“It can’t be good to beat yourself up so much.” It is the phrase that many athletes who practice high intensity sports have had to hear. But specialists in Cardiology deny this: in fact, they affirm that the most demanding exercise -such as cycling, mountaineering or running a marathon- does not cause pathological sequelae nor is it harmful to a healthy heart.
This was stated by a recent study carried out with professional excicists that analyzed the possible cardiac consequences of high-performance endurance sports in middle age.
Winner of the National Sports Medicine Research Prize convened by the University of Oviedo in 2022, this study indicated some very clear data: high-level sport maintained for many years is healthy and does not cause significant cardiac repercussions.
Traditionally, this type of sports practice has been associated with an increased risk of myocardial fibrosis or coronary calcification. However, this investigation of prominent sports professionals, such as Alejandro LucÃa and Araceli Boraita, with ex-cyclists from the Grand Tours (Giro d’Italia, Tour de France and Vuelta a España), did not detect the existence of this relationship. But this does not mean that you do not have to be careful. The heart is one of the organs that must be taken care of the most when practicing sports on a regular basis.
Magnetic resonance imaging is a very precise tool to assess the cardiovascular health of athletes. It is the perfect test to, among other aspects, rule out possible heart problems such as cardiomyopathies and help set new personal challenges with complete peace of mind.
But in cardiology clinics, specialists have tended to use the same reference parameters to study the cardiovascular health of the adult population as a whole: both people accustomed to intense exercise and those who are not. And, in reality, their hearts are not the same.
Now, an investigation led by the biomedical group Ascires -the same one that introduced the first magnetic resonance imaging in Spain and that participated in the study of professional excicists- has determined, for the first time in our country, what are the specific reference values of an athlete’s heart versus the general population. Because the muscles and the resistance are not the same, but neither is the heart. And this should be revised with specific reference values ​​for athletes.
“In the same way that we cannot analyze a child’s heart using the parameters of the adult population, we cannot study the athlete’s heart with the normal values ​​established for the general population either,” explains Dr. Alicia Maceira, cardiologist and director Ascires, a group that includes the Catalan team Cetir. Knowing how to differentiate what a heart accustomed to the most demanding sport is like in its normal state is important for the athlete’s health. And it is to avoid, for example, “erroneous or imprecise diagnoses,” adds the specialist.
According to this pioneering research in Sports Cardiology and developed in collaboration with cardiologists Araceli Boraita (Supreme Sports Council) and MarÃa Dolores Masiá, from the Hospital de San Juan (Alicante), the key lies in knowing in detail the morphology and functioning of the heart of the athletes. For example, in the normal heart of an athlete, the ventricles are larger in volume and the wall thickness may be slightly increased. “The function of the heart and how the different parameters are related will also be within certain limits and this allows us to know if the athlete, in addition to doing sports, is healthy or if his heart presents a possible cardiopathy”, says Dr. Maceira.
That is, athletes have the largest ventricles and it should not be a problem. “But, if this is not taken into account, a completely healthy athlete can be diagnosed with dilated cardiomyopathy,” explains the cardiologist from Ascires. To avoid these errors, it is important that, before assessing the heart of someone who performs high-intensity sports (whether at a professional or amateur level), the cardiologist knows the type of patient before him.
In this way, the medical specialist will be able to apply maximum precision when analyzing the cardiovascular health of an athlete, knowing that he may present parameters that would be abnormal in a person who does not practice intense sports. “Thanks to these new reference values, we can accurately determine whether or not an athlete has heart diseaseâ€, explains Dr. Alicia Maceira. And here the size of the ventricles or the papillary muscles come into play, but also some proportions, thicknesses or the synchrony of cardiac contraction.
All these new reference ranges have been published in the Journal of Cardiovascular Magnetic Resonance after the authors of the study analyzed to the millimeter the hearts of 272 people, including 148 high-level athletes from all over Spain. New values ​​that, from now on, serve to establish a normal heart for those people who train intensely and who feel strong enough to attack a marathon or a climb up the Tourmalet.
Thus, for those who want to “crush” and maximize their performance safely, these parameters represent a before and after in their cardiac check-ups.
