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Long-Term Clinical Consequences of Intense, Uninterrupted Endurance Training in Olympic Athletes
Open accessAbstract
Objectives The aim of this study was to assess incidence of cardiac events and/or left ventricular (LV) dysfunction in athletes exposed to strenuous and uninterrupted training for extended periods of time. Background Whether highly intensive and uninterrupted athletic conditioning over a long period of time might be responsible for cardiac events and/or LV dysfunction is unresolved. Methods We assessed clinical profile and cardiac dimensions and function in 114 Olympic athletes (78% male; mean age 22 +/- 4 years), free of cardiovascular disease, participating in endurance disciplines, who experienced particularly intensive and uninterrupted training for 2 to 5 consecutive Olympic Games (total, 344 Olympic events), over a 4- to 17-year-period (mean 8.6 +/- 3 years). Results Over the extended period of training and competition, no cardiac events or new diagnoses of cardiomyopathies occurred in the 114 Olympic athletes. Global LV systolic function was unchanged (ejection fraction: 62 +/- 5% to 63 +/- 5%; p = NS), and wall motion abnormalities were absent. In addition, LV volumes (142 +/- 26 ml to 144 +/- 25 ml; p = 0.52) and LV mass index (109 +/- 21 g/m(2) to 110 +/- 22 g/m(2); p = 0.74) were unchanged, and LV filling patterns remained within normal limits, although left atrial dimension showed a mild increase (37.8 +/- 3.7 mm to 38.9 +/- 3.2 mm; p < 0.001). Conclusions In young Olympic athletes, extreme and uninterrupted endurance training over long periods of time (up to 17 years) was not associated with deterioration in LV function, significant changes in LV morphology, or occurrence of cardiovascular symptoms or events.
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“Exercise is a powerful intervention in the prevention and treatment of cardiovascular disease for which compelling evidence exists across a wide range of exercise volumes and intensities, including among competitive athletes.4,26,37”
From Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes (2012) · cites this paper as [4]
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Cites
Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography
Schiller, N. B., Shah, P. M., Crawford, M., DeMaria, A. N., Devereux, R. B., Feigenbaum, H., Gutgesell, H. P., Reichek, N., Sahn, D. J., Schnittger, I., et al. (1989) · Journal of the American Society of Echocardiography · doi:10.1016/s0894-7317(89)80014-8 · Cited by 8,110
Sahn, D. J., DeMaria, A. N., KISSLO, J. A., & Weyman, A. E. (1978) · Circulation · doi:10.1161/01.cir.58.6.1072 · Cited by 7,430
Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings
Devereux, R. B., Alonso, D. R., Lutas, E. M., Gottlieb, G. J., Campo, E., Sachs, I., & Reichek, N. (1986) · The American Journal of Cardiology · doi:10.1016/0002-9149(86)90771-x · Cited by 6,226
Statistical Methods in Medical Research.
Armitage, P. (1972) · Biometrics · doi:10.2307/2556182 · Cited by 5,383
Pluim, B. M., Zwinderman, A. H., van der Laarse, A., & van der Wall, E. E. (2000) · Circulation · doi:10.1161/01.cir.101.3.336 · Cited by 1,141
The Upper Limit of Physiologic Cardiac Hypertrophy in Highly Trained Elite Athletes
Pelliccia, A., Maron, B. J., Spataro, A., Proschan, M. A., & Spirito, P. (1991) · New England Journal of Medicine · doi:10.1056/nejm199101313240504 · Cited by 1,014
Self-citationMaron, B. J., & Pelliccia, A. (2006) · Circulation · doi:10.1161/circulationaha.106.613562 · Cited by 758
Self-citationPhysiologic Left Ventricular Cavity Dilatation in Elite Athletes
Pelliccia, A., Culasso, F., Paolo, F. M. D., & Maron, B. J. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-1-199901050-00005 · Cited by 581
Self-citationScharhag, J., Schneider, G. K., Urhausen, A. J. P., Rochette, V., Kramann, B. H., & Kindermann, W. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02478-6 · Cited by 525
