Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes-A Narrative Review

Area of Science:

• Sports Cardiology
• Exercise Physiology
• Cardiovascular Health

Background:

• Growing participation in endurance sports among master athletes (MAs) over 40.
• Moderate exercise benefits cardiovascular health, but extreme endurance training raises concerns.
• Prolonged high-intensity exercise may lead to athlete's heart, involving cardiac remodeling.

Purpose of the Study:

• To review cardiovascular controversies associated with extreme endurance exercise in MAs.
• To discuss exercise-induced immunological responses and the role of nutritional supplements.
• To inform sports medicine practitioners on contemporary issues in sports cardiology.

Main Methods:

• Literature review focusing on extreme endurance exercise and cardiovascular outcomes in MAs.
• Analysis of studies on cardiac remodeling, arrhythmogenesis, and atherosclerosis in master athletes.
• Examination of research on exercise immunology and nutritional supplement effects.

Main Results:

• Extreme endurance exercise linked to potential risks: atrial fibrillation, accelerated atherosclerosis, and cardiac remodeling.
• Exercise modulates immunological responses, including proteomic changes and cytokine alterations.
• Nutritional supplements in MAs may have both benefits and harmful interactions.

Conclusions:

• Long-term extreme endurance exercise in MAs presents cardiovascular controversies requiring careful consideration.
• Understanding exercise-induced immunological and supplement-related effects is crucial for MAs.
• Shared decision-making is vital for managing clinical uncertainty in master athlete cardiology.