ReviewPhysiological reviews2016
Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise?
Review in Physiological reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 7 syntheses or guidelines pooled it, 216 citations in OpenAlex.
- Effect of exercise intervention on quality of life and exercise capacity in patients with atrial fibrillation: a systematic review and network meta-analysis.Frontiers in public health · 2025Pooled it
- Effects of exercise training on cardiotoxicity in cancer survivors. A systematic review.F1000Research · 2022Pooled it
- Alcohol Consumption and Risk of Atrial Fibrillation: A Dose-Response Meta-Analysis of Prospective Studies.Frontiers in cardiovascular medicine · 2022Pooled it
- Preclinical techniques to investigate exercise training in vascular pathophysiology.American journal of physiology. Heart and circulatory physiology · 2021Pooled it
- Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis.Frontiers in physiology · 2021Pooled it
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- Guideline
- The metabolic effects of habitual leg shaking: A randomized crossover trial.Journal of diabetes · 2024Trial
- Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation? A Longitudinal Study of Left Atrial Structure and Function.Circulation. Arrhythmia and electrophysiology · 2018Trial
- Left ventricular vascular and metabolic adaptations to high-intensity interval and moderate intensity continuous training: a randomized trial in healthy middle-aged men.The Journal of physiology · 2016Trial
- Masters Athletes With Abnormal Cardiovascular Findings: A Clinical Consensus Statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.Journal of the American College of Cardiology · 2026Article
- Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.European heart journal · 2026Article
- Physical activity and risk of adverse events in atrial fibrillation: evidence from European and Asian cohorts.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- MicroRNA, MicroRNA-lncRNA and MicroRNA-Circular RNA axes, and exosomal MicroRNAs: driving exercise-induced cardioprotection in heart failure.Frontiers in cell and developmental biology · 2026Review
- Acute effects of marathon running on the heart: a systematic review and meta-analysis.BMJ open sport & exercise medicine · 2026Article
- Article
- Running the risk: extreme right ventricular remodelling in an endurance athlete-a case report.European heart journal. Case reports · 2025Article
- Association between questionnaire- and accelerometer-measured physical activity and incidence of cardiovascular disease in subjects with metabolic dysfunction-associated steatotic liver disease.American journal of preventive cardiology · 2025Article
- Adaptive Changes in Endurance Athletes: A Review of Molecular, Echocardiographic and Electrocardiographic Findings.International journal of molecular sciences · 2025Review
- Impact of High Intensity Contact Physical Activity During a Match on Echocardiographic Parameters and High-Sensitivity Troponin I in Competitive Rugby Players.Journal of clinical medicine · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including "myocardial" creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.