Doctors studying what is probably the most intensive
physical effort on earth have found that if the
body is pushed hard enough, the heart will slow
down.
The finding came as a bit of a surprise, because
until recently, the conventional wisdom was that
the heart never slowed down, according to lead
investigator Dr. Euan A. Ashley, an assistant
professor of cardiology at Stanford University.
"Your heart is going to beat two or three
billion times in your lifetime," Ashley said.
"It was believed that in the absence of disease,
it would not slow down. What we showed was that
if you exercise for 19 or 20 hours at a time,
your heart will tire a bit, about 10 percent."
And the slowdown is greater in people who carry
what's been called the "fitness gene,"
Ashley's team reported in the August issue of
the Journal of the American Cardiology.
The gene is called "ACE" because it
is linked to the angiotensin-converting enzyme,
the target of ACE inhibitor heart medications.
For the study, Ashley and his colleagues set
up shop at the finishing line of an ultra-endurance
race called the "Adrenalin Rush," held
in the Scottish Highlands. The annual event is
grueling even by "iron man" standards,
with one or two competitors usually requiring
hospitalization after every race.
As athletes crossed the line after 90 hours of
biking, climbing, swimming, paddling and rope
work, the researchers tested their hearts.
The athletes' average heartbeat had slowed from
what was measured before the race, by about 8
percent for athletes who did not carry the ACE
fitness gene and 13 percent for those who did
carry it.
The ACE gene has been associated with improved
athletic performance, and Ashley said the association
could explain the difference. "It could be
that people with the fitness gene pushed themselves
harder," he said. "They were the ones
pulling the others along."
Other studies have suggested the heart might
tire with intense effort, said study senior author
Dr. Pamela Douglas, chief of cardiovascular medicine
at Duke University in Durham, N.C.
But it's the relationship of the fitness gene
with heart performance that interested Douglas
the most. Ashley's explanation of the relationship
is reasonable but remains unproven, she said.
The study results might have some application
to the ordinary world of cardiology, Douglas said.
For one thing, "people with heart disease
or borderline heart disease should not be running
marathons," she said. "There are data
to suggest much more subtle changes occur in marathon
running."
The information gathered in the study might help
shed more light on heart failure, in which the
heart cannot pump enough blood, Ashley said. "There
may be a similar mechanism involved," he
said.