The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index; 13 of the 33 sources its claims cite were checked for support.
Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes
Open accessAbstract
AIMS: Endurance training may be associated with arrhythmogenic cardiac remodelling of the right ventricle (RV). We examined whether myocardial dysfunction following intense endurance exercise affects the RV more than the left ventricle (LV) and whether cumulative exposure to endurance competition influences cardiac remodelling (including fibrosis) in well-trained athletes. METHODS AND RESULTS: Forty athletes were studied at baseline, immediately following an endurance race (3-11 h duration) and 1-week post-race. Evaluation included cardiac troponin (cTnI), B-type natriuretic peptide, and echocardiography [including three-dimensional volumes, ejection fraction (EF), and systolic strain rate]. Delayed gadolinium enhancement (DGE) on cardiac magnetic resonance imaging (CMR) was assessed as a marker of myocardial fibrosis. Relative to baseline, RV volumes increased and all functional measures decreased post-race, whereas LV volumes reduced and function was preserved. B-type natriuretic peptide (13.1 ± 14.0 vs. 25.4 ± 21.4 ng/L, P = 0.003) and cTnI (0.01 ± .03 vs. 0.14 ± .17 μg/L, P < 0.0001) increased post-race and correlated with reductions in RVEF (r = 0.52, P = 0.001 and r = 0.49, P = 0.002, respectively), but not LVEF. Right ventricular ejection fraction decreased with increasing race duration (r = -0.501, P < 0.0001) and VO(2)max (r = -0.359, P = 0.011). Right ventricular function mostly recovered by 1 week. On CMR, DGE localized to the interventricular septum was identified in 5 of 39 athletes who had greater cumulative exercise exposure and lower RVEF (47.1 ± 5.9 vs. 51.1 ± 3.7%, P = 0.042) than those with normal CMR. CONCLUSION: Intense endurance exercise causes acute dysfunction of the RV, but not the LV. Although short-term recovery appears complete, chronic structural changes and reduced RV function are evident in some of the most practiced athletes, the long-term clinical significance of which warrants further study.
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Written from the paper’s full text.
TL;DR
In 40 well-trained endurance athletes, intense endurance exercise caused acute right ventricular (RV) dysfunction and dilation while left ventricular (LV) function was preserved, with most RV recovery by 1 week. A minority showed septal delayed gadolinium enhancement (DGE) and greater cumulative exercise exposure, suggesting possible chronic RV-predominant remodelling.
Key findings
- Post-race RV volumes increased and all RV functional measures decreased, whereas LV volumes decreased and LV function was preserved; RVEF fell by 9% relative to baseline (P < 0.0001) and mostly recovered by 1 week, except RVSRs remained depressed.
- Post-race BNP (13.1 ± 14.0 vs. 25.4 ± 21.4 ng/L, P = 0.003) and cTnI (0.01 ± 0.03 vs. 0.14 ± 0.17 mg/L, P < 0.0001) increased and correlated with reductions in RVEF (r = 0.52, P = 0.001 and r = 0.49, P = 0.002, respectively), but not LVEF.
- RVEF decreased with increasing race duration (r = −0.501, P < 0.0001) and VO2max (r = −0.359, P = 0.011); race completion time and VO2max independently explained 34% of the variance in ΔRVEF (P = 0.001).
- DGE localized to the interventricular septum in 5 of 39 athletes (12.8%); those athletes had greater cumulative exercise exposure and lower RVEF (47.1 ± 5.9 vs. 51.1 ± 3.7%, P = 0.042) than those with normal CMR.
Methods
- Prospective study of 40 well-trained athletes competing in a marathon, endurance triathlon, alpine cycling race, or ultratriathlon; assessments were at baseline, immediately post-race, and 6–11 days after the race.
- Evaluation included cardiac troponin I, B-type natriuretic peptide, echocardiography (three-dimensional volumes, ejection fraction, systolic strain rate), and cardiac magnetic resonance imaging with delayed gadolinium enhancement for myocardial fibrosis.
- Statistical analysis used paired t-tests, ANOVA, factorial repeated-measures ANOVA, and forward stepwise multivariable analysis; the sample size of 40 was prospectively determined to have 90% power to detect a 10% relative reduction in RVEF.
Limitations
- Stated: DGE within the RV free wall was not assessed because adequate nulling of normal RV free wall myocardium was visualized in only a minority of athletes; athletic remodelling may cause fibrosis to be under-appreciated with relative-enhancement techniques.
- Stated: the cohort was relatively small and underpowered for clinical sequelae; biomarker assessment at a single time point may limit interpretation; conclusions about exercise duration are tempered by confounders such as training levels, exercise modality, race conditions, and motivation.
- Evident from text: the study reports no long-term clinical outcomes, and prognostic implications from other clinical conditions should not be extrapolated to this healthy athletic cohort.
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Claims the paper makes
32 Own result · 15 Own interpretation · 8 Own method · 7 No full text of the sources · 4 Partly supported · 3 Supported so far · 2 Supported · 1 Not checked yet · 1 No basis given · accuracy not yet measured
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, right ventricular (RV) function may be more profoundly affected by intense endurance exercise 6 -10”
What the sources say
- Not checked — no full text of the sourcecites [6] 2008, Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise, Heart source
- Not checked — no full text of the sourcecites [7] 2010, Acute cardiac effects of marathon running, J Appl Physiol source
- Not checked — no full text of the sourcecites [8] 2009, Relation of biomarkers and cardiac magnetic resonance imaging after marathon running, Am J Cardiol source
- Supportedcites [9] 2006, Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon, Circulation source
The Echocardiography section reports that RV percentage area change decreased after the marathon while LV ejection fraction remained unchanged. It also reports changes in LV diastolic function, so the comparison is clearest for systolic function; the claim’s hedged wording is consistent with these findings. Page numbers are not provided in our copy. (LLM, conf=0.90)
- Supportedcites [10] 1990, Different effects of prolonged exercise on the right and left ventricles, J Am Coll Cardiol source
The paper reports that after the Ironman Triathlon, the filling pattern of the right ventricle, but not the left, was altered (Right and left ventricular diastolic function; page unavailable). Its Conclusions also state that the ventricles responded differently to exercise. These findings support the cautious claim that right ventricular function may be more profoundly affected. (LLM, conf=0.87)
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Every source the paper cites for this claim was checked and supports it.
