding the 'pros' and 'cons' of SEE from a cardiological point of view.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Research Institute Hospital 12 de Octubre ('i+12'), Edificio Actividades Ambulatorias, 6ª Planta, Avda. de Córdoba s/n, 28041, Madrid, Spain.
| | - Laura M Pérez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Herbert Löllgen
- European Federation of Sports Medicine Associations (EFSMA) and German Federation of Sports Medicine, Remscheid, Germany
| | - Alejandro Lucia
- Research Institute Hospital 12 de Octubre ('i+12'), Edificio Actividades Ambulatorias, 6ª Planta, Avda. de Córdoba s/n, 28041, Madrid, Spain.,European University, Madrid, Spain
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Morin DP, Lavie CJ. The Many Faces of Sudden Death. Mayo Clin Proc 2016; 91:S0025-6196(16)30512-2. [PMID: 27810087 DOI: 10.1016/j.mayocp.2016.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel P Morin
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA.
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
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Lavie CJ, Harmon KG. Routine ECG Screening of Young Athletes. J Am Coll Cardiol 2016; 68:712-4. [DOI: 10.1016/j.jacc.2016.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 06/27/2016] [Indexed: 01/13/2023]
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Shin KA, Park KD, Ahn J, Park Y, Kim YJ. Comparison of Changes in Biochemical Markers for Skeletal Muscles, Hepatic Metabolism, and Renal Function after Three Types of Long-distance Running: Observational Study. Medicine (Baltimore) 2016; 95:e3657. [PMID: 27196469 PMCID: PMC4902411 DOI: 10.1097/md.0000000000003657] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The purpose of this study is to compare changes in biochemical markers for the skeletal muscles, hepatic metabolism, and renal function based on extreme long-distance running.Among healthy amateur endurance athletes who participated in a marathon, 100 km-, or 308 km ultramarathon, 15 athletes with similar physical and demographic characteristics were chosen to be the subjects in this study, upon completion of each course. The subjects' blood was collected before and after the course to identify biochemical markers for the skeletal muscles, hepatic metabolism, and renal function.After all of the courses, creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine transaminase (ALT), blood urea nitrogen (BUN), and creatinine were found to be significantly increased compared with values obtained before the race (P <0.05 for each marker). CK, LDH, AST, and LDH were significantly higher after completion of the 100 km race than the marathon (P <0.05) and were significantly higher after the 308 km race than the marathon or 100 km race (P <0.05). Total protein was significantly lower after the 308 km race than the marathon or 100 km race (P <0.05). Albumin significantly increased after the marathon but significantly decreased after the 308 km course (P <0.05). Total and direct bilirubin were significantly increased after the 100 km and 308 km races (P <0.05), and were significantly higher after the 308 km than the marathon or 100 km course (P <0.05). BUN was significantly higher after the 100 km race than the marathon (P <0.05) and was significantly lower after the 308 km than the 100 km race (P <0.05). Creatinine was significantly higher after the marathon and 100 km than the 308 km race (P <0.05). Uric acid significantly increased after the marathon and 100 km race (P <0.05); it was significantly higher after completing the marathon and 100 km than the 308 km race (P <0.05).Muscular damage, decline in hepatic function, and hemolysis in the blood were higher after running a 308 km race, which is low-intensity running compared with a marathon, and a temporary decline in renal function was higher after completing a 100 km race, which is medium-to-high intensity.
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Affiliation(s)
- Kyung-A Shin
- From the Department of Clinical Laboratory Science (K-AS), Shinsung University, Chungnam; Department of Rehabilitation Medicine (KDP), Gachon University Gil Medical Center, Incheon; and Department of Rehabilitation Medicine (JA, YP, Y-JK), College of Medicine, Sanggye-Paik Hospital, Inje University, Seoul, Republic of Korea
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Després JP. Physical Activity, Sedentary Behaviours, and Cardiovascular Health: When Will Cardiorespiratory Fitness Become a Vital Sign? Can J Cardiol 2016; 32:505-13. [DOI: 10.1016/j.cjca.2015.12.006] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 01/09/2023] Open
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Parto P, O'Keefe JH, Lavie CJ. The Exercise Rehabilitation Paradox: Less May Be More? Ochsner J 2016; 16:297-303. [PMID: 27660580 PMCID: PMC5024813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Debatably, the most commonly prescribed lifestyle modification for cardiovascular health involves daily exercise training (ET) and physical activity. Exercise has numerous known health benefits on blood pressure, lipid profile, weight loss, and glucose metabolism. However, controversy exists regarding the link between excessive endurance ET and harmful cardiac effects. METHODS We review the current literature and discuss the numerous known adverse effects of endurance ET on cardiac function. RESULTS Excessive endurance ET may negatively affect cardiac anatomy, play a role in osteoarthritis and coronary artery disease development, and increase the risks of cardiac arrhythmia and sudden cardiac death. CONCLUSION More ET may not always be better when it comes to endurance ET, and optimal ET dosing regimens are clearly needed.
