Regular aerobic physical exercise of moderate intensity is undeniably associated with improved health and increased longevity, with some studies suggesting that more is better. Endurance athletes exceed the usual recommendations for exercise by 15-fold to 20-fold. The need to sustain a large cardiac output for prolonged periods is associated with a 10–20% increase in left and right ventricular size and a substantial increase in left ventricular mass. A large proportion of endurance athletes have raised levels of cardiac biomarkers (troponins and B-type natriuretic peptide) and cardiac dysfunction for 24–48 h after events, but what is the relevance of these findings? In the longer term, some endurance athletes have an increased prevalence of coronary artery disease, myocardial fibrosis and arrhythmias. The inherent association between these ‘maladaptations’ and sudden cardiac death in the general population raises the question of whether endurance exercise could be detrimental for some individuals. However, despite speculation that these abnormalities confer an increased risk of future adverse events, elite endurance athletes have an increased life expectancy compared with the general population.

无可否认，定期进行中等强度的有氧体育锻炼与改善健康状况和延长寿命有关，一些研究表明，做得更好。耐力运动员比通常的运动建议高出15倍至20倍。长时间保持较大的心输出量与左，右心室大小增加10–20％以及左心室质量大量增加有关。大部分耐力运动员在赛后24-48小时内都有心脏生物标志物（肌钙蛋白和B型利钠肽）水平升高和心脏功能障碍，但是这些发现的意义何在？从长远来看，一些耐力运动员的冠状动脉疾病，心肌纤维化和心律不齐的患病率会增加。这些“不适应症”与一般人群的心源性猝死之间的内在联系引发了这样的问题：耐力运动是否会对某些人有害。然而，尽管推测这些异常会增加未来发生不良事件的风险，但与一般人群相比，耐力运动员的预期寿命也有所增加。