In the paper
“While this could be interpreted as abnormal enhancement, it is more likely to reflect the limitations in spatial resolution of the technique, a sentiment echoed by a panel of experts who deemed that DGE assessment in the RV free wall was too unreliable to be included in the recent revision of diagnostic criteria for arrhythmogenic RV cardiomyopathy.35”
What the sources say
- Supportedcites [35] 2010, Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria, Circulation source
The citation supports the expert panel’s caution about assessing delayed enhancement in the RV free wall, not the citing authors’ observation about athletes. The Discussion (page unavailable) says RV late enhancement can be difficult to identify because the wall is thin and may be confused with fat; the Results describe revised MRI criteria based on RV size, function, and wall motion rather than late enhancement. (LLM, conf=0.88)
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The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, there is also emerging evidence that intense endurance exercise may be associated with an excess in arrhythmic disorders, the mechanisms for which remain unexplained.38 -41”
What the sources say
- Not matchedcites [38] 2008, Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists, Eur Heart J
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [39] 2011, Strenuous endurance exercise: is more better for everyone? Our genes won't tell us, Br J Sports Med source
- Supportedcites [40] 2011, Marathon rat: myocardial remodeling in an animal model of vigorous endurance exercise and implications for humans, Circulation source
The Article (see p. 13) reports a higher prevalence of atrial fibrillation in sportsmen than in the general population and describes potential arrhythmia-producing changes from extreme exercise. It also says there is very little information about the myocardial tissue alterations underlying arrhythmias, consistent with the sentence’s uncertainty about mechanisms. (LLM, conf=0.91)
- Supportedcites [41] 2010, Arrhythmias and sport practice, Heart source
The ‘Atrial arrhythmias and endurance exercise’ section reports an association between endurance sport and atrial fibrillation or flutter, and the Conclusions say athlete’s heart may create a substrate for atrial and ventricular arrhythmias. The ‘Mechanisms of AF and flutter’ section describes proposed mechanisms rather than an established explanation; page numbers are unavailable in our copy. (LLM, conf=0.90)
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Every source the paper cites for this claim was checked and supports it.
In the paper
“Studies focussing on the LV of athletes have failed to provide these mechanistic insights, 4 but recent data have suggested that exercise-induced proarrhythmic substrates may develop in the RV while sparing the LV.12,13,15”
What the sources say
- Supportedcites [12] 2007, Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment, Eur Heart J source
The Patient characteristics section (page unavailable) reports an RV origin or arrhythmogenic substrate in most athletes with ventricular arrhythmias, while LV ejection fraction did not differ between athlete groups. The Discussion and Conclusions (pages unavailable) suggest that endurance exercise could promote RV changes, but explicitly leave that causal role unproven—consistent with the claim’s hedged wording. (LLM, conf=0.88)
- Supportedcites [13] 2003, High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification, Eur Heart J source
In “Presentation, electrophysiological and morphological findings” (page unavailable), the paper reports frequent RV arrhythmogenic involvement but very little evidence of underlying LV disease in its endurance athletes with ventricular arrhythmias. In “Endurance sports and arrhythmogenic structural RV damage” (page unavailable), it speculates that endurance sports may itself lead to RV structural damage. This supports the citing sentence’s hedged claim, within that studied population. (LLM, conf=0.91)
- Supportedcites [15] 2011, Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training, Circulation source
In “Chamber-Specific Myocardial Fibrosis After Intensive Exercise Training” (page not available), the paper reports RV fibrosis after long-term intensive exercise and says the LV did not appear to be affected. In “Intense Exercise Training and Arrhythmogenic Remodeling” (page not available), it suggests that the fibrosis could contribute to the increased ventricular arrhythmia susceptibility observed in exercise-trained rats. This supports the citing sentence’s hedged claim about a possible RV substrate while sparing the LV. (LLM, conf=0.92)
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- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The considerable increases in pulmonary pressures demonstrated in trained athletes during intense exercise 29,30,34 suggest a similar physiological stress, albeit only transient.”
What the sources say
- Not checked — no full text of the sourcecites [29] 2011, Disproportionate exercise load and remodeling of the athlete's right ventricle, Med Sci Sports Exerc source
- Not checked — no full text of the sourcecites [30] 2010, Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise, J Appl Physiol source
- Supportedcites [34] 1999, Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: implications for the diagnosis of pulmonary hypertension, J Am Coll Cardiol source
The CO section reports that pulmonary artery systolic pressure rose with workload and continued to rise in athletes after 160 watts. The Mechanisms of pressure elevation section also states that the study confirmed higher exercise pressures in athletes than in nonathletes. (LLM, conf=0.92)
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In the paper
“Extending these hypotheses to human populations, Ector et al. 12 demonstrated that RVEF (and not LVEF) was reduced in athletes with complex ventricular arrhythmias when compared with healthy athletes and non-athletes without arrhythmias.”
What the sources say
- Partly supportedcites [12] 2007, Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment, Eur Heart J sourceExperimental — accuracy not yet measured
The RV volumes and EF results report significantly lower RVEF in endurance athletes with ventricular arrhythmias than in athletes without them; the Discussion also describes lower RVEF than in non-athlete controls. Neither section reports an LVEF comparison, so the parenthetical claim that LVEF was not reduced is unsupported by our copy. Page numbers are not supplied. (LLM, conf=0.86)
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and VO 2 max (r ¼ 20.359, P ¼ 0.011).”
