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The endurance athletes heart: acute stress and chronic adaptation
  1. Keith George1,
  2. Greg P Whyte1,
  3. Danny J Green1,2,
  4. David Oxborough3,
  5. Rob E Shave4,
  6. David Gaze5,
  7. John Somauroo1,6
  1. 1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  2. 2School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
  3. 3School of Healthcare, University of Leeds, Leeds, UK
  4. 4School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK
  5. 5Department of Clinical Chemistry, St George's Hospital, Tooting, London, UK
  6. 6Cardiorespiratory and Vascular Department, Countess of Chester Hospital, Chester, UK
  1. Correspondence to Dr Keith George, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK; k.george{at}ljmu.ac.uk

Abstract

The impact of endurance exercise training on the heart has received significant research and clinical attention for well over a century. Despite this, many issues remain controversial and clinical interpretation can be complex of biomarkers of cardiomyocyte insult. This review assesses the current state of knowledge related to two areas of research where problems with clinical decision making may arise: (1) the impact of chronic endurance exercise training on cardiac structure, function and electrical activity to the point where the athletic heart phenotype may be similar to the expression of some cardiac pathologies (a diagnostic dilemma referred to as the ‘grey-zone’) and (2) the impact of acute bouts of prolonged exercise on cardiac function and the presentation of biomarkers and cardiomyocyte insult in the circulatory system. The combination of acute endurance exercise stress on the heart and prolonged periods of training are considered together in the final section.

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