Morphological and Hemodynamic Adaptations of the Athlete’s Heart to Chronic Exercise-Induced Cardiac Remodeling

Abstract

Purpose: The aim of this review is to examine exercise-induced cardiac remodeling within the conceptual framework of the athlete’s heart, to clarify the different effects of endurance and strength training on cardiac structure and function, and to distinguish physiological adaptations from pathological cardiac remodeling.

Method: In this study, the existing literature on the topic was systematically reviewed, and studies investigating the effects of chronic exercise on cardiac structure and function were evaluated. As a result of the screening process, a total of 42 scientific studies that met the inclusion criteria were included and analyzed within the scope of this review.

Results: The findings of the literature indicate that endurance training promotes eccentric cardiac remodeling associated with volume overload in the heart. This adaptation is characterized by increases in ventricular volume, stroke volume, cardiac output, and maximal oxygen uptake. In addition, endurance training leads to positive functional outcomes such as reduced resting heart rate and increased cardiac efficiency. In contrast, strength training appears to be more closely associated with concentric hypertrophic adaptations related to pressure overload. These exercise-induced cardiac changes are largely physiological in nature and are generally associated with improved performance outcomes.

Conclusion: Overall, cardiac remodeling resulting from chronic exercise can largely be considered a beneficial and adaptive physiological response. However, excessive or inadequately monitored training loads may contribute to maladaptive cardiac changes in some cases. Therefore, individualized training programs and regular cardiovascular monitoring remain important for maintaining long-term cardiac health in athletes.

Keywords

• Athlete’s heart
• Cardiac remodeling
• Cardiovascular adaptation
• Exercise
• Hemodynamic changes

Kronik Egzersize Bağlı Kardiyak Yeniden Yapılanmaya Sporcu Kalbinin Morfolojik ve Hemodinamik Adaptasyonları

Abstract

Amaç: Bu derlemenin amacı, sporcu kalbi kavramsal çerçevesi içerisinde kronik egzersizin kardiyovasküler sistem üzerinde oluşturduğu kardiyak yeniden şekillenme süreçlerini incelemek, dayanıklılık ve kuvvet antrenmanlarının kalp yapısı ve fonksiyonları üzerindeki farklı etkilerini ortaya koymak ve egzersize bağlı gelişen fizyolojik adaptasyonları patolojik kardiyak yeniden şekillenmeden ayırt etmektir.

Yöntem: Çalışmada konuya ilişkin mevcut literatür sistematik bir yaklaşımla taranmış ve kronik egzersizin kardiyak yapı ve fonksiyon üzerindeki etkilerini inceleyen araştırmalar değerlendirmeye alınmıştır. Tarama süreci sonucunda dahil edilme kriterlerini karşılayan toplam 42 bilimsel çalışma analiz edilerek derleme kapsamında incelenmiştir.

Bulgular: Literatür bulguları, dayanıklılık antrenmanlarının kalpte hacim yüklenmesine bağlı olarak gelişen eksantrik yeniden şekillenmeyi desteklediğini göstermektedir. Bu adaptasyon; ventrikül hacminde artış, atım hacmi ve kardiyak debide yükselme ile maksimal oksijen tüketiminde artış gibi fizyolojik değişikliklerle karakterizedir. Bununla birlikte dayanıklılık antrenmanı, dinlenim kalp hızının azalması ve kardiyak verimliliğin artması gibi olumlu fonksiyonel sonuçlar da ortaya çıkarmaktadır. Öte yandan kuvvet antrenmanlarının daha çok basınç yüklenmesine bağlı konsantrik hipertrofik adaptasyonlarla ilişkili olduğu belirlenmiştir. Egzersiz kaynaklı bu kardiyak değişimlerin büyük ölçüde fizyolojik nitelikte olduğu ve spor performansını destekleyici etkiler taşıdığı görülmektedir.

Sonuç: Genel olarak kronik egzersizin neden olduğu kardiyak yeniden şekillenme, çoğunlukla faydalı ve adaptif bir fizyolojik yanıt olarak değerlendirilmektedir. Bununla birlikte aşırı veya uygun şekilde izlenmeyen antrenman yükleri, bazı durumlarda maladaptif kardiyak değişimlere yol açabilmektedir. Bu nedenle sporcularda kardiyak sağlığın korunması açısından bireyselleştirilmiş antrenman programlarının uygulanması ve düzenli kardiyovasküler izlemin sürdürülmesi önem taşımaktadır.

Keywords

• Egzersiz
• Hemodinamik değişiklikler
• Kardiyak yeniden yapılanma
• Kardiyovasküler adaptasyon
• Sporcu kalbi

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