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In the paper
“Relative to baseline, RV volumes increased”
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In the paper
“and lower RVEF (47.1 + 5.9 vs. 51.1 + 3.7%, P ¼ 0.042) than those with normal CMR.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In contrast, all measures of LV function were unchanged.”
plain- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 10
- It may state two separate claims as one. 25
- The quote only partly states this claim. 2
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Benito et al. 15 recently documented that intense endurance exercise promoted RV-specific fibrosis in rats which increased vulnerability to ventricular tachycardia following programmed stimulation.”
What the sources say
- Partly supportedcites [15] 2011, Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training, Circulation sourceExperimental — accuracy not yet measured
The chamber-specific remodeling section reports right-ventricular fibrosis after intensive training, with no observed left-ventricular difference. The ventricular-arrhythmia section reports greater inducibility during programmed stimulation in exercise rats (42% versus 6%). But the discussion says fibrosis *could play a role* in that susceptibility; it does not establish that the fibrosis caused the increase. (LLM, conf=0.87)
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In the paper
“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”
What the sources say
- Partly supportedcites [4] 2010, Long-term clinical consequences of intense, uninterrupted endurance training in olympic athletes, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The Conclusions (page not provided) report that prolonged, intense endurance training in young Olympic athletes was not associated with cardiovascular events or deterioration in left ventricular function. That supports a limited point about competitive athletes, but the study enrolled athletes free of cardiovascular disease and does not establish exercise as a prevention or treatment intervention across a wide range of volumes and intensities. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [26] 2010, Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity, Circulation source
- Not matchedcites [37] 1993, Increased life expectancy of world class male athletes, Med Sci Sports Exerc
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“More recently, Wilson et al. 18 observed DGE in 6 of 12 elite veteran athletes but not in 17 young novice athletes or 20 older non-athletes.”
What the sources say
- Partly supportedcites [18] 2011, Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes, J Appl Physiol sourceExperimental — accuracy not yet measured
The Results report LGE in 6 of 12 veteran athletes and none in the 17 young athletes or 20 age-matched controls. But the Methods describe the young athletes as experienced endurance competitors with 11–31 years of training, not novices. The paper calls the imaging finding LGE rather than DGE. (LLM, conf=0.90)
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“all measures of systolic RV function were reduced post-race.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Also, focal gadolinium enhancement and increased RV remodelling were more prevalent in those athletes with a longer history of competitive sport”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“the occurrence of an early diastolic 'septal bounce' on M-mode echocardiography in 26 of 40 athletes which was not present at baseline”
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In the paper
“Significant correlations were evident between the change in RVEF and post-race troponin (r ¼ 0.494, P ¼ 0.002) and BNP levels (r ¼ 0.518, P ¼ 0.001).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“those with DGE had 16% greater RVEDV and 25% greater RVESV than those athletes in whom there was no DGE (P ¼ 0.029 and 0.003, respectively).”
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In the paper
“There was no correlation between changes in LVEF and post-race cTnI (r ¼ 20.065, P ¼ 0.702) or BNP (r ¼ 0.250, P ¼ 0.125).”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Race completion time and VO 2 max remained as independent predictors in the multivariable analysis (b ¼ 0.459, P ¼ 0.002 and b ¼ 0.294, P ¼ 0.036, respectively), together explaining 34% of the variance in △RVEF (P ¼ 0.001).”
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In the paper
“athletes who had greater cumulative exercise exposure”
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In the paper
“There was a significant interaction between event type and time point (P-value) with a greater reduction in function in those completing the longest event (ultra-triathlon).”
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In the paper
“Right ventricular volumes increased in the post-race setting while left ventricular volumes decreased resulting in a decrease in right ventricular ejection fraction but not left ventricular ejection fraction.”
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In the paper
“These athletes had been competing in endurance sport for longer and had greater structural remodelling of the RV.”
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In the paper
“In addition, we demonstrate that the acute injury and chronic remodelling of the myocardium both disproportionately affect the RV”
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In the paper
“In all cases, focal DGE was confined to the interventricular septum and commonly at the site of RV attachment.”
- Also stated in: § Conclusion and clinical implications · plain
“Images of five athletes in whom focal delayed gadolinium enhancement (DGE) was identified in the interventricular septum (indicated with arrows) when compared with an athlete with a normal study (top left).”
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- Also stated in: § Conclusion and clinical implications · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ejection fraction (A), fractional area change (B), and systolic strain rate (C ) decreased in the post-race setting.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Functional abnormalities were confined to the RV and were largely reversible 1 week following the event.”
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In the paper
“A tolerance of .0.5 was set to avoid collinearity between the five entered variables (race duration, VO 2 max, age, weekly, and career training).”
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In the paper
“Written informed consent was obtained from all subjects and the protocol was approved by the St Vincent's Hospital Human Research Ethics Committee in accordance with the Declaration of Helsinki.”
