@misc{ScharhagKnebelMayeretal.2011,
  author    = {Scharhag, J{\"u}rgen and Knebel, F. and Mayer, Frank and Kindermann, Wilfried},
  title     = {Does marathon running damage the heart? - an update},
  series = {Deutsche Zeitschrift f{\"u}r Sportmedizin : offizielles Organ der Deutschen Gesellschaft f{\"u}r Sportmedizin und Pr{\"a}vention (Deutscher Sport{\"a}rztebund) e.V. (DGSP) und Weiterbildungsorgan der {\"O}sterreichischen Gesellschaft f{\"u}r Sportmedizin und Pr{\"a}vention},
  volume    = {62},
  journal   = {Deutsche Zeitschrift f{\"u}r Sportmedizin : offizielles Organ der Deutschen Gesellschaft f{\"u}r Sportmedizin und Pr{\"a}vention (Deutscher Sport{\"a}rztebund) e.V. (DGSP) und Weiterbildungsorgan der {\"O}sterreichischen Gesellschaft f{\"u}r Sportmedizin und Pr{\"a}vention},
  number    = {9},
  publisher = {WWF-Verl.-Ges.},
  address   = {Greven},
  issn      = {0344-5925},
  pages     = {293 -- 298},
  year      = {2011},
  abstract  = {Since the legend of the ancient Marathon run, the risk of endurance exercise-induced cardiovascular damage or sudden cardiac death is discussed. In recent studies, the exercise-induced increases in cardiac biomarkers in endurance athletes as well as acute alterations in cardiac function and cardiovascular abnormalities have been reported. As elevations of the cardiac biomarkers troponin and BM) have been observed frequently for the vast majority of athletes after Marathon runs or strenuous exercise bouts followed by a decrease within a short period, a physiological reaