Regular exercise training is known to improve cardiovascular health and longevity. For this purpose, the World Health Organization recommends adults to perform 150 minute per week of moderate intensity physical activity. Recent studies, however, report that acute and/or lifelong high volumes of vigorous intensity endurance exercise can lead to cardiac mal-adaptations such as increased concentrations of biomarkers that reflect cardiomyocyte damage and presence of scar tissue in the heart of presumably healthy athletes.
CARDI-ACHE aimed to elucidate the clinical relevance of these observations. More specifically, we assessed (1) the prognostic value of exercise-induced cardiac biomarker release, (2) the functional consequences of myocardial scarring was assessed in an athletic population, and (3) the potential association between cardiomyocyte damage and markers of cardiac scar tissue.
These studies are important as the uptake of endurance exercisers is rapidly increasing across Europe and the world and this is set against a backdrop where the popular media frequently cover the potential harmful effects of endurance exercise in a largely unbalanced fashion. These alternative facts may stimulate the general population to continue their unhealthy and sedentary lifestyle and prevent exercise adoption of any sort. Consequently our research seeks to provide important new novel information that has a broad-based impact on individuals undertaking endurance exercise through to public health policy makers.
CARDI-ACHE revealed that exercise-induced increases in cardiac biomarkers are highly variable across individuals, and partially depend on exercise intensity and health status. Adverse event rate was yet too low to perform statistical analyses, but will be repeated in the near future. Presence of myocardial scarring did not affect global cardiac function, although regional dysfunction was observed in co-localized scar tissue. Finally, biomarkers of myocardial scarring significantly increased following exercise, though no association was found with markers for cardiomyocyte damage. Taken together, the cardiac ‘maladaptations’ that are typically observed in lifelong athletes presumably have only minor clinical significance. These findings align with previous studies that report a superior life expectancy in athletes compared to the general population and support the concept that Exercise is Medicine.
