© Springer Nature Singapore Pte Ltd. 2017 21
J. Xiao (ed.), Exercise for Cardiovascular Disease Prevention and Treatment,
Advances in Experimental Medicine and Biology 999,
DOI 10.1007/978-981-10-4307-9_2
Chapter 2
Acute and Chronic Response to Exercise
in Athletes: The “Supernormal Heart”
Antonello D’Andrea, Tiziana Formisano, Lucia Riegler, Raffaella Scarafile,
Raffaella America, Francesca Martone, Marco di Maio,
Maria Giovanna Russo, Eduardo Bossone, Maurizio Galderisi,
and Raffaele Calabrò
Abstract During last decades, most studies have examined the exercise-induced
remodeling defined as “athlete’s heart”. During exercise, there is an increased car-
diac output that causes morphological, functional, and electrical modification of the
cardiac chambers. The cardiac remodeling depends also on the type of training, age,
sex, ethnicity, genetic factors, and body size. The two main categories of exercise,
endurance and strength, determine different effects on the cardiac remodeling. Even
if most sport comprise both strength and endurance exercise, determining different
scenarios of cardiac adaptation to the exercise. The aim of this paper is to assemble
the current knowledge about physiologic and pathophysiologic response of both the
left and the right heart in highly trained athletes.
Keywords Athletes heart • Doppler • Exercise-induced cardiomyopathy • Left ven-
tricular hypertrophy • Right heart • Sport training • Strain
A. D’Andrea (*) • T. Formisano • L. Riegler • R. Scarafile • R. America • F. Martone
M. di Maio • M.G. Russo • R. Calabrò
Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli,
Corso Vittorio Emanuele 121, 80121 Naples, Italy
e-mail: [email protected]
E. Bossone
Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio,
Salern, Italy
M. Galderisi
Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy