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 701–773 of 773
Plasma Heart Failure Markers in Athletic Heart Progress in Long Distance Runners
Bagato, A. Y., & Dseouey, M. E. (2014) · Journal of Applied Sports Science · doi:10.21608/jass.2014.84815
moghaddam, A. M., Tadıbı, V., Behpoor, N., & Nazari, A. (2021) · Journal of Sport and Exercise Physiology · doi:10.52547/joeppa.14.1.73
Dawkins, T. G., Curry, B. A., Drane, A. L., Lord, R. N., Richards, C. T., Lodge, F. M., Yousef, Z. R., Pugh, C. J. A., Shave, R., & Stembridge, M. R. (2021) · Experimental Physiology · doi:10.1113/ep089882 · Cited by 2
“Although elite athletes were not included, trained individuals were performing a substantial volume of training and had a cardiorespiratory fitness similar to individuals in other studies investigating RV myocardial mechanics in athletes (La Gerche et al., 2015).”
ResultLamaa, N., López, J. L. G., Zeizoun, A., et al. (2021) · Cureus · doi:10.7759/cureus.19665
“described a potential exercise-induced RV dysfunction and remodeling in endurance athletes where he suggested the term “load-induced, RV arrhythmogenic cardiomyopathy‟, which could stem from repetitive microtraumas to chronic and structural changes in RV and pro-arrhythmogenesis [1].”
BackgroundLes pathologies induites par le triathlon
Marblé, C., & Coste, O. (2021) · Elsevier eBooks · doi:10.1016/b978-2-294-76780-7.00006-4
Recommendations for cardiovascular evaluation in athletes – a viewpoint
(2019) · Swiss Sports & Exercise Medicine · doi:10.34045/ssem/2019/8
“In regard to screening frequency, we recommend to repeat ECGs every 1–2 years in these young athletes because some cardiomyopathies only become apparent with increasing age and training loads [2,24,30,31], and some primary arrhythmia syndromes vary in their appearance on the resting ECG [2].”
BackgroundGeraedts, P. (2019) · Springer eBooks · doi:10.1007/978-3-662-58296-1_14
Noninvasive predictors of cardiac arrhythmias in bodybuilders
Mert, K. U., İlgüy, S., Mert, G. Ö., Dural, M., & İskenderov, K. (2018) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2018.01.007
D’Silva, A., & Sharma, S. (2018) · Echocardiography · doi:10.1007/978-3-319-71617-6_37
About the risk of arrhythmogenic heart disease in professional football players
Yanguas, J., Pruna, R., & Pons, E. (2016) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2016.12.011
Prior, D., & Brosnan, M. J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-40125-8.00037-8 · Cited by 1
Self-citationNorouzi, J., Papadakis, M., Akbarnejad, A., & Anvari, M. (2022) · European Heart Journal - Case Reports · doi:10.1093/ehjcr/ytac174
Picco, J. M., Gonzalez-Dávila, E., Wolff, S., et al. (2022) · Revista Colombiana de Cardiología · doi:10.24875/rccar.m22000135
Lalonde, F. M., Caru, M., Baudet, M., et al. (2022) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.22.14108-3
The electrocardiogram in athletes with left ventricular dilatation and reduced ejection fraction
Jorstad, H. T., & Rienks, R. (2022) · European Journal of Clinical Investigation · doi:10.1111/eci.13844
Mahdhaoui, A., Ayachi, S., Abdessalem, M. A. B., et al. (2022) · Annales de Cardiologie et d Angéiologie · doi:10.1016/j.ancard.2022.08.008
“En effet, des s eances d’exercice chez des individus en bonne sant e entrâınent souvent une el evation transitoire du taux de troponine et des r esultats d’imagerie a court terme sugg erant une fatigue cardiaque, notamment une inflammation du myocarde [13,14].”
BackgroundSchmied, C. M. (2023) · Aktuelle Kardiologie · doi:10.1055/a-2018-3703
“[25] La Gerche A, Burns AT, Mooney DJ et al.”