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Affiliation(s)
- Parham Parto
- Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA
| | - James H. O'Keefe
- Department of Cardiology, St. Luke's Mid America Heart Institute, Kansas City, MO
| | - Carl J. Lavie
- Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
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Lavie CJ, Lee DC, Sui X, Arena R, O'Keefe JH, Church TS, Milani RV, Blair SN. Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality. Mayo Clin Proc 2015; 90:1541-52. [PMID: 26362561 DOI: 10.1016/j.mayocp.2015.08.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/10/2015] [Accepted: 08/03/2015] [Indexed: 12/25/2022]
Abstract
Considerable evidence has established the link between high levels of physical activity (PA) and all-cause and cardiovascular disease (CVD)-specific mortality. Running is a popular form of vigorous PA that has been associated with better overall survival, but there is debate about the dose-response relationship between running and CVD and all-cause survival. In this review, we specifically reviewed studies published in PubMed since 2000 that included at least 500 runners and 5-year follow-up so as to analyze the relationship between vigorous aerobic PA, specifically running, and major health consequences, especially CVD and all-cause mortality. We also made recommendations on the optimal dose of running associated with protection against CVD and premature mortality, as well as briefly discuss the potential cardiotoxicity of a high dose of aerobic exercise, including running (eg, marathons).
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Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, LA.
| | - Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Timothy S Church
- Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Richard V Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, LA
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
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Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee DC, Earnest CP, Church TS, O'Keefe JH, Milani RV, Blair SN. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circ Res 2015; 117:207-19. [PMID: 26139859 PMCID: PMC4493772 DOI: 10.1161/circresaha.117.305205] [Citation(s) in RCA: 483] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Substantial evidence has established the value of high levels of physical activity, exercise training (ET), and overall cardiorespiratory fitness in the prevention and treatment of cardiovascular diseases. This article reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the effect of physical activity and cardiorespiratory fitness on cardiovascular diseases. This review also surveys data from epidemiological and ET studies in the primary and secondary prevention of cardiovascular diseases, particularly coronary heart disease and heart failure. These data strongly support the routine prescription of ET to all patients and referrals for patients with cardiovascular diseases, especially coronary heart disease and heart failure, to specific cardiac rehabilitation and ET programs.
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Affiliation(s)
- Carl J Lavie
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
| | - Ross Arena
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Damon L Swift
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Neil M Johannsen
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Xuemei Sui
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Duck-Chul Lee
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Conrad P Earnest
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Timothy S Church
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - James H O'Keefe
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Richard V Milani
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
| | - Steven N Blair
- From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.)
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Möhlenkamp S, Halle M. Myocardial adaptation in response to marathon training: do short-term benefits translate into long-term prognosis? Circ Cardiovasc Imaging 2015; 8:e003030. [PMID: 25673648 DOI: 10.1161/circimaging.115.003030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stefan Möhlenkamp
- From the Clinic of Cardiology, Angiology and Intensive Care Medicine, Bethanien Hospital Moers, Moers, Germany (S.M.); Center of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany (M.H.); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (M.H.); and Else-Kröner-Fresenius-Zentrum, Klinikum Rechts der Isar, Munich, Germany (M.H.).
| | - Martin Halle
- From the Clinic of Cardiology, Angiology and Intensive Care Medicine, Bethanien Hospital Moers, Moers, Germany (S.M.); Center of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany (M.H.); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (M.H.); and Else-Kröner-Fresenius-Zentrum, Klinikum Rechts der Isar, Munich, Germany (M.H.)
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