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In the paper
“Intense endurance exercise causes an acute reduction in RV function that increases with race duration and correlates with increases in biomarkers of myocardial injury.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“suggesting that repetitive ultra-endurance exercise may lead to more extensive RV change and possible myocardial fibrosis.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All reported values are the average of three repeated measures from separate cardiac cycles.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The sample size of 40 was prospectively determined to have a 90% power of detecting a 10% relative reduction in RVEF averaged across all four endurance events”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Delayed gadolinium enhancement within the RV free wall was not assessed because adequate nulling of normal RV free wall myocardium (the reference against which abnormal enhancement is compared) was visualized in only a minority of athletes.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Intense endurance exercise causes acute dysfunction of the RV, but not the LV.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Post-race changes in load, myocardial substrates, and metabolites should confound right ventricular and left ventricular measures similarly.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Intense endurance exercise causes an acute reduction in RV function that increases with race duration”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The four endurance events represent a progressive increase in exercise duration.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To be deemed significant, DGE had to be independently identified by both clinicians and, in addition, mean signal intensities in the region of hyperenhancement were required to be more than two standard deviations (SDs) higher than the mean signal intensity of a region of adjacent myocardium”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Delayed gadolinium enhancement (DGE) was qualitatively assessed by two experienced clinicians after comparing pre-and post-contrast short-axis slices to exclude artefacts.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Greater reductions in RV function occurred in those athletes competing for a longer duration, suggesting that the heart has a finite capacity to maintain the increased work demands of exercise.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The four endurance events represent a progressive increase in exercise duration.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, BNP may provide a measure of both acute RV load and the resultant fatigue which occurs when this load is sustained.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“We have previously demonstrated that BNP release during intense exercise is associated with greater relative increases in RV systolic pressures, but not LV pressures.30”
What the sources say
- Not checked — no full text of the sourcecites [30] 2010, Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise, J Appl Physiol source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It has been demonstrated that ventricular load increases with exercise intensity and is greater for the RV than the LV, 29”
What the sources say
- Not checked — no full text of the sourcecites [29] 2011, Disproportionate exercise load and remodeling of the athlete's right ventricle, Med Sci Sports Exerc source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The four endurance events represent a progressive increase in exercise duration.
“The four events were selected to represent a progressive increase in exercise duration”
The paper relies on this without support.
Post-race changes in load, myocardial substrates, and metabolites should confound right ventricular and left ventricular measures similarly.
“Comparisons with the LV are most instructive, given that post-race changes in load, myocardial substrates, and metabolites should confound RV and LV measures similarly.”
The paper relies on this without support.
Athletic training results in relatively uniform cardiac remodelling.
“Secondly, athletic training results in relatively uniform cardiac remodelling and it is possible that cardiac fibrosis may be under-appreciated with current techniques that assess relative enhancement.”
The paper relies on this without support.
Focal delayed gadolinium enhancement on cardiac magnetic resonance indicates myocardial fibrosis.
“However, there remained a significant minority of athletes in whom there was evidence of myocardial fibrosis in the interventricular septum.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Conclusion and clinical implications
“Functional abnormalities were confined to the RV”
§ Interventricular dependence
“Post-race LV diastolic filling was impaired, as evidenced by a decrease in the ratio of early (E) to late (A) transmitral flow (EA ratio 1.84 + 0.35 at baseline vs. 1.34 + 0.35 post-race, P , 0.0001) and an increase in E deceleration time (187 + 29 vs. 212 + 40 ms, P ¼ 0.002)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Correlation between functional and biochemical evidence of myocardial injury
“median 0.018 mg/L”
§ Correlation between functional and biochemical evidence of myocardial injury
“range 0.020-0.99mg/L”
Citations
Cites
Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., Picard, M. H., Roman, M. J., Seward, J., Shanewise, J. S., et al. (2005) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2005.10.005 · Cited by 11,318
Rudski, L., Lai, W. W., Afilalo, J., Hua, L., Handschumacher, M. D., Chandrasekaran, K., Solomon, S. D., Louie, E. K., & Schiller, N. B. (2010) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2010.05.010 · Cited by 7,080
Recommendations for chamber quantification☆
Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., Picard, M. H., Roman, M. J., Seward, J. B., & Shanewise, J. S. (2006) · European Journal of Echocardiography · doi:10.1016/j.euje.2005.12.014 · Cited by 3,588
Marcus, F. I., McKenna, W. J., Sherrill, D., Basso, C., Bauce, B., Bluemke, D. A., Calkins, H., Corrado, D., Cox, M. G. P. J., Daubert, J. P., et al. (2010) · Circulation · doi:10.1161/circulationaha.108.840827 · Cited by 2,676
Marcus, G. M., McKenna, W. J., Sherrill, D., Basso, C., Bauce, B., Bluemke, D. A., Calkins, H. G., Corrado, D., Cox, M. G. P. J., Daubert, J. P., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq025 · Cited by 1,610
Iles, L., Pflüger, H., Phrommintikul, A., Cherayath, J., Ciris, P. A., Gupta, S., Kaye, D. M., & Taylor, A. J. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.06.049 · Cited by 741
Self-citationShiroma, E. J., & Lee, I.-M. (2010) · Circulation · doi:10.1161/circulationaha.109.914721 · Cited by 578
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
Mohlenkamp, S., Lehmann, N., Breuckmann, F., Brocker-Preuss, M., Nassenstein, K., Halle, M., Budde, T., Mann, K., Barkhausen, J., Heusch, G., et al. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn163 · Cited by 487
Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training
Benito, B., Gay-Jordi, G., Serrano-Mollar, A., Guasch, E., Shi, Y., Tardif, J.-C., Brugada, J., Nattel, S., & Mont, L. (2011) · Circulation · doi:10.1161/circulationaha.110.938282 · Cited by 478
Cited by
Sorted by citations
Items 601–700 of 773
Exercise-Induced Right Heart Disease in Athletes
Prior, D., & Gerche, A. L. (2014) · Respiratory medicine · doi:10.1007/978-1-4939-1065-6_15 · Cited by 1
“The result of the RV dilation combined with pericardial constraint is that the interventricular septum is pushed toward the LV resulting in an increase in the LV eccentricity index [ 58 , 62 ].”
BackgroundMethodInfluentialSelf-citationOverbuilt for exercise or not: how do lung structure and distensibility impact exercise capacity?
