ReviewEuropean heart journal2021
The heart of the ageing endurance athlete: the role of chronic coronary stress.
Review in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Coronary Artery Disease in Masters Athletes: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Society for Cardiovascular Magnetic Resonance reference values ("normal values") in cardiovascular magnetic resonance: 2025 update.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Guideline
- A 9-year longitudinal investigation into physiological aging in highly active older adults.GeroScience · 2026Article
- [Extrasystoles in endurance athletes].Herzschrittmachertherapie & Elektrophysiologie · 2026Article
- Coronary Artery Disease in Male Athletes-Is Sport Healthy in the Long Run?Journal of clinical medicine · 2026Review
- Exercise-specific epigenetic effects on cardiovascular health.Clinical epigenetics · 2026Review
- Role of Cardiopulmonary Exercise Testing in the Monitoring of Cardiovascular Risk Factors in Athletes - State-of-the-Art Review.Vascular health and risk management · 2026Review
- Myocardial Fibrosis in Young and Veteran Athletes: Evidence from a Systematic Review of the Current Literature.Journal of clinical medicine · 2024Review
- Investigation of left atrial mechanical function and left ventricular systolic and diastolic parameters in athletes performing resistance exercise and combined exercise.BMC cardiovascular disorders · 2024Article
- Allometric scaling for left ventricular mass and geometry in male and female athletes of mixed and endurance sports.Echo research and practice · 2024Article
- Effects of Sixty-Minute Race-Pace Running on Cardiac Stress Biomarkers in Recreational Distance Runners.Physiological research · 2023Article
- Masters athlete screening study (MASS): incidence of cardiovascular disease and major adverse cardiac events and efficacy of screening over five years.European journal of preventive cardiology · 2023Article
- Kidney fibrosis: from mechanisms to therapeutic medicines.Signal transduction and targeted therapy · 2023Review
- Exercise and the Heart: Benefits, Risks and Adverse Effects of Exercise Training.Reviews in cardiovascular medicine · 2023Review
- Study of Morpho-Functional Characteristics of the Cardiovascular System According to Electrocardiography, Phonocardiography, Echocardiography in Masters Athletics.Clinical interventions in aging · 2023Article
- How to Unmask Hidden Cardiovascular Diseases through Preparticipation Screening in Master Athletes?Reviews in cardiovascular medicine · 2022Review
- Mild Left Ventricular Hypertrophy in Middle-Age Male Athletes as a Sign of Masked Arterial Hypertension.International journal of environmental research and public health · 2022Article
- The relationship between cardiac damage biomarkers and heart rate variability following 60 min of running.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2022Article
- Exercise-related major adverse cardiovascular events in asymptomatic recreational master athletes: a case series.European heart journal. Case reports · 2022Article
- Ageing, comorbidities, and the complex determinants of atrial fibrillation in athletes.European heart journal · 2021Article
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.
Funding
Abstract
Moderate physical exercise is associated with an irrefutable reduction in cardiac morbidity and mortality. The current guidelines recommend at least 150 min of moderate exercise or 75 min of vigorous exercise per week. Endurance athletes perform exercise at a level that is 10- to 20-fold greater than these recommendations. These athletes reveal several structural and functional cardiac adaptations including increased cardiac size, enhanced ventricular filling, and augmentation of stroke volume even at the highest heart rates. The long-term effects of endurance exercise on the heart are unknown. Endurance exercise is associated with a transient increase in serum concentrations of biomarkers of cardiac damage and ventricular dysfunction which improves within 72 h. Over the past decade, there have been emerging studies reporting attenuated mortality benefit amongst individuals who perform the highest volume of exercise. Studies in lifelong male athletes aged above 40 years old show a higher prevalence of high coronary artery calcium scores (>300 Agatston units), a higher coronary plaque burden, and myocardial fibrosis compatible with subclinical myocardial infarction compared with relatively sedentary healthy controls, raising speculation that lifelong intense exercise imposes chronic coronary stress on the heart. This review article will provide a critical analysis of the existing data.
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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.