{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:12:37Z","timestamp":1791159157357,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Sports Med"],"published-print":{"date-parts":[[1999,8]]},"abstract":"<jats:p>OBJECTIVES: Sustained aerobic dynamic exercise is beneficial in preventing cardiovascular disease. The effect of lifelong endurance exercise on cardiac structure and function is less well documented, however. A 12 year follow up of 20 veteran athletes was performed, as longitudinal studies in such cohorts are rare. METHODS: Routine echocardiography was repeated as was resting, exercise, and 24 hour electrocardiography. RESULTS: Nineteen returned for screening. Mean (SD) age was 67 (6.2) years (range 56-83). Two individuals had had permanent pacemakers implanted (one for symptomatic atrial fibrillation with complete heart block, the other for asystole lasting up to 15 seconds). Only two athletes had asystolic pauses in excess of two seconds compared with seven athletes in 1985. Of these seven, five had no asystole on follow up. Two of these five had reduced their average running distance by about 15-20 miles a week. One athlete sustained an acute myocardial infarction during a competitive race in 1988. Three athletes had undergone coronary arteriography during the 12 years of follow up but none had obstructive coronary artery disease. Ten of 19 (53%) had echo evidence of left ventricular hypertrophy in 1997 but only two (11%) had left ventricular dilatation. Ten athletes had ventricular couplets on follow up compared with only two in 1985. CONCLUSIONS: Although the benefits of moderate regular exercise are undisputed, high intensity lifelong endurance exercise may be associated with altered cardiac structure and function. These adaptations to more extreme forms of exercise merit caution in the interpretation of standard cardiac investigations in the older athletic population. On rare occasions, these changes may be deleterious.<\/jats:p>","DOI":"10.1136\/bjsm.33.4.239","type":"journal-article","created":{"date-parts":[[2008,12,31]],"date-time":"2008-12-31T23:10:53Z","timestamp":1230765053000},"page":"239-243","source":"Crossref","is-referenced-by-count":62,"title":["Cardiac assessment of veteran endurance athletes: a 12 year follow up study."],"prefix":"10.1136","volume":"33","author":[{"given":"S","family":"Hood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Northcote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"ref_1","first-page":"222","article-title":"Cardiovascular benefits of physical activity","volume":"16","author":"Morris, C.K.; Froelicher, V.F.","year":"1991","unstructured":"Morris CK, Froelicher VF. Cardiovascular benefits of physical activity. Herz 1991;16:222\u201336.","journal-title":"Herz"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/0002-8703(91)90290-X","article-title":"Exercise as a coronary protective factor","volume":"122","author":"Chandrashekhar, Y.; Anand, I.S.","year":"1991","unstructured":"Chandrashekhar Y, Anand IS. Exercise as a coronary protective factor. Am Heart J 1991;122:1723\u201339.","journal-title":"Am Heart J"},{"key":"ref_3","first-page":"2","article-title":"Preventing heart attack and death in patients with coronary artery disease","volume":"92","author":"SC, Jr, Smith; SN, Blair; MH, Criqui","year":"1995","unstructured":"Smith SC Jr, Blair SN, Criqui MH, et al. Preventing heart attack and death in patients with coronary artery disease. Circulation 1995;92:2\u20134.","journal-title":"Circulation"},{"key":"ref_4","article-title":"Cardiac rehabilitation as secondary prevention. Clinical practice guideline no 17","author":"Wenger, N.K.; Froelicher, E.S.; Smith, L.K.","year":"1995","unstructured":"Wenger NK, Froelicher ES, Smith LK, et al. Cardiac rehabilitation as secondary prevention. Clinical practice guideline no 17. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and the National Heart, Lung and Blood Institute, 1995:ACHCPR publication no 96-0672.","journal-title":"Health Care Policy and Research and the National Heart, Lung and Blood Institute; US Department of Health and Human Services, Public Health Service, Agency for"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1056\/NEJM198603063141003","article-title":"Physical activity, all cause mortality, and longevity of college alumni","volume":"314","author":"RS, Jr, PfaVenberger; RT, Hyde; AL, Wing","year":"1986","unstructured":"PfaVenberger RS Jr, Hyde RT, Wing AL, et al. Physical activity, all cause mortality, and longevity of college alumni. N Engl J Med 1986;314:605\u201313.","journal-title":"N Engl J Med"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1161\/01.CIR.96.8.2534","article-title":"Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise","volume":"96","author":"Niebauer, J.; Hambrecht, R.; Velich, T.","year":"1997","unstructured":"Niebauer J, Hambrecht R, Velich T, et al. Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise. Circulation 1997;96:2534\u201341.","journal-title":"Circulation"},{"key":"ref_7","first-page":"857","article-title":"Statement on exercise: benefits and recommendations for physical activity programs","volume":"94","author":"Fletcher, G.F.; Balady, G.; Blair, S.N.","year":"1996","unstructured":"Fletcher GF, Balady G, Blair SN, et al. Statement on exercise: benefits and recommendations for physical activity programs for all Americans. Circulation 1996;94:857\u2013 62.","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1161\/01.CIR.61.4.832","article-title":"Echocardiographic evaluation of long-term eVects of exercise on left ventricular hypertrophy and function in professional bicyclists","volume":"61","author":"Nishimura, T.; Yamada, Y.; Kawai, C.","year":"1980","unstructured":"Nishimura T, Yamada Y, Kawai C. Echocardiographic evaluation of long-term eVects of exercise on left ventricular hypertrophy and function in professional bicyclists. Circulation 1980;61:832\u201340.","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1161\/01.CIR.67.4.896","article-title":"Non-invasive assessment of seasonal variations in cardiac structure and function in cyclists","volume":"67","author":"Fagard, R.; Aubert, A.; Lysens, R.","year":"1983","unstructured":"Fagard R, Aubert A, Lysens R, et al. Non-invasive assessment of seasonal variations in cardiac structure and function in cyclists. Circulation 1983;67:896\u2013901.","journal-title":"Circulation"},{"key":"ref_10","first-page":"401","article-title":"Cardiovascular future in athletes","author":"Murayama, M.; Kuroda, Y.","year":"1980","unstructured":"Murayama M, Kuroda Y. Cardiovascular future in athletes. In: Lubich T, Venerando A, ed. Sports cardiology. Bologna: Aulo Gaggi, 1980:401\u201313."},{"key":"ref_11","first-page":"244","article-title":"The long-term involution of physiological cardiomegaly and cardiac hypertrophy","volume":"21","author":"Dickhuth, H.H.; Horstmann, T.; Staiger, J.","year":"1989","unstructured":"Dickhuth HH, Horstmann T, Staiger J, et al. The long-term involution of physiological cardiomegaly and cardiac hypertrophy. Med Sci Sports Exerc 1989;21:244\u20139.","journal-title":"Med Sci Sports Exerc"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0002-9149(97)00898-9","article-title":"Exerciseinduced silent myocardial ischaemia in master athletes","volume":"81","author":"Katzel, L.I.; Fleg, J.L.; Busby-Whitehead, M.J.","year":"1998","unstructured":"Katzel LI, Fleg JL, Busby-Whitehead MJ, et al. Exerciseinduced silent myocardial ischaemia in master athletes. Am J Cardiol 1998;81:261\u20135.","journal-title":"Am J Cardiol"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1136\/hrt.79.2.161","article-title":"High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise","volume":"79","author":"Jensen-Urstad, K.; Bouvier, F.; Saltin, B.","year":"1998","unstructured":"Jensen-Urstad K, Bouvier F, Saltin B, et al. High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise. Heart 1998;79:161\u20134.","journal-title":"Heart"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1136\/hrt.61.2.155","article-title":"Electrocardiographic findings in male veteran endurance