The effects of prolonged strenuous exercise on left ventricular function: A brief review

In summary, PSE performed for longer than 1 hour appears to be associated with a decline in LVSF in a time-dependent fashion (Table V). The decline in LVSF appears to be most notable after exercise lasting more than 6 hours. The decline in systolic function appears to occur in untrained, well-conditioned, and elite athletes after competitive situations and in controlled laboratory settings. The observed decrease in function is transient and returns to basal values within 24 to 48 hours of cessation of exercise. The etiologic and short- and long-term pathophysiologic factors associated with altered 'LVSF remain equivocal; however, recent evidence points toward alterations in β-adrenergic signaling or downregulation of receptors. Future directions should further examine the time-course of changes in LVSF throughout prolonged exercise and after extreme races lasting several days (eg, Tour de France or Eco-Challenge), which have become very popular. Few data have been published describing the effects of prolonged exercise on left ventricular diastolic function; therefore, this is an area that requires further investigation. In addition, further research into the effect of prolonged bouts of exercise on LVSF in women is required to determine whether gender differences exist. Finally, research should be directed toward a mechanism through which prolonged exercise may induce changes in LVSF.