BackgroundD’Andrea, A., Bossone, E., Serio, A., & Pontone, G. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-95221-7.00002-1
Persch, H., & Steinacker, J. M. (2023) · Springer eBooks · doi:10.1007/978-3-662-65165-0_28
Die sportkardiologische Untersuchung und klinische Konsequenzen
Berent, R. (2023) · Springer eBooks · doi:10.1007/978-3-662-65165-0_11
Abdiyan, R. D., Sadeghpour, A., Alizadehasl, A., Ahmadi, A., Saed, D., Ravasi, A. A., Akbarnejad, A., Maleki, M., Shariati, A., Shahed, A., et al. (2023) · Journal of Sports Sciences · doi:10.1080/02640414.2023.2260636
“The relationships among these factors have become important in light of recent evidence suggesting that high-volume endurance exercise induces significant cardiac dysfunction (Kim & Park, 2020; La Gerche et al., 2012; Stewart et al., 2016).”
BackgroundWhat is Bad for the Heart is Bad for the Brain?
Sangüesa, G., Batlle, M., & Guasch, E. (2023) · Heart and Mind · doi:10.4103/hm.hm-d-23-00014
Stress Echocardiography in Athletes and Extreme Physiology
Citro, R., & Picano, E. (2023) · Springer eBooks · doi:10.1007/978-3-031-31062-1_38
Gavrilova, E. A. (2023) · Human Physiology · doi:10.1134/s0362119723700585
“In this case, the acute effect of prolonged physical activity is reflected to a greater extent on the function of the right than the left ventricle [85].”
InfluentialDuttaroy, A. K., & Mallick, R. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99570-2.00019-9
Ragazzoni, G. L., Cavigli, L., & D’Ascenzi, F. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-19091-9.00006-8
Carnabuci, C., Rinaldi, V., Tommaso, M. D., et al. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4834792
Erevik, C. B., Kleiven, Ø., Frøysa, V., Bjørkavoll-Bergseth, M. F., Chivulescu, M., Klæboe, L. G., Dejgaard, L. A., Auestad, B., Skadberg, Ø., Melberg, T. H., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.124.034382 · Cited by 1
“9 However, in the present study, there were no significant differences in RV longitudinal strain or RV fractional area change after exercise comparing the 2 groups, nor were there any significant differences in RV dimensions.”
Olympic distance duathlon and cardiac performance in highly‐trained triathletes
Donaldson, J. A., Wiles, J. D., Papadakis, M., Sharma, S., Sharma, R., & O’Driscoll, J. M. (2024) · Physiological Reports · doi:10.14814/phy2.70154
“…LV deformation has been shown to impact RV strain (Oxborough et al., 2011), and previous research has demonstrated an increased incidence of septal bounce secondary to RV dilatation following PSE (Dawson et al., 2005; La Gerche et al., 2012; Oxborough et al., 2011; Oxborough et al., 2012).”
Liu, B.-Y., Zhang, F., Tang, M.-S., Kou, X.-Y., Liu, Q., Fan, X., Li, R., & Chen, J. (2025) · Current Medical Imaging Formerly Current Medical Imaging Reviews · doi:10.2174/0115734056316396241227064057
Oláh, A., Bódi, B., Barta, B. A., Bottlik, O., Sayour, A. A., Ruppert, M., Kolodziejska, K. K., Varga, Z. V., Ferdinandy, P., Schilling, O., et al. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5142525
The Role of the Autonomic Nervous System in Cardiovascular Toxicity
Carll, A. P., Reynolds, B. R., & Roberts, A. M. (2025) · Elsevier eBooks · doi:10.1016/b978-0-323-95488-4.00263-1
Pagourelias, E. D., Ouzouni, S., Salmatzidis, P., et al. (2025) · Heart Failure Reviews · doi:10.1007/s10741-025-10541-y
Além dos Limites: O que 366 Maratonas Consecutivas Revelam sobre o Coração Humano
Braga, F., & Stein, R. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250231
Beyond Limits: What 366 Consecutive Marathons Reveal about the Human Heart
Braga, F., & Stein, R. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20250231i
Impact of Myocardial Fibrosis in Endurance Athletes: A Systematic Review
Kaddoura, R., & Al-Tamimi, H. (2025) · Heart Views · doi:10.4103/heartviews.heartviews_13_23 · Cited by 3
Oláh, A., Bódi, B., Barta, B. A., Bottlik, O., Sayour, A. A., Ruppert, M., Kolodziejska, K. K., Kovács, A., Varga, Z. V., Ferdinándy, P., et al. (2025) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2025.08.008
Cardiac impact of high-intensity functional training
Chen, C.-F., Kelly, S., & Emery, M. S. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-30014-1.00004-9
Leistungssport Ü35 – Herausforderungen bei älter werdenden Sportlern: Ausdauersport/Herz-Kreislauf
Lang, C. I., & Halle, M. (2025) · Sports Orthopaedics and Traumatology · doi:10.1016/j.orthtr.2025.07.005
Healthy Training Versus Unhinged Straining: A Cautionary Tale
Quinaglia, T., & Matos‐Souza, J. R. (2025) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.125.019134
Rowe, S. J., McKubre, K., Janssens, K., Mitchell, A. M., Cullen, O., Spencer, L. W., Bekhuis, Y., D’Ambrosio, P., Newcomb, K., Paratz, E. D., et al. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag249.376
Pokan, R., Hofmann, P., & Wonisch, M. (2025) · Springer eBooks · doi:10.1007/978-3-662-68883-0_8
Ausdauersport und kardiale Schädigung – eine kritische Analyse
Leischik, R. (2014) · Prävention und Gesundheitsförderung · doi:10.1007/s11553-014-0476-8
Heidbüchel, H., & Gerche, A. L. (2014) · Springer eBooks · doi:10.1007/978-1-4471-2398-9_3
“1 ) [ 23 ].”
