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First endurance multi v11/18/2023 ![]() Pathophysiology of HD induced by endurance exercise Therefore, it is important to understand the pathophysiological process of HD induced by endurance exercise in order to recognize the upper limit of exercise within different patient populations. It has been suggested that intense endurance exercise could lead to increased cardiac remodelling, myocardial fibrosis, and arrhythmias which could ultimately progress to cardiac dysfunction. While these forms of exercise promote healthier lifestyles, improper modifications in diet along with excessive training may have an association with HD. ![]() ![]() This does not include other forms of extensive endurance exercise such as marathons, cycling, and canoeing. In the USA, the number of individuals who participated in triathlons increased from 0.92 million in 2006 to 4.08 million in 2017. The association between endurance exercise and HD is becoming more important since self-trained individuals within the general public are participating in highly intensive endurance activities that sometimes require vigorous exercise well beyond the recommendations by the CDC. However, it has also been suggested that individuals who participate in long-term and intense endurance exercise have a higher prevalence of cardiovascular complications than their sedentary counterparts. For instance, hearts of athletes are larger in mass, have an increased right and left ventricular end-diastolic volume (EDV) and increased contractility, resulting in increased lung perfusion and cardiac output (CO). Athletic hearts structurally and physiologically adapt towards the body’s increased oxygen demand during extensive exercise. Exercise unequivocally results in many physical and psychological health benefits however, the upper limit of exercise and its implications on cardiac health are not as clear. Following these recommendations ultimately has a lasting impact on reducing the risk of developing HD and mitigating the effects of existing HD. This is also recommended to be in combination with weight training of all muscle groups two times a week. The exercise guidelines for adults are 2.5 hours to 5 hours a week of moderate exercise or 1.25 hours to 2.5 hours of vigorous-intensity, aerobic exercise once a week. Long-term moderate exercise is one of the most important interventions that has been proven to reduce body weight, normalize insulin sensitivity, reduce cholesterol, and normalize blood pressure. Įxercise recommendations and endurance exercise in the USAįortunately, there are known solutions that can counteract the modifiable risk factors for developing HD. Some of the modifiable risk factors that increase the risk for HD are tobacco use, obesity, diets high in sodium and fat, and poorly controlled diabetes and hypertension. The non-modifiable factors linked to increased risk for developing HD are older age, male gender, African or Asian ethnicity, and family history of HD. There are modifiable and unmodifiable risk factors associated with HD. All of these conditions could lead to further cardiovascular remodelling and death. HD includes a variety of pathologies of the heart such as myocardial fibrosis, cardiomyopathies, systolic and diastolic dysfunctions, and arrhythmias. In 2018, heart disease (HD) was the leading cause of death worldwide and accounts for 15.2 million deaths. Findings from these studies could contribute to exercise recommendations. The interaction between performance-enhancing drugs and endurance exercise needs to be further studied to determine its action on cardiac health. The reversibility of cardiac changes needs to be further investigated and can be applied in the differential diagnosis of other cardiomyopathies. All review articles in this study were limited by a low sample size since it was difficult to obtain a full record of previous endurance activity. However, increased incidence of sinus node disease (SND) and atrial flutter in endurance athletes, even after deconditioning, seems to be most associated with endurance exercise.Ĭardiac remodelling, fibrosis, and arrhythmia were associated with cardiac dysfunction. Clinically significant dysfunction from endurance exercise-induced cardiac remodelling and myocardial fibrosis is not certain. Increased cardiac remodelling, myocardial fibrosis, and arrhythmias were associated with increased endurance exercise in most instances. Peer-reviewed primary literature related to endurance exercise, cardiac remodelling, myocardial fibrosis, and arrhythmia was searched and selected from the PubMed Database to be reviewed. High-intensity endurance exercise and its association with cardiac dysfunction are becoming more important as more people in the USA participate in endurance activity. Intensive endurance exercise is associated with heart disease. Exercise is known to improve cardiac health however, the upper limit of exercise is not as clear.
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