Bates, M. L., Hotter, J. A., Zhang, H., et al. (2013) · The Journal of Physiology · doi:10.1113/jphysiol.2012.248393 · Cited by 1
“Indeed, elite endurance athletes experience acute right ventricular dysfunction and show evidence of right ventricular fibrosis after a race (3–11 h) although left ventricular structure and function are unaffected (La Gerche et al. 2012).”
BackgroundMaron, B. A. (2014) · Pulmonary Circulation · doi:10.1086/678544 · Cited by 1
“37,38 La Gerche et al. 37 used CMR imaging to characterize the effects of ultraendurance athletic activity on RV performance.”
BackgroundMethodInfluentialGiant clear cell renal carcinoma extended from the kidney until the pulmonary artery
Laguna, G., Stefano, S. D., Melero, J. M., Rodríguez–Bailón, I., & López, J. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht276 · Cited by 1
Sportkardiologie – ein praxisorientiertes Update
Schmied, C. M. (2014) · Praxis · doi:10.1024/1661-8157/a001743 · Cited by 1
“eindrücklich demonstrieren, dass es im Rahmen von intensiven Ausdauerbelastungen bei gewissen Sportlern zu einer signifikanten Dilatation und Funktionseinschränkung des rechten Ventrikels kommen kann, die vereinzelt auch noch über mehrere Wochen und Monate anhält [54].”
BackgroundD’Andrea, A., Corte, A. D., Padalino, R., Limongelli, G., Scarafile, R., Fratta, F., Pezzullo, E., Fusco, A., Pisacane, F., Coppola, G., et al. (2015) · Journal of Cardiovascular Echography · doi:10.4103/2211-4122.158418 · Cited by 1
Halle, M. (2013) · Der Kardiologe · doi:10.1007/s12181-013-0504-5 · Cited by 1
Spatial Organization Types of Sinoatrial Node in Dogs with Different Body Functional Reserve Levels
Vasyagina, T. I., & Biriukova, O. V. (2016) · Современные технологии в медицине · doi:10.17691/stm2016.8.2.05 · Cited by 1
Sudden Cardiac Deaths in Athletes, Including Commotio Cordis
Link, M. S., & Estes, N. A. M. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-44733-1.00108-5 · Cited by 1
OBSOLETE: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Calkins, H. G. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99796-4 · Cited by 1
Pratiques sportives : risques et toxicité cardiaques potentiels
Ancion, A., & Lancellotti, P. (2018) · Journal de Traumatologie du Sport · doi:10.1016/j.jts.2018.07.003 · Cited by 1
Ventricular Tachycardias in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Tandri, H. S., & Calkins, H. G. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2856-5.00087-x · Cited by 1
Influence of Physical Activity on the Level of Cardiac Troponins (Literature Review)
Chaulin, A. M., Grigoryeva, J., & Suvorova, G. N. (2020) · Bulletin of Science and Practice · doi:10.33619/2414-2948/56/12 · Cited by 1
Heart Failure Prediction in Athletic Heart Remodeling among Long Distance Runners
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
“Right heart dilation and hypokinesis after prolonged strenuous exercise has been observed using cardiac magnetic resonance imaging [30] [31].”
MethodRight Ventricular Structure and Function During Exercise
Gerche, A. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-78255-9_6 · Cited by 1
Atrial fibrillation in elite athletes. What is missing?
Tsougos, E., Giallafos, E., & PARASKEVAIDIS, I. A. (2022) · Journal of Cardiology and Cardiovascular Medicine · doi:10.29328/journal.jccm.1001139 · Cited by 1
“[30,32], with unknown consequences [18,30,32,44,45].”
BackgroundWang, M., Lv, C., Zhang, Y., et al. (2023) · European Journal of Applied Physiology · doi:10.1007/s00421-023-05245-w · Cited by 1
“…(Fiuza-Luces et al. 2018; Seo et al. 2020); (ii) exercise may result in cardiac fatigue, but the heart can recover within a certain time (Gerche et al. 2008; Oxborough et al. 2010); and (iii) myocardial injury can occur after exercise and cannot be recovered (Gerche et al. 2012; Liang et al. 2017).”
BackgroundViel hilft viel; schädigt Sport das Myokard?
Pokan, R., & Hofmann, P. (2023) · Springer eBooks · doi:10.1007/978-3-662-65165-0_5 · Cited by 1
Heart Failure With Preserved Ejection Fraction
Letnes, J. M., Wisløff, U., & Dalen, H. (2023) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2023.05.026 · Cited by 1
Lord, R. N., Adams, Z. H., George, K., Somauroo, J. D., Jones, H., & Oxborough, D. (2023) · Echo Research and Practice · doi:10.1186/s44156-023-00035-8 · Cited by 2
“In studies assessing the endurance-exercise response of both ventricles, left ventricular function remains normal whilst right ventricular function has declined [5, 15, 30].”
BackgroundMethodInfluentialAdvanced cardiac imaging in preventing sudden cardiac death in athletes
Locatelli, E., Lis, C., Monti, L., Catapano, F., & Francone, M. (2024) · Journal of the Mexican Federation of Radiology and Imaging · doi:10.24875/jmexfri.m23000061 · Cited by 1
Lima, F. V. P., Andrade, D. D. M., Filho, J. E., Souza, P. L., Azevedo, L. F., Coelho, M. M., de Lima, J. R. P., Trevizan, P. F., Laterza, M. C., & Martinêz, D. G. (2024) · International Journal of Cardiology · doi:10.1016/j.ijcard.2024.132106 · Cited by 2
Elevated troponin levels in an athlete: Myocardial infarction or a physiological reaction?
Janković, T., & Đorđević, S. (2024) · Naucni casopis urgentne medicine - Halo 194 · doi:10.5937/halo30-52186 · Cited by 1
The Early Detection of Cardiac Fatigue: Could the HRV Be Used as a Physiological Biomarker by AI?