BackgroundResultInfluentialSelf-citationHughes, L. E., & Lowry, J. K. (2006) · INFM-OAR (INFN Catania) · doi:10.5281/zenodo.172590
Knechtle, B., Andrade, M. S., Leite, L. B., Forte, P. M., Nikolaidis, P. Τ., Chlíbková, D., Weiss, K., Rosemann, T. J., & Đurić, S. (2026) · Sport Sciences for Health · doi:10.1007/s11332-026-01652-6
Kaur, J., Sikka, G., & ., D. (2026) · International Journal of Science and Healthcare Research · doi:10.52403/ijshr.20260112
Taoussi, O., Daoudi, Y., Azeddoug, Z., et al. (2026) · Cureus · doi:10.7759/cureus.102948
“These observations emphasize the need for cautious interpretation, standardized reporting, and prospective follow-up studies to clarify their clinical relevance [14,20].”
Rossi, M., Bucci, T., Tartaglia, E., Askarinejad, A., Lam, S. H. M., Rigutini, A. G., Ferri, C., Boriani, G., Tse, H.-F. T., Chao, T., et al. (2026) · EP Europace · doi:10.1093/europace/euag032 · Cited by 1
“…benefits of physical activity, extreme endurance exercise has been associated with adverse structural changes in the heart, including the progression of coronary artery calcification, 41 myocardial fibrosis, 42 and pathological cardiac remodelling, including enlargement of all four heart chambers.”
Amorim, R. M., Guilherme, L. Q., Filgueiras, M. D. S., Saborosa, G. P., Pires, G. F., Neumann, N. D. O., Scheer, V., Leite, L. B., Forte, P. M., Malheiro, A., et al. (2026) · Physiologia · doi:10.3390/physiologia6010021
Dynamique Spatiotemporelle de la protéine kinase AMPc dépendante dans les myocytes cardiaques
Slimane, Z. H. (2012) · theses.fr (ABES) · doi:10.70675/08615677zf11dz454fz84b1z9f6f5375fb6d
Analyse du cœur d'athlète : définition et adaptations aux efforts prolongés et répétés
Ménard, V. (2023) · theses.fr (ABES) · doi:10.70675/bda56abezf144z44abza871z4ed0345ca307
Blandin, C. (2023) · theses.fr (ABES) · doi:10.70675/bedafc9ez5195z4b52z913bz548743c18b89
Sportkardiologie in Deutschland und Europa: inhaltliche und strukturelle Aspekte
Bauer, T., Dahm, J. B., & Halle, M. (2026) · Aktuelle Kardiologie · doi:10.1055/a-2804-4055
Yeo, T. C. (2026) · Springer eBooks · doi:10.1007/978-981-96-7667-5_3
Foulkes, S., Anderson, M., Janssens, K., Beaudry, R., Carey, A., Mitchell, A. M., Spencer, L., Angus, D., Haykowsky, M. J., & Gerche, A. L. (2026) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00140.2026
Östenson, B., Ostenfeld, E., Edlund, J., Arheden, H., & Steding‐Ehrenborg, K. (2026) · PLoS ONE · doi:10.1371/journal.pone.0347745
“As the RV of the athlete’s heart has gained increasing attention in the past years in relation to exercise-induced car-diomyopathies [ 7,9], the healthy athlete’s response to exercise is of interest.”
