Moser Othmar, Schunk Stefan J, Schöffl Volker, Schierbauer Janis, Zimmermann Paul
Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95447 Bayreuth, Germany.
Exercise Physiology, Training & Training Therapy Research Group, Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria.
Life (Basel). 2025 Jul 12;15(7):1095. doi: 10.3390/life15071095.
While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise-a condition known as athlete's heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty.
近几十年来，人们对一般耐力训练和休闲体育比赛的兴趣及参与度持续上升，休闲类大师级耐力运动员的数量更是成倍增加。年龄超过40岁、参与竞技体育的男女运动员通常被称为大师级运动员（MAs）。先前的研究揭示了定期适度体育活动的显著益处，即其对心血管危险因素和心血管健康的积极影响；然而，最近的数据引发了人们的担忧，即长期参与耐力运动与心脏重塑及潜在的不良心血管结局有关。先前的研究还表明，由于长期反复进行高强度耐力运动，大师级运动员可能会出现结构、功能和电生理重塑，这种情况被称为运动员心脏。在本综述中，我们重点关注极限耐力运动水平与潜在心血管争议之间的关联，如新发性房颤导致的心律失常、冠状动脉粥样硬化加速以及运动诱导的心脏重塑。此外，还讨论了运动依赖的免疫反应调节，如蛋白质组反应和细胞因子改变。此外，我们还讨论了营养补充剂对大师级运动员的影响及其潜在益处和有害相互作用。我们旨在为运动医学从业者提供有关运动心脏病学中这些当代长寿争议的知识，并强调在临床不确定性情况下共同决策的重要性。