Zimatore, G., Gallotta, M. C., Alessandria, M., Campanella, M., Ricci, M., & Galiuto, L. (2025) · Applied Sciences · doi:10.3390/app15105489 · Cited by 1
Cardiovascular adaptations in judo: a narrative review
Rossi, C., Giustino, V., Patti, A., Roklicer, R., Manojlović, M., Trivić, T., Fukuda, D. H., Bianco, A., & Drid, P. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1607549 · Cited by 1
Das Elektrokardiogramm des Sporttreibenden und der Sport-assoziierte plötzliche Herztod
Trachsel, L. D., & Wilhelm, M. (2015) · Therapeutische Umschau · doi:10.1024/0040-5930/a000680 · Cited by 1
Asplund, C. A. (2014) · ACSMʼs Health & Fitness Journal · doi:10.1249/fit.0000000000000047 · Cited by 1
Körperliche Aktivität, Sport, Genetik und kardiovaskuläre Erkrankungen
Löllgen, H., Schulze‐Bahr, E., Löllgen, R., & Bachl, N. (2017) · Springer eBooks · doi:10.1007/978-3-7091-1591-6_16 · Cited by 1
Athlete’s heart in a Brazilian paralympic judo team. Case series study
Filho, J. A. O., Barros, M. B. M., Salles, A. F., et al. (2018) · Sao Paulo Medical Journal · doi:10.1590/1516-3180.2017.0240281017 · Cited by 1
Prolonged and strenuous exercise does not influence serum relaxin levels in healthy male athletes
Schoenfeld, J., Haller, B., Weichenberger, M., et al. (2020) · European Journal of Preventive Cardiology · doi:10.1177/2047487320902329 · Cited by 1
“There is an ongoing debate about whether acute, prolonged and strenuous exercise induces structural myocardial damage or even myocardial fibrosis.(4,5) This is supported by findings that a single bout of prolonged and strenuous exercise leads to an increase in cardiac biomarkers – for example, cardiac troponins (cTn)…”
BackgroundThe importance of ST elevation in V2–4 ECG leads in athletes
Major, Z., Kirschner, R., Medvegy, N., Kiss, K., Török, G., Pavlik, G., Simonyi, G., Komka, Z., & Medvegy, M. (2019) · Physiology International · doi:10.1556/2060.106.2019.34 · Cited by 1
Löllgen, H., Sanchis‐Gomar, F., & Predel, G. (2017) · Deutsches Ärzteblatt · doi:10.3238/perskardio.2017.11.10.01 · Cited by 1
Systemic disease and other conditions: athlete’s heart
D’Andrea, A., Gerche, A. L., & Selton‐Suty, C. (2016) · doi:10.1093/med/9780198726012.003.0055 · Cited by 1
Cardiac Structural Repercussions Induced by Exhaustive Physical Training in the Animal Model
Nunes, G. F. S., Camelo, E., Bovolini, A., Cardoso, C., Maia, S., Reis-Mendes, A., Martín, L. C., & Duarte, J. A. (2020) · Archives of Cardiology and Cardiovascular Diseases · doi:10.22259/2638-4744.0302006 · Cited by 1
High-sensitivity cardiac troponins in health and disease
Klinkenberg, L. J. J. (2016) · doi:10.26481/dis.20160304lk · Cited by 3
Dynamic Remodeling of the Heart and Blood Vessels
Takahashi, K., Piao, H., & Naruse, K. (2016) · Mechanobiology · doi:10.1002/9781118966174.ch11 · Cited by 1
Guasch, E., Benito, B., & Nattel, S. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.07.102 · Cited by 1
“Thus, plasma troponin increases correlate with RV dysfunction after high-intensity exercise (4).”
BackgroundLander, B. S., & Engel, D. J. (2021) · Springer eBooks · doi:10.1007/978-3-030-69384-8_8 · Cited by 1
Gounder, S. S., Kannan, S., Devadoss, D., Miller, C. J., Whitehead, K. S., Odelberg, S. J., Firpo, M. A., Paine, R., Hoidal, J. R., Abel, E. D., et al. (2013) · PLoS ONE · doi:10.1371/annotation/684807c2-1777-4008-9eda-c6036553b082 · Cited by 1
Exploring the Relationship between Cardiorespiratory Fitness and Physical Literacy: A scoping reviewPreprint
Palma, B. E. P., Rodas, A. G., & Claros, A. V. (2023) · Research Square · doi:10.21203/rs.3.rs-3648745/v1 · Cited by 1
Petrosyan, T., & Ter-Margaryan, N. (2026) · Sports Medicine · doi:10.1007/s40279-025-02384-2 · Cited by 1
The Heart as a Special Muscle in Athletes and Anabolic–Androgenic Steroids (Ab)use
Slart, R. H. J. A., Tio, R. A., & Nieuwland, W. (2015) · Springer eBooks · doi:10.1007/978-3-662-46491-5_44
Tobon‐Gomez, C., Palau-Caballero, G., Sitges, M., & Bijnens, B. H. (2013) · Lecture notes in computer science · doi:10.1007/978-3-642-36961-2_38
Can exercise be detrimental? Considerations based on determinations of cardiac troponins
Ma̧czewski, M. (2014) · Postępy Nauk Medycznych
Tissue Characterisation in Acquired Heart Disease with Cardiovascular Magnetic Resonance Imaging
McDiarmid, A. K. (2015) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
Novel aspects of heart failure: from combined neurohormal blockade to embryonic stem cells
Lüscher, T. F. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv293
Evaluating the athlete’s heart - now and in the future
Jackson, G. (2012) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2012.02995.x
Further Evidence of Harm From Exercise in ARVD/C
Judge, D. P., & Chelko, S. P. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.01.046
トリガーPVCの起源である右室中隔に一致した部位にLGEを認めた "特発性" 多形性心室頻拍の1例
白井, 康., 佐々木, 毅., 井原, 健., et al. (2014) · 心臓 · doi:10.11281/shinzo.46.s2_173
Fibrillation auriculaire et activité physique Faut-il être prudent?
