Wednesday, October 27, 2010

Breaking the Athlete's Heart

Breaking some one's heart is easy. There are the typical ways often seen in relationships: cheating, saying hurtful things, being neglectful .. but, although popular, these are not specific to athletes. So how, exactly, do you break an athletes heart?
I once dated a competitive cyclist. Although a wonderful man with beautiful legs, he was one of the athletes I'm referencing who's heart had broken. At the age of 36, while racing, his heart went from about 180 beats/minute to about 30 beats/minute in a matter of seconds. This resulted in a crash off the bike, unconsciousness, a few weeks in the ICU and an operation to install a pace maker that re-activates his heart if it plummets below a certain value. Interestingly, he is one of three competitive cyclist men that I know with heart conditions. So what's up with this? Isn't exercise supposed to make you healthier?!
A friend recently sent me a link written by researcher Dr. Andre La Gerche. I'm not sure that this was sent to me for the actual reading, or due to my dating a broken hearted athlete or simply because there is a picture of Dr. La Gerche and he's really hot (see above)! Regardless, I'll take the opportunity to summarize the article and its insightful points.
This is what happens when you are active: your heart beats faster and harder to accommodate for the muscles' demands for oxygen. Over time, with regular exercise, the heart gets bigger (like any muscle that is exercised). This growth increases efficiency. Studies have shown that if the exercise ceases, the heart muscle in a normal individual (verses an elite athlete) returns to its original size over time. In the elite athlete, things are different: the heart muscle does not return to normal. It is speculated that this change in size may interfere with co-ordination of electrical impulses that move through the heart that initiate contraction: this disruption can cause arrhythmia or irregular heart contraction.
So, we know that the heart gets bigger but is this growth normal muscle growth? Any muscle under trauma, including the heart, can develop scar tissue (or fibrotic tissue hypertrophy). Scar tissue does not have the flexibility and structure of normal muscle tissue. It is projected that the presence of scar tissue within the heart muscle may inhibit normal function of the heart. In order to determine this, a scope of the heart would have to be preformed in order to properly assess fibrotic tissue development and its impact .. this is a difficult procedure if the athlete is actually alive.
On the dead, elite athlete Ryan Shay, however, a post-2008 marathon trial autopsy WAS done. Interestingly, it revealed a over sized heart with fibrotic (scar) tissue development. There is no real physiology to explain this occurrence. All we really know is that it is not normal, it likely had an impact on how his heart functioned and it may be happening in other well conditioned athletes.
How does this information translate to the recreational athlete? In short, it doesn't! The physiological implications of training at more than 50% of your maximum output as a seasoned athlete has not been adequately studied .. this is where the hot Dr. La Gerche comes in!
What we do know is that moderate exercise is really good for you. Jogging, cycling and swimming at 50% of your maximum output improves blood sugar levels, cardiovascular conditioning, lung capacity, mood and body composition. Exerting yourself regularly on hard rides that push your limits may be causing heart damage rather than heart health. However, be consoled: you are more likely to get hit by a car than die of a heart attack on your ride! As for me, at this point, I like to think that I am more likely to experience heart break from love than from athletics!

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