Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review
While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, wh...
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MDPI AG
2025-07-01
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| Online Access: | https://www.mdpi.com/2075-1729/15/7/1095 |
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| author | Othmar Moser Stefan J. Schunk Volker Schöffl Janis Schierbauer Paul Zimmermann |
| author_facet | Othmar Moser Stefan J. Schunk Volker Schöffl Janis Schierbauer Paul Zimmermann |
| author_sort | Othmar Moser |
| collection | DOAJ |
| description | While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise—a condition known as athlete’s heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty. |
| format | Article |
| id | doaj-art-05fe523d833c4242aa381328d2ffe53e |
| institution | DOAJ |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj-art-05fe523d833c4242aa381328d2ffe53e2025-08-20T03:07:58ZengMDPI AGLife2075-17292025-07-01157109510.3390/life15071095Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative ReviewOthmar Moser0Stefan J. Schunk1Volker Schöffl2Janis Schierbauer3Paul Zimmermann4Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, GermanyDepartment of Internal Medicine IV, Nephrology and Hypertension, Saarland University, 66421 Homburg/Saar, GermanyInterdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, GermanyDivision of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, GermanyDivision of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, GermanyWhile the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise—a condition known as athlete’s heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty.https://www.mdpi.com/2075-1729/15/7/1095master athletecardiovascular riskatrial fibrillationcoronary artery atherosclerosiscardiac remodelingnutritional supplements |
| spellingShingle | Othmar Moser Stefan J. Schunk Volker Schöffl Janis Schierbauer Paul Zimmermann Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review Life master athlete cardiovascular risk atrial fibrillation coronary artery atherosclerosis cardiac remodeling nutritional supplements |
| title | Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review |
| title_full | Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review |
| title_fullStr | Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review |
| title_full_unstemmed | Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review |
| title_short | Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review |
| title_sort | cardiovascular remodeling and potential controversies in master endurance athletes a narrative review |
| topic | master athlete cardiovascular risk atrial fibrillation coronary artery atherosclerosis cardiac remodeling nutritional supplements |
| url | https://www.mdpi.com/2075-1729/15/7/1095 |
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