Bosomworth, N. J. (2015) · PubMed Central
Messung der Respiratorischen Sinusarrhythmie bei Ausdauerläufern
Ludewig, D. (2016) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-10936
Athlete Screening for Cardiomyopathies: Recent Insights and Latest Guidelines
Aagaard, P., & Phelan, D. M. J. (2016) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-016-0494-5
Şimşek, Z., Tas, M. H., Günay, E., & Değirmenci, H. (2013) · International Journal of Cardiology · doi:10.1016/s0167-5273(13)70265-1
Ventricular Tachycardias in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Tandri, H. S., & Calkins, H. G. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-44733-1.00087-0
Die sportkardiologische Untersuchung und klinische Konsequenzen
Berent, R. (2015) · Springer eBooks · doi:10.1007/978-3-662-43711-7_12
Plötzlicher Herztod bei jungen Sportlern
Leischik, R. (2014) · MMW - Fortschritte der Medizin · doi:10.1007/s15006-014-3268-3
“In der Arbeit von LaGerche [26] wird nach Ausdauerwettkämpfen eine geringe Zunahme des enddiastolischen Volumens des RV um 9 ml (5%, von 170 ± 30 ml) beschrieben und als Hinweis für eine Schädigung des RV gewertet.”
BackgroundInfluentialCodreanu, A., Delagardelle, C., Groben, L., & Urhausen, A. J. P. (2015) · Springer eBooks · doi:10.1007/978-3-662-43711-7_22
Viel hilft viel; schädigt Sport das Myokard?
Pokan, R., & Hofmann, P. (2015) · Springer eBooks · doi:10.1007/978-3-662-43711-7_6
Is Ultra‐Endurance Exercise Damaging to the Right Ventricle?
Claessen, G., & Heidbüchel, H. (2016) · Wiley eBooks · doi:10.1002/9781119046899.ch42
Self-citationFibrillation auriculaire et activité physique
Bosomworth, N. J. (2015) · Canadian Family Physician
Acerca del riesgo de cardiopatía arritmogénica en el fútbol profesional
Yanguas, J., Pruna, R., & Pons, E. (2016) · Medicina Clínica · doi:10.1016/j.medcli.2016.07.007
Fibrosis miocárdica y extrasistolia ventricular. Caso clínico
Grazioli, G., la Garza, M. S., Brugada, J., & Sitges, M. (2017) · Apunts Sports Medicine · doi:10.1016/j.apunts.2017.01.001
Jansen, M., & Burke, F. W. (2016) · Cardiovascular Innovations and Applications · doi:10.15212/cvia.2015.0020
Monitoring und Individualisierung von körperlichem Training bei Patienten mit pulmonaler Hypertonie
Harbaum, L., Grimminger, J., Galow, S., Grünig, E., Klose, H. F. E., & Hennigs, J. K. (2017) · Der Pneumologe · doi:10.1007/s10405-017-0124-z
“Exzessives Training kann jedoch auch bei Gesunden negative Effekte auf den RV haben [20, 21].”
BackgroundExercise is good for the heart, but the intensity matters
Zhang, X., & Gao, F. (2017) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00323.2017
“These results are consistent with the 52 observation of right ventricle (RV) structural and functional adaptations in some 53 athletes (6, 10).”
BackgroundResultExercise-Induced Right Ventricular Cardiomyopathy Seek and You Will Find
Heidbüchel, H. (2013)
Self-citationGolshani, S., Dabirian, M., Bagheri, B., Nabati, M., Moshtaghian, S., & Darvishi‐Khezri, H. (2017) · DOAJ (DOAJ: Directory of Open Access Journals)
Arrhythmias in Special Populations
Wang, P. J., & Joe, W. B. (2017) · Cardiovascular medicine · doi:10.1007/978-3-319-58000-5_22
Coates, A. M. (2017) · The Atrium (University of Guelph)
MYOCARDIAL REACTION TO ENERGY DRINKS IN A GUINE A PIG: STRUCTURAL CHANGES
Gružienė, A., Malcienė, L., Kerzienė, S., Skaudickas, D., Vaitiekaitis, G., & Pečiulytė, G. (2017) · Sveikatos mokslai · doi:10.5200/sm-hs.2017.060
Impact of exercise early in life on the adult heart
Asif, Y. (2017) · Figshare
Ali, M. J. (2018) · DR-NTU (Nanyang Technological University) · doi:10.32657/10356/73344
Exercise and Cardiovascular Disease: Emphasis on Efficacy, Dosing, and Adverse Effects and Toxicity
Morledge, M. D., Kachur, S. M., Lavie, C. J., Parto, P., O’Keefe, J. H., & Milani, R. V. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811279-3.00010-0
Growth and Development of Sports and Exercise Cardiology in the US
Lawless, C. E. (2018) · WORLD SCIENTIFIC (EUROPE) eBooks · doi:10.1142/9781786342577_0001
Effect of Endurance Sport on the Right Heart
Manolis, A. S., & Manolis, A. S. (2018) · Springer eBooks · doi:10.1007/978-3-319-73764-5_6
Exercise-induced right ventricular impairment and arrhythmia susceptibility in mice
Lakin, R. (2018) · TSpace (University of Toronto)
Honegger, U., Walter, J. E., Mueller, D. L., Puelacher, C., Schaerli, N., Twerenbold, R., Badertscher, P., Boeddinghaus, J., Nestelberger, T., de Lavallaz, J. D. F., et al. (2019) · European Journal of Clinical Investigation · doi:10.1111/eci.13112
“Hypertensive Heart Diseases 25 (8) 20 (9) 5 (6) 0.”
