Study Finds No Evidence of Cardiac Impairment in Elite Endurance Athletes Interview with:

Dr. Philipp Bohm MD Institute of Sports and Preventive Medicine Saarland University, Saarbrücken, Germany

Dr. Philipp Bohm

Dr. Philipp Bohm MD
Institute of Sports and Preventive Medicine
Saarland University, Saarbrücken, Germany What is the background for this study?

Dr. Bohm: It is currently under debate whether the cumulative effects of high-volume, high-intensity endurance training induce chronic cardiac damage, mainly involving the right heart. A Belgian study group even put forward the hypothesis of an ’exercise-induced arrhythmogenic right ventricular cardiomyopathy’.

In our study, we examined 33 male elite master endurance athletes (average age: 47y) by means of exercise testing, echocardiography and Cardiac MRI and compared them to a control group of 33 men who were similar in terms of age, size and weight but who had not done any kind of endurance exercise. The group of athletes, which included former Olympians as well as previous Ironman participants and champions, have been training at an elite level for around 30 years and still continue to train for an average of about 17 hours a week. Thus, we made sure to have the highest possible cumulative training load in our athlete’s group. What are the main findings?

Dr. Bohm: Our key findings were that athletes demonstrated clear evidence of structural exercise-induced cardiac remodeling as reflected by relative biventricular dilation and hypertrophy in comparison with controls. Importantly, we found no evidence of lasting damage, pathological enlargement or functional impairment of either the right or left ventricle in the athletes who had been doing long-term intensive elite-level endurance exercise. What should readers take away from your report?

Dr. Bohm: According to our results, chronic right ventricular damage in asymptomatic elite endurance master athletes with lifelong high training volumes seems to be unlikely. Thus, the hypothesis of an exercise-induced arrhythmogenic right ventricular cardiomyopathy, which had been put forward by Belgian researchers, has to be questioned. What recommendations do you have for future research as a result of this study?

Dr. Bohm:  Our cohort of elite master athletes represents to date our best means of investigating the long-term impact of years of competition-level endurance sport on the heart. Data from longitudinal studies, in which subjects have been monitored by MRI for years, potentially decades, do not exist. In the future, we should aim for long-term, longitudinal studies with ethnically diverse endurance athletes to comprehensively understand how cumulative high-dose exercise impacts health. Thank you for your contribution to the community.


Philipp Bohm, Günther Schneider, Lutz Linneweber, Axel Rentzsch, Nadine Krämer, Hashim Abdul-Khaliq, Wilfried Kindermann, Tim Meyer, Jürgen Scharhag. Right and Left Ventricular Function and Mass in Male Elite Master AthletesClinical Perspective. Circulation, 2016; 133 (20): 1927 DOI: 10.1161/CIRCULATIONAHA.115.020975

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Last Updated on June 8, 2016 by Marie Benz MD FAAD