The Impact of Exercise and Athletic Training on Vascular Structure and Function
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(2020) 22:59
Sports Cardiology (M Wasfy, Section Editor)
The Impact of Exercise and Athletic Training on Vascular Structure and Function Timothy W. Churchill, MD Address Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA, 02114, USA Email: [email protected] 2 Echocardiography Laboratory, Massachusetts General Hospital, Boston, MA, 02114, USA
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Sports Cardiology Keywords Exercise I Athlete’s heart I Vascular function I Arterial stiffness I Vasodilation
Abstract Purpose of review Myocardial adaptation to athletics and exercise training is a welldescribed process that has garnered much interest over the past decades. By contrast, our understanding of how the vascular system adapts in the trained athlete remains limited. The goal of this review is to provide a comprehensive overview of the impact of exercise on structure and function of the extra-cardiac vascular system. Recent findings While structural changes in the size of the aorta are rare in young athletes, emerging data suggest that long-term athletic participation may be a risk factor for aortic dilation in middle-age and beyond. In addition, new findings show that even modest amounts of athletic training such as participation in an individual’s first marathon can have important salutary effects on vascular health. Summary Vascular adaptations represent an important part of the athletic phenotype and likely play an important role in the overall cardiovascular health of the trained athlete.
Introduction Exercise-induced cardiac remodeling (EICR) was first documented well over a century ago with near simultaneous observations of cardiac enlargement in Swedish Nordic skiers and elite American rowers [1, 2].
Subsequent work has clearly established the exercise responsiveness of the four chambers of the heart [3–5] as well as of the cardiac electrical system [6]. In contrast, the impact of exercise and athletic training on the
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Curr Treat Options Cardio Med
vascular system, defined broadly here as the extracardiac arterial and venous system, remains considerably less well studied and less well understood. Nonetheless, both strength and endurance training appear to have important impacts on both vascular structure and function, and in turn these areas have important implications for overall cardiovascular health. One of the hallmarks of the endurance-trained athlete is the ability to augment cardiac output (CO) significantly during exercise, but this typically not coupled with significant increases in the mean
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arterial pressure (MAP). Returning to the basic physiologic equation that MAP = CO * vascular resistance, we observe a priori that vascular resistance must by definition reduce in concert with these increases in cardiac output [7]. Where, to what extent, and how these changes take place are the focus of this review, which seeks to summar
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