Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention

Intensive physical activity, especially when performed regularly and at high levels, leads to characteristic cardiovascular adaptations called "athlete’s heart" (AH). These physiological changes include left ventricular hypertrophy, atrial enlargement, and electrophysiological modification...

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Main Authors: Pawel Bollin, Urszula Szymczak, Wojciech Wiesław Lachór, Monika Barbara Solarz, Julia Piekarska, Justyna Maria Solarz, Jakub Tomasz Wawrzyńców, Weronika Cyrkler, Jakub Robak, Stanisław Telega
Format: Article
Language:English
Published: Nicolaus Copernicus University in Toruń 2025-04-01
Series:Quality in Sport
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Online Access:https://apcz.umk.pl/QS/article/view/59786
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author Pawel Bollin
Urszula Szymczak
Wojciech Wiesław Lachór
Monika Barbara Solarz
Julia Piekarska
Justyna Maria Solarz
Jakub Tomasz Wawrzyńców
Weronika Cyrkler
Jakub Robak
Stanisław Telega
author_facet Pawel Bollin
Urszula Szymczak
Wojciech Wiesław Lachór
Monika Barbara Solarz
Julia Piekarska
Justyna Maria Solarz
Jakub Tomasz Wawrzyńców
Weronika Cyrkler
Jakub Robak
Stanisław Telega
author_sort Pawel Bollin
collection DOAJ
description Intensive physical activity, especially when performed regularly and at high levels, leads to characteristic cardiovascular adaptations called "athlete’s heart" (AH). These physiological changes include left ventricular hypertrophy, atrial enlargement, and electrophysiological modifications, reflecting the heart’s adaptive response to increased demands during exercise. While typically benign, these adaptations can closely mimic pathological conditions like hypertrophic cardiomyopathy (HCM), complicating diagnosis and requiring careful differentiation to avoid unnecessary restrictions on athletic participation. Ethnic variability in cardiac remodeling, particularly among athletes of African descent, increases the potential for misdiagnosis and unjustified disqualification from sports. Although generally considered physiological, athlete’s heart may exhibit proarrhythmic properties, elevating the risk of cardiac arrhythmias in some individuals. Prolonged, high-intensity exercise, especially in middle-aged male athletes, is linked to a greater incidence of atrial fibrillation, transient right ventricular dysfunction, and other rhythm disturbances. Diagnostic tools such as electrocardiography (ECG) and transthoracic echocardiography remain essential in differentiating physiological from pathological findings, though newer imaging techniques and biomarkers are being evaluated for better accuracy. Additionally, the use of doping substances and energy drinks poses an added burden on the cardiovascular system, warranting further research and clinical attention. This review aims to analyze current knowledge on both physiological and pathological cardiac adaptations to exercise, focusing on assessing and preventing cardiovascular risks in athletes.
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publisher Nicolaus Copernicus University in Toruń
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spelling doaj-art-ac0cc5ed52f14bd5958a44bf78734e902025-08-20T03:09:12ZengNicolaus Copernicus University in ToruńQuality in Sport2450-31182025-04-014010.12775/QS.2025.40.59786Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and PreventionPawel Bollin0https://orcid.org/0009-0001-7687-4674Urszula Szymczak1https://orcid.org/0009-0007-6560-6539Wojciech Wiesław Lachór2https://orcid.org/0009-0003-2017-4788Monika Barbara Solarz3https://orcid.org/0009-0008-4476-8755Julia Piekarska4https://orcid.org/0009-0004-7164-2833Justyna Maria Solarz5https://orcid.org/0009-0002-8686-0142Jakub Tomasz Wawrzyńców6https://orcid.org/0009-0001-3716-4784Weronika Cyrkler7https://orcid.org/0009-0002-1214-0249Jakub Robak8https://orcid.org/0009-0009-8830-5717Stanisław Telega9https://orcid.org/0009-0007-2355-5876Medical Univeristy of LodzMedical University of Lodz, PolandMedical University of Lodz, PolandMedical University of Lodz, PolandMedical University of Lodz, PolandMedical University of Silesia in Katowice, PolandMedical University of Lodz, PolandMedical University of Lodz, PolandMedical University of Lodz, PolandMedical University of Lodz, PolandIntensive physical activity, especially when performed regularly and at high levels, leads to characteristic cardiovascular adaptations called "athlete’s heart" (AH). These physiological changes include left ventricular hypertrophy, atrial enlargement, and electrophysiological modifications, reflecting the heart’s adaptive response to increased demands during exercise. While typically benign, these adaptations can closely mimic pathological conditions like hypertrophic cardiomyopathy (HCM), complicating diagnosis and requiring careful differentiation to avoid unnecessary restrictions on athletic participation. Ethnic variability in cardiac remodeling, particularly among athletes of African descent, increases the potential for misdiagnosis and unjustified disqualification from sports. Although generally considered physiological, athlete’s heart may exhibit proarrhythmic properties, elevating the risk of cardiac arrhythmias in some individuals. Prolonged, high-intensity exercise, especially in middle-aged male athletes, is linked to a greater incidence of atrial fibrillation, transient right ventricular dysfunction, and other rhythm disturbances. Diagnostic tools such as electrocardiography (ECG) and transthoracic echocardiography remain essential in differentiating physiological from pathological findings, though newer imaging techniques and biomarkers are being evaluated for better accuracy. Additionally, the use of doping substances and energy drinks poses an added burden on the cardiovascular system, warranting further research and clinical attention. This review aims to analyze current knowledge on both physiological and pathological cardiac adaptations to exercise, focusing on assessing and preventing cardiovascular risks in athletes. https://apcz.umk.pl/QS/article/view/59786athlete's heartcardiac adaptationarrythmiascardiac hypertrophyscreening testssudden cardiac death
spellingShingle Pawel Bollin
Urszula Szymczak
Wojciech Wiesław Lachór
Monika Barbara Solarz
Julia Piekarska
Justyna Maria Solarz
Jakub Tomasz Wawrzyńców
Weronika Cyrkler
Jakub Robak
Stanisław Telega
Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
Quality in Sport
athlete's heart
cardiac adaptation
arrythmias
cardiac hypertrophy
screening tests
sudden cardiac death
title Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
title_full Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
title_fullStr Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
title_full_unstemmed Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
title_short Impact of Intense Physical Exercise on Athletes’ Hearts – Adaptation, Risk, and Prevention
title_sort impact of intense physical exercise on athletes hearts adaptation risk and prevention
topic athlete's heart
cardiac adaptation
arrythmias
cardiac hypertrophy
screening tests
sudden cardiac death
url https://apcz.umk.pl/QS/article/view/59786
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