• British medical bulletin · Dec 2024

    The athletes heart-from acute stimulus to chronic adaptation.

    • Joseph D Maxwell and David Oxborough.
    • Research Institute of Sports and Exercise Science, Cardiovascular Health Science Research Group, Liverpool John Moores University, Liverpool, Tom Reilly Building, L3 3AF, United Kingdom.
    • Br. Med. Bull. 2024 Dec 7.

    IntroductionThe complex phenomenon of the athlete's heart (AH) describes the chronic physiological structural and functional adaptation secondary to repeated exposure of an acute exercise stimulus.Sources Of DataThis narrative review is based on published evidence.Areas Of AgreementHighly trained athletic individuals frequently display cardiac parameters which are suggestive of an AH and can exceed the traditional 'normal' limits.Area Of ControversyThe physiological processes underpinning the extent of cardiac adaption and how this is closely linked to exercise type, but also sex, ethnicity, and body size.Growing PointsSince its seminal description by Morganroth and colleagues in 1975, our understanding of the AH has evolved in tandem with improvements in cardiac imaging techniques alongside the exploration of more diverse athletic populations. This narrative review aims to provide a balanced discussion of the multi-factorial nature of structure and function of the AH with specific reference to the unique physiological exercise stimuli.Areas Timely For Developing ResearchDespite great interest in cardiac adaptations across a broad spectrum of athletic populations, future research designs should consider the use of new and novel imaging techniques to enhance our understanding of the acute cardiovascular responses which ultimately mediates such adaptations, especially in athletic populations underrepresented in the literature.© The Author(s) 2024. Published by Oxford University Press.

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