Dorian, D., Chatterjee, D., Banks, L., Connelly, K. A., Goodman, J. M., Bentley, R. F., Yan, A. T.-K., Hamilton, R. M., & Dorian, P. (2019) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2019.07.055
Cardiovascular Adaptations in Triathlon
Sharma, S., & Accame, M. M. (2019) · Springer eBooks · doi:10.1007/978-3-030-22357-1_11 · Cited by 1
An Exercise Mimetic That Targets Nitroso-Redox Balance as a Therapeutic for Heart Disease
Shettigar, V., & Ziolo, M. T. (2019) · Springer eBooks · doi:10.1007/978-981-13-8946-7_22
Dörr, M. (2020) · European Journal of Preventive Cardiology · doi:10.1177/2047487319898955
“increased myocardial fibrosis) as well as a persistently reduced function and an increased frequency of arrhythmias have been demonstrated.(4,7,8) In addition, significant interindividual and sex differences have been reported with regard to these right ventricular adaptations to endurance exercise.”
BackgroundMyocardial Strain Imaging in Asian Competitive Athletes – A Single Centre Study
Keh, Y. S., Tan, P. J., Chai, S. C., et al. (2020) · American Journal of Sports Science · doi:10.11648/j.ajss.20200801.13
“[17] They postulated that the RV, being less muscular than the LV, could be more susceptible to injury from the increase in preload during endurance exercise.”
BackgroundPreßler, A., & Möhlenkamp, S. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_32
Corrado, D., Zorzi, A., & Thiene, G. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_14
Potential Cardiac Damage Induced by Strenuous Exercise
Möhlenkamp, S., & Preßler, A. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_31
Schnell, F., & Carré, F. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_19
Medical Evaluation of Athletes: Further Imaging Modalities—Stress Echo, CT and MRI
Claessen, G., & Gerche, A. L. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_9
Toward Controlling Cardiac Tissue Pacing Using Modified mRNA
Zhao, Y. (2020) · Open Scholarship Institutional Repository (Washington University in St. Louis) · doi:10.7936/0wrs-jt78
“It is also a crucial aspect of distinguishing the contribution of different potassium currents and drug-induced action potential in cardiomyocytes (La Gerche et al., 2012).”
BackgroundArrhythmias due to athletic training
MacLachlan, H., & Sharma, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817728-0.00029-2
The super healthy atrial fibrillation conundrum
Lie, Ø. H., & Haugaa, K. H. (2020) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jeaa217
(Statistically speaking, sports is healthy for your heart, but statistics can be tricky)
Linhart, A. (2020) · Cor et Vasa · doi:10.33678/cor.2020.079
The “V1 continuum” in the athletes’ ECG
Díaz-González, L., Bruña, V., Velásquez‐Rodríguez, J., et al. (2020) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13806
The “V1 continuum” on the surface ECG of apparently healthy athletes
Ollitrault, P., Pellissier, A., Reboursière, E., Milliez, P., & Hodžić, A. (2020) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13801
Buchan, T. A. (2017) · TSpace (University of Toronto)
Leischik, R., Sanchis‐Gomar, F., & Lucía, A. (2016) · Circulation · doi:10.1161/circulationaha.116.023345
Glibbery, M. (2018) · TSpace (University of Toronto)
The Impact of COVID-19 on Sports Cardiology
Lander, B. S., Engel, D. J., & Phelan, D. M. J. (2021) · Springer eBooks · doi:10.1007/978-3-030-69384-8_23
Association between physical activity and hypertension: A retrospective studyPreprint
Hou, Z., Wan, S., Yong, Z., Yu, W., Zhang, Y., Wu, X., & Tong, R. (2020) · doi:10.21203/rs.3.rs-48088/v1
Trachsel, L. D., David, L., Gayda, M., Boidin, M., Lalongé, J., Juneau, M., Nigam, A., & Henri, C. (2021) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2021-0055
Metadata
- Authors
- La Gerche, A., Burns, A. T., Mooney, D. J., Inder, W. J., Taylor, A. J., Bogaert, J., MacIsaac, A. I., Heidbüchel, H., & Prior, D. L.
- Affiliations
- St Vincent's Hospital Melbourne (AU)
- The University of Melbourne (AU)
- Baker Heart and Diabetes Institute (AU)
- Universitair Ziekenhuis Leuven (BE)
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-12-06
- Volume
- 33
- Issue
- 8
- Pages
- 998-1006
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2148325692
- Semantic Scholar
- 7d299222e3e0cabc4deedc38d9035410d00d5777
- Cited by
- 776
- References
- 48
- Citations by year
- 2026: 34 · 2025: 41 · 2024: 36 · 2023: 38 · 2022: 62 · 2021: 42 · 2020: 82 · 2019: 48 · 2018: 62 · 2017: 61 · 2016: 64 · 2015: 62 · 2014: 71 · 2013: 38 · 2012: 30
- FWCI
- 28.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- 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 athletes, right ventricular dysfunction, cardiac remodeling, myocardial fibrosis, arrhythmogenic cardiomyopathy, endurance exercise, right ventricular ejection fraction, late gadolinium enhancement, cardiac troponin I, brain natriuretic peptide, exercise-induced myocardial injury
- MeSH terms
- Adult, Female, Fibrosis, Humans, Male, Middle Aged, Myocardium, Physical Endurance, Stroke Volume, Biomarkers, Exercise, Ventricular Dysfunction, Right, Magnetic Resonance Angiography, Troponin I, Ventricular Remodeling, Athletes
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