The Effects of Training

Darling, Eugene A.

doi:10.1056/nejm189909071411001

Cited by 54 publications

(7 citation statements)

References 23 publications

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“…Responsiveness of the heart to exercise training was first suggested well over 100 years ago. 25,26 Subsequent longitudinal studies have established a causal relationship between exercise and structural, functional, and electrical myocardial adaptation, [27][28][29] with remodeling often leading to phenotypes that overlap with forms of myocardial pathology. 7,8,30 In contrast, prior work focused on aortic adaptations to exercise has suggested that aortic remodeling is comparatively minimal and rarely adequate to produce aortic dilatation of clinical relevance.…”

Section: Discussionmentioning

confidence: 99%

“…Findings from this study fill an important gap in our understanding of how long-term participation in endurance sport affects the cardiovascular system. Responsiveness of the heart to exercise training was first suggested well over 100 years ago . Subsequent longitudinal studies have established a causal relationship between exercise and structural, functional, and electrical myocardial adaptation, with remodeling often leading to phenotypes that overlap with forms of myocardial pathology .…”

Section: Discussionmentioning

confidence: 99%

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Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

et al. 2020

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IMPORTANCE Aortic dilatation is frequently encountered in clinical practice among aging endurance athletes, but the distribution of aortic sizes in this population is unknown. It is additionally uncertain whether this may represent aortic adaptation to long-term exercise, similar to the well-established process of ventricular remodeling.OBJECTIVE To assess the prevalence of aortic dilatation among long-term masters-level male and female athletes with about 2 decades of exercise exposure. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study evaluated aortic size in veteran endurance athletes. Masters-level rowers and runners aged 50 to 75 years were enrolled from competitive athletic events across the United States from February to October 2018. Analysis began January 2019.EXPOSURES Long-term endurance exercise. MAIN OUTCOMES AND MEASURESThe primary outcome was aortic size at the sinuses of Valsalva and the ascending aorta, measured using transthoracic echocardiography in accordance with contemporary guidelines. Aortic dimensions were compared with age, sex, and body size-adjusted predictions from published nomograms, and z scores were calculated where applicable. RESULTS Among 442 athletes (mean [SD] age, 61 [6] years; 267 men [60%]; 228 rowers [52%]; 214 runners [48%]), clinically relevant aortic dilatation, defined by a diameter at sinuses of Valsalva or ascending aorta of 40 mm or larger, was found in 21% (n = 94) of all participants (83 men [31%] and 11 women [6%]). When compared with published nomograms, the distribution of measured aortic size displayed a rightward shift with a rightward tail (all P < .001). Overall, 105 individuals (24%) had at least 1 z score of 2 or more, indicating an aortic measurement greater than 2 SDs above the population mean. In multivariate models adjusting for age, sex, body size, hypertension, and statin use, both elite competitor status (rowing participation in world championships or Olympics or marathon time under 2 hours and 45 minutes) and sport type (rowing) were independently associated with aortic size. CONCLUSIONS AND RELEVANCEClinically relevant aortic dilatation is common among aging endurance athletes, raising the possibility of vascular remodeling in response to long-term exercise. Longitudinal follow-up is warranted to establish corollary clinical outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

et al. 2020

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“…Exercise-induced cardiovascular remodeling (EICR) is often a result of adaptive, structural, functional, and molecular changes caused by exercise training. Although the term EICR is more recent, its study dates originated to over a century ago when researchers noted enlarged hearts in Nordic skiers and American university rowers [3,4]. Since then, several forms of EICR have been reported.…”

Section: Introductionmentioning

confidence: 99%

Sex-Specific Impacts of Exercise on Cardiovascular Remodeling

Islam

Khalsa

Vyas

et al. 2021

JCM

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Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field.

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“…Several structural and morphological cardiac adaptations occur in response to regular exercise. More than a century ago, Eugene Darling observed cardiac enlargement among Harvard University rowers, 116 a finding that has been corroborated by cross-sectional data in endurance athletes over the subsequent century. 117 More recently, prospective and longitudinal assessments of competitive athletes confirmed that regular endurance exercise promotes cardiac chamber enlargement.…”

Section: Cardiac Adaptations To Exercisementioning

confidence: 78%

Exercise, Physical Activity, and Cardiometabolic Health

Belanger

Rao

Robbins

2022

Cardiology in Review

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Physical activity and its sustained and purposeful performance—exercise—promote a broad and diverse set of metabolic and cardiovascular health benefits. Regular exercise is the most effective way to improve cardiorespiratory fitness, a measure of one’s global cardiovascular, pulmonary and metabolic health, and one of the strongest predictors of future health risk. Here, we describe how exercise affects individual organ systems related to cardiometabolic health, including the promotion of insulin and glucose homeostasis through improved efficiency in skeletal muscle glucose utilization and enhanced insulin sensitivity; beneficial changes in body composition and adiposity; and improved cardiac mechanics and vascular health. We subsequently identify knowledge gaps that remain in exercise science, including heterogeneity in exercise responsiveness. While the application of molecular profiling technologies in exercise science has begun to illuminate the biochemical pathways that govern exercise-induced health promotion, much of this work has focused on individual organ systems and applied single platforms. New insights into exercise-induced secreted small molecules and proteins that impart their effects in distant organs (“exerkines”) highlight the need for an integrated approach towards the study of exercise and its global effects; efforts that are ongoing.

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The Effects of Training

Cited by 54 publications

References 23 publications

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

Sex-Specific Impacts of Exercise on Cardiovascular Remodeling

Exercise, Physical Activity, and Cardiometabolic Health

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