Almost everyone knows that exercise is good for the health, but medical experts often caution against high-level intense exercise, saying it is dangerous for the heart and could be counter-productive to the health.
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A new study published in the Canadian Journal of Cardiology now examines the merits of the argument that intense exercise may cause structural damage to the heart while also predisposing others to abnormal heart rhythm.
There is a growing body of evidence linking very intense exercises with increased incidents of atrial fibrillation, and how this is related to chronic altered atrial substrate. Sports cardiologist André La Gerche does not debate the benefits of low and moderately intense exercises, but he wants a balanced view to the idea of very intense exercise where they might cause adverse cardiac changes in certain people.
"Much of the discussion regarding the relative risks and benefits of long-term endurance sports training is hijacked by definitive media-grabbing statements, which has fueled an environment in which one may be criticized for even questioning the benefits of exercise," explained Dr. La Gerche, who is Head of Sports Cardiology at the Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
The sports cardiologist points out that all the benefits of drugs and therapies diminish at high doses and the risks of adverse events increases. Dr. La Gerche agrees that there could be adverse clinical events in athletes who exercise intensely in the face of existing or underlying health conditions, but he still felt certain controversies over these issues must be addressed:
• Is there a non-linear dose-response relationship with exercise?
• Elite athletes tend to live longer but is this the effect of exercise or other factors such as the absence of smoking and alcohol consumption?
• Is endurance exercise in athletes associated with arrhythmias?
• What are the potential mechanisms that predispose athletes to arrhythmias?
• Is chronic cardiac remodelling a consequence of repeated bouts of injury?
• Why is there disproportionate right ventricular (RV) injury following an acute bout of intense exercise and are there any long-term consequences?
• Is the risk of ischemic heart disease increased with intense exercise?
Dr. La Gerche finally submitted that the actual health or effects of extreme exercises cannot be fully known, raising the need for more research into the controversy because of the large number of people potentially affected by the phenomenon.
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“The lack of large prospective studies of persons engaged in high-volume and high-intensity exercise represents the biggest deficiency in the literature to date, and, although such work presents a logistical and financial challenge, many questions will remain controversies until such data emerge," he said.