Neilan, T. G., Januzzi, J. L., Lee-Lewandrowski, E., Ton-Nu, T.-T., Yoerger, D. M., Jassal, D. S., Lewandrowski, K. B., Siegel, A. J., Marshall, J. E., Douglas, P. S., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.647461 · Cited by 519
Cited by
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Ghasem, W., Abouzeid, C. M., Toresdahl, B. G., & Shah, A. B. (2022) · Current Hypertension Reports · doi:10.1007/s11906-022-01210-8 · Cited by 6
Left ventricular morphology and geometry in élite athletes characterised by extreme anthropometry
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The hearts of competitive athletes: An up-to-date overview of exercise-induced cardiac adaptations
Dores, H., Freitas, A., Malhotra, A., Mendes, M., & Sharma, S. (2015) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2014.07.008 · Cited by 4
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Leowattana, W. (2020) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2020.28.004640 · Cited by 3
The athlete's heart: different training responses, gender and ethnicity dependencies
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Krumm, P., Krauß, S., Mangold, S., Zitzelsberger, T., Klumpp, B. D., Nikolaou, K., Niess, A. M., Krämer, U., & Burgstahler, C. (2018) · Acta Radiologica · doi:10.1177/0284185118764203 · Cited by 2
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Liu, Q., Li, C., Qi, W.-Y., Tang, M., Luo, Y., Zhang, X., Zhong, L., & Chen, J. (2026) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.70235 · Cited by 1
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de Araújo, C. G. S., Belém, L. H. J., & Gottlieb, I. (2014) · SAGE Open Medical Case Reports · doi:10.1177/2050313x14522439 · Cited by 1
Physiologic and Molecular Responses of the Heart to Chronic Exercise
Levine, B. D., & Buttrick, P. M. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-381510-1.00024-7 · Cited by 1
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Shaheen, H. A. A., Mohamed, M. A., Basset, F. H. A., Rashed, M., Theruvan, N. B., & Mosbah, S. A. (2022) · World Journal of Cardiovascular Diseases · doi:10.4236/wjcd.2022.121001 · Cited by 1
Agarwal, S., & Tuzcu, E. M. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-26219-4.00031-1 · Cited by 1
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Shephard, R. J. (2014) · Studies in history and philosophy of science · doi:10.1007/978-3-319-11671-6_9 · Cited by 1
Vega, J., Briceño, F. A. C., Saavedra, R., Fernández, R., Herrera, S., Salinas, M., Godoy, P., Ocaranza, M. P., Jalil, J., Lavandero, S., et al. (2018) · Revista chilena de cardiología · doi:10.4067/s0718-85602018000200093 · Cited by 1
Myocardial Adaptation in Response to Marathon Training
Möhlenkamp, S., & Halle, M. (2015) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.115.003030 · Cited by 1
Editorial commentary: The athlete's heart: Friend or foe?
Kyrouac, D., & Levine, B. D. (2022) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2022.09.002 · Cited by 1
Singh, T. K. (2021) · Springer eBooks · doi:10.1007/978-3-030-69384-8_6 · Cited by 1
Riding, N. R. (2016) · Liverpool John Moores University · doi:10.24377/ljmu.t.00004586
Steriotis, A. K. (2011) · Padua Research Archive (University of Padova)
The use of dietary supplements and medication among Finnish elite athletes
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Apor, P. (2013) · Orvosi Hetilap · doi:10.1556/oh.2013.29554
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Grimsmo, J., & Arnesen, H. (2010) · Expert Review of Cardiovascular Therapy · doi:10.1586/erc.10.69
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Bosomworth, N. J. (2015) · Canadian Family Physician
Efeito do treinamento físico em portadores de marcapasso definitivo
Licariao, E. G. D. (2016) · doi:10.11606/t.5.2016.tde-06122016-122515
Cardiovascular effects and alterations from endurance sports. A systematic review
