Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners

Abstract

ObjectiveIn the last years, a debate exists about type, intensity and frequency of physical exercise that is really indicated to protect healthy subjects from cardiovascular disease. Regular physical training has been associated with an improved cardiovascular risk profile, but it has also been demonstrated that strenuous and uncontrolled physical exercise could be dangerous, in terms of increased cardiovascular morbidity and mortality. In the present study, we evaluated a group of 35 amateur half-marathon runners, who were likewise studied 10 years before (B). The results of B suggested that an increased cardiac sympathetic modulation could potentially represent a negative prognostic factor. The aim of this follow-up was to assess the medium–long-term effects of moderate to vigorous physical training on the cardiovascular neural control, cardiac function and occurrence of cardiovascular diseases.MethodsEach enrolled subject underwent: (1) an interview and physical examination to ascertain the presence of cardiovascular disease; (2) standing test to evaluate the cardiovascular neural control by means of heart rate variability (HRV), arterial blood pressure (AP) variability and baroreflex sensitivity (BRS); (3) transthoracic echocardiography to evaluate cardiac function.ResultsAt 10-year follow-up (FU), in this group of middle-aged athletes the occurrence of cardiovascular diseases was low, not unlike that of the overall population. The results of HRV analysis showed a decreased sympathetic and increased vagal modulation directed to the heart, compared with B. In addition, HRV, AP variability and BRS indices showed a physiological response to active standing. Finally, athletes had normal echocardiographic measures.ConclusionWe conclude that in our group of athletes a regular moderate–vigorous physical training through the 10 years was quite beneficial as the prevalence of sympathetic cardiac modulation observed at B was not accompanied by increased cardiovascular risk, on the contrary a slight prevalence of vagal indices was observed at FU.

Improvement of Sympathovagal Balance by Regular Exercise May Counteract the Ageing Process. A Study by the Analysis of QT Variability

“…The experimental protocol has fully been described previously ( Dalla Vecchia et al, 2014 ; De Maria et al, 2021 ). The study population consisted of a group of 18 half-marathon runners (17 males) first studied at the fifth Corripavia race and then at a 10-year follow-up.…”

“…In the last years, more and more attention has been paid to the evaluation of the cardiovascular risk in athletes exposed to very high levels of physical stress, focusing on the medium-long term effects ( Albert et al, 2000 ; Kim et al, 2012 ; Dalla Vecchia et al, 2014 ; Lear et al, 2017 ; Eijsvogels et al, 2018 ; Dalla Vecchia et al, 2019 ; De Maria et al, 2021 ).…”

“…A recent study ( De Maria et al, 2021 ) demonstrated that in a group of middle-aged amateur half-marathon runners, considering a 10-year follow-up, the shift from a strenuous exercise training to a still regular but lower level of exercise, namely a moderate one, was associated to a rebalancing of the sympatho-vagal modulation directed to the heart. Such changes were accompanied by a very low occurrence of cardiovascular disease ( De Maria et al, 2021 ).…”

“…A recent study ( De Maria et al, 2021 ) demonstrated that in a group of middle-aged amateur half-marathon runners, considering a 10-year follow-up, the shift from a strenuous exercise training to a still regular but lower level of exercise, namely a moderate one, was associated to a rebalancing of the sympatho-vagal modulation directed to the heart. Such changes were accompanied by a very low occurrence of cardiovascular disease ( De Maria et al, 2021 ). This would represent a key finding, as an enhanced vagal and decreased sympathetic cardiac modulation to the heart is known to be associated with a reduced risk of cardiovascular events ( La Rovere et al, 1998 ; La Rovere et al, 2001 ; Thayer et al, 2010 ; Pinna et al, 2017 ), confirming physical exercise among the effective cardiovascular prevention measures ( Thompson et al, 2003 ).…”

“…The aim of the present study is to evaluate the complementary information derived by QT variability assessment, including its complexity, with respect to HP variability, in a group of middle-aged half-marathon runners studied over a 10-year follow-up period. The results of the QT variability and complexity analyses will be compared and discussed in relation to previous data derived from the HP variability analysis ( De Maria et al, 2021 ).…”