Study Advises Physicians on Excessive Physical Activity

Orthopedic Sports Medicine

Chronic training for and competing in extreme endurance exercise — such as marathons, iron man distance triathlons and very long distance bicycle races — may cause structural changes to the heart and large arteries, leading to myocardial injury, according to a study in the June issue of Mayo Clinic Proceedings.
Researchers conducted a review of published literature and found some elite athletes are at increased risk of patchy myocardial fibrosis, particularly in the atria, interventricular septum and right ventricle, and an increased susceptibility to atrial and ventricular arrhythmias. In one study, approximately 12 percent of apparently healthy marathon runners showed evidence for patchy myocardial scarring, and the coronary heart disease event rate during a two-year follow up was significantly higher in marathon runners than in controls.

Researchers noted that vigorous exercisers generally have low mortality and disability rates and excellent functional capacity and further investigation is needed to help physicians identify who is at risk for adverse cardiovascular remodeling.

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