Ojeda, Á. H., Navarrete-Peña, R., Valenzuela-Fernández, N., & Maliqueo, S. G. (2017) · Apunts Sports Medicine · doi:10.1016/j.apunts.2016.12.001
Physical Activity, Blood Pressure, and Cardiac Structure and Function
Kokkinos, P., Narayan, P., & Pittaras, A. (2019) · Cardiorespiratory Fitness in Cardiometabolic Diseases · doi:10.1007/978-3-030-04816-7_10 · Cited by 1
Exercise-induced right ventricular impairment and arrhythmia susceptibility in mice
Lakin, R. (2018) · TSpace (University of Toronto)
Glibbery, M. (2018) · TSpace (University of Toronto)
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Bagato, A. Y., & Dseouey, M. E. (2014) · Journal of Applied Sports Science · doi:10.21608/jass.2014.84815
Pelliccia, A., & Maron, B. J. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.06.019
Self-citationVlachopoulos, C., O'Rourke, M., & Nichols, W. W. (2011) · CRC Press eBooks · doi:10.1201/b13568-32
Prävention durch körperliche Aktivität
Löllgen, H., & Löllgen, R. (2023) · Springer eBooks · doi:10.1007/978-3-662-65165-0_3
Sport bei linksventrikulären Klappenvitien
Kindermann, W., Niederdöckl, J. D., Urhausen, A. J. P., & Scharhag, J. (2023) · Springer eBooks · doi:10.1007/978-3-662-65165-0_24
Chiong, M., Briceño, F. A. C., Fernández, R., Llevaneras, S., Salinas, M., Herrera, S., Saavedra, R., & Gabrielli, L. (2023) · Revista chilena de cardiología · doi:10.4067/s0718-85602023000200090
Pintér, J. A., Polyák, A., Varró, A., Farkas, S., Baczkó, I., & Topál, L. (2023) · Cardiologia Hungarica · doi:10.26430/chungarica.2023.53.5.436
Syihab, S. F., Novan, N. A., Mulyana, M., Nuryadi, N., Pramono, A., & Mohamed, H. J. J. (2024) · International Journal of Disabilities Sports & Health Sciences · doi:10.33438/ijdshs.1503971
Gosden, J. A. G. (2024) · Research Square · doi:10.21203/rs.3.rs-5313971/v1
Kafara, Z., Jurczak, D., Koronczok-Matusiak, J., Kafara, A., Kulka, K., Król, W., Kowalczyk, D., Lechowska, Z., Michta, K., & Szarek, R. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.4(48).2025.4397
Briceño, F. A. C., Sanhueza‐Olivares, F., Fernández, R., Llevaneras, S., Castro, P., Gabrielli, L., & Chiong, M. (2026) · Experimental Physiology · doi:10.1113/ep093665
Szabo, D., Babocsay, D., Eklics, K., Szokodi, I., Toth, M., Ács, P., Cziráki, A., & Sárszegi, Z. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15176879
Atrial Fibrillation In Athletes: Pathophysiology, Clinical Presentation, Evaluation and Management.
(2015) · PubMed Central · doi:10.4022/jafib.1309 · Cited by 41
Metadata
- Authors
- Pelliccia, A., Kinoshita, N., Pisicchio, C., Quattrini, F., DiPaolo, F. M., Ciardo, R., Di Giacinto, B., Guerra, E., De Blasiis, E., Casasco, M., Culasso, F., & Maron, B. J.
- Affiliations
- National Research Council (IT)
- Keio University (JP)
- Sapienza University of Rome (IT)
- Minneapolis Heart Institute Foundation (US)
- Corresponding author
- Pelliccia, Antonio
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 55
- Issue
- 15
- Pages
- 1619-1625
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2104680346
- Cited by
- 159
- References
- 32
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 13 · 2017: 3 · 2016: 8 · 2015: 22 · 2014: 15 · 2013: 5 · 2012: 17
- FWCI
- 10.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
- Keywords
- endurance training, Olympic athletes, left ventricular dysfunction, left ventricular hypertrophy, left atrial enlargement, left ventricular ejection fraction, left ventricular mass, left ventricular filling, cardiomyopathy, cardiovascular events
- MeSH terms
- Echocardiography, Electrocardiography, Female, Follow-Up Studies, Humans, Italy, Male, Motor Activity, Cardiomyopathies, Physical Endurance, Reference Values, Risk Factors, Sports, Stroke Volume, Time Factors, Incidence, Ventricular Function, Left, Ventricular Dysfunction, Left, Young Adult, Athletes
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