Right Heart Diastology, Where Are We Now?
Kocx, C., Hemnes, A. R., Healy, J., Kaye, D. M., Haddad, F., Lal, S., & Celermajer, D. S. (2026) · Circulation Research · doi:10.1161/circresaha.125.327196
Dewi, D. A. M. S. K., Adji, A. S., Haksama, S., Dharmasaputra, A., Puspita, A., Suwito, B. E., Widjaja, J. S., & Billah, A. (2026) · Jurnal Penelitian Pendidikan IPA · doi:10.29303/jppipa.v12i5.14859
“…imaging, such as cardiac MRI, and electrocardiographic findings helps to track the progress of these adaptations over time, allowing for personalized recovery strategies (Adji et al., 2024; Adji, Widjaja, et al., 2024; Bouchard et al., 1999; La Gerche et al., 2012; Pavlović et al., 2006) .”
Acute effects of marathon running on the heart: a systematic review and meta-analysis
Laily, I., van Steijn, N., Rizki, P., de Vries, M. R., Liastuti, L. D., Zwinderman, A. H., Verhagen, E. A. L. M., Bakermans, A. J., & Jorstad, H. T. (2026) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2026-003201 · Cited by 1
Marwaha, S., Basu, J., Bhatia, R., et al. (2026) · Echo Research and Practice · doi:10.1186/s44156-026-00123-5
“However, emerging evidence suggests that approximately 13% of lifelong male athletes display subepicardial or mid-wall scarring, typically affecting the basal inferolat-eral wall, without significant implications [9, 16].”
Briceño, F. A. C., Sanhueza‐Olivares, F., Fernández, R., Llevaneras, S., Castro, P., Gabrielli, L., & Chiong, M. (2026) · Experimental Physiology · doi:10.1113/ep093665
“In humans, veteran endurance athletes with LV hypertrophy exhibit disruptedcollagenturnover,favouringfibrosis(Lindsay&Dunn,2007), and MRI studies have identified delayed gadolinium enhancement in the interventricular septum of some athletes, indicating myocardial fibrosis (La Gerche et al., 2012).”
Tokuda, M., Yamashita, S., Yokoyama, M., Tokutake, K., & Yamane, T. (2026) · Journal of Cardiology · doi:10.1016/j.jjcc.2026.06.018
Macartney, M. J., Anthony, R., Craddock, J. C., Batterham, M. J., & Peoples, G. E. (2026) · Sports Medicine - Open · doi:10.1186/s40798-026-01070-5 · Cited by 2
“Highly trained athletes develop sport-specific cardiac adaptations in response to sustained training loads [50, 51].”
Zhang, J., Meng, X., Shin, H., & Choi, W. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1870365
“Extreme endurance training may accelerate right ventricular remodeling and fibrosis in genetically predisposed individuals, particularly those with subclinical arrhythmogenic substrates (20).”
InfluentialThe Emergence of Sports Electrophysiology
Chung, E. H., Darden, D. J., Zorzi, A., Hammond, B. H., Stewart, K., Singh, T., Tso, J., Ackerman, M. J., Baggish, A. L., Bunch, T. J., et al. (2026) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2026.06.028
Dineen, E. H., Haigney, M. C., Levine, B. D., Ackerman, M. J., Baggish, A. L., Batts, T. C., Braverman, A. C., Chung, E. H., Cole, G. J., Cornwell, W. K., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001476
Yargıç, M. P., Akın, Ş., Ardalı, S., et al. (2026) · European Journal of Applied Physiology · doi:10.1007/s00421-026-06412-5
PKP2 orchestrates OXPHOS expression in cardiomyocytes via a PGC1α-dependent mechanism
Han, S. J., van den Berg, D., de Ruiter, H., Tsui, H., Kyriakopoulou, E., Koopmans, T., Perini, I., Monshouwer‐Kloots, J., van Kampen, S. J., Riele, A. S. J. M. T., et al. (2026) · Cardiovascular Research · doi:10.1093/cvr/cvag141 · Cited by 1
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-12, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-12 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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