athletes","volume":"61","author":"Northcote, R.J.; Canning, G.P.; Ballantyne, D.","year":"1989","unstructured":"Northcote RJ, Canning GP, Ballantyne D. Electrocardiographic findings in male veteran endurance athletes. Br Heart J 1989;61:155\u201360.","journal-title":"Br Heart J"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/oxfordjournals.eurheartj.a059585","article-title":"The eVect of habitual sustained endurance exercise on cardiac structure and function","volume":"11","author":"Northcote, R.J.; McKillop, G.; Todd, I.C.","year":"1990","unstructured":"Northcote RJ, McKillop G, Todd IC, et al. The eVect of habitual sustained endurance exercise on cardiac structure and function. Eur Heart J 1990;11:17\u201322.","journal-title":"Eur Heart J"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/0002-8703(49)90562-1","article-title":"The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads","volume":"37","author":"Sokolow, M.; Lyon, T.P.","year":"1949","unstructured":"Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 1949;37:161\u201386.","journal-title":"Am Heart J"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1136\/hrt.47.3.213","article-title":"Ambulatory electrocardiographic recording in endurance athletes","volume":"47","author":"Viitasalo, M.T.; Kala, R.; Eisalo, A.","year":"1982","unstructured":"Viitasalo MT, Kala R, Eisalo A. Ambulatory electrocardiographic recording in endurance athletes. Br Heart J 1982;47:213\u201320.","journal-title":"Br Heart J"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/oxfordjournals.eurheartj.a061546","article-title":"Ambulatory electrocardiographic findings in young athletes between 14\u201316 years of age","volume":"5","author":"Viitasalo, M.T.; Kala, R.; Eisalo, A.","year":"1984","unstructured":"Viitasalo MT, Kala R, Eisalo A. Ambulatory electrocardiographic findings in young athletes between 14\u201316 years of age. Eur Heart J 1984;5:2\u20136.","journal-title":"Eur Heart J"},{"key":"ref_19","first-page":"591","article-title":"Bradycardia, ventricular pauses, syncope and sports","volume":"ii:","author":"Ector, H.; Verlinden, M.; Vanden Eynde, E.","year":"1984","unstructured":"Ector H, Verlinden M, Vanden Eynde E, et al. Bradycardia, ventricular pauses, syncope and sports. Lancet 1984;ii: 591\u20134.","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1161\/01.CIR.44.1.130","article-title":"Approaches to sudden death from coronary artery disease","volume":"44","author":"Lown, R.; Wolf, M.A.","year":"1971","unstructured":"Lown R, Wolf MA. Approaches to sudden death from coronary artery disease. Circulation 1971;44:130\u201342.","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/j.0954-6820.1966.tb07968.x","article-title":"Physiological analysis of physically well-trained middle-aged and old athletes","volume":"179","author":"Grimby, G.; Saltin, B.","year":"1996","unstructured":"Grimby G, Saltin B. Physiological analysis of physically well-trained middle-aged and old athletes. Acta Med Scand 1996;179:513\u201326.","journal-title":"Acta Med Scand"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1136\/hrt.77.3.252","article-title":"High incidence of scintigraphic myocardial uptake defects at rest and during exercise in male elite runners","volume":"77","author":"Bouvier, F.; Nejat, M.; Bergland, B.","year":"1997","unstructured":"Bouvier F, Nejat M, Bergland B, et al. High incidence of scintigraphic myocardial uptake defects at rest and during exercise in male elite runners. Heart 1997;77:252\u20135.","journal-title":"Heart"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsm.33.4.239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T07:18:30Z","timestamp":1715671110000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsm.33.4.239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,8]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1999,8,1]]},"published-print":{"date-parts":[[1999,8]]}},"alternative-id":["10.1136\/bjsm.33.4.239"],"URL":"https:\/\/doi.org\/10.1136\/bjsm.33.4.239","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,8]]}}}