Stress on the heart for ultra-endurance athletes

Dr Glenn McConell chats with Assoc Prof Andre La Gerche a world leading Sports Cardiologist from St Vincent’s Institute of Medical Research, Melbourne, Australia. Acute exercise for long periods at a high intensity can result in abnormal right ventricle function. In addition, years of long, hard exercise training is associated with increased coronary artery calcium (CAC) levels and atrial fibrillation (AF). Despite this, Andre is a huge advocate of exercise across the population and generally even in these individuals. The evidence is that exercise training increase healthspan and reduces mortality rates despite some of these changes. A very important, interesting chat. Twitter: @ALaGerche
0:00. Introduction + how Andre got into sports/exercise research
5:30. Andre’s excellent marathon running
7:32. Is exercise good for the heart?
10:50. Media fear around ex and the heart
13:45. Increased CAC and heart attack risk
17:00. Exercise protective even if increased CAC
18:56. Andre hasn’t had a CAC scan
22:28. Plague build up in the coronary arteries
23:50. Some people never have coronary issues
24:50. Genetics and the heart
26:55. Jim Fixx: died running
27:40. How can exercise increase CAC?
32:00. Get into exercise slowly
33:30. Coronary “hot plagues” and heart attacks
35:30. Exercise before a heart operation
36:45. Exercise training increases hearts reserve with age
37:33. 1969 marathon WR holder Derek Clayton: still amazing heart
43:15. AF more common in endurance athletes
45:43. Female endurance athletes have increased AF
47:55. Generally if in doubt, keep exercising
50:43. Women have relatively more stable hearts
52:50. Cardiac screening of athletes
55:55. Ventricular arrhythmias: continue sport or not?
59:50. It's hard to estimate heart attack risk
1:01:58. Right ventricle after long hard races
1:08:10. Rare ventricular tachycardia in professional athletes
1:11:34. The importance of seeing a sports cardiologist
1:14:40. Big vs enormous hearts in top endurance athletes
1:18:10. Genetics and the heart
1:19:25. EPO, anabolic steroids, very hard training and the heart
1:24:20. Resistance training, anabolic steroids and the heart
1:28:15. Best exercise to do for the heart and health
1:29:50. What’s the cutoff of ex for increased AF?
1:33:50. Blood indicators of heart damage/recovery
1:36:45. Right ventricle “fatigue” and recovery
1:40:50. Heart failure/heart reserve and exercise (sex differences)
1:44:00. Don't assume sudden death in athletes drug related
1:45:45. Negative cardiac effects of the Covid19 vaccine in some people
1:50:12. Takeaway messages
1:52:38. Outro (9 seconds)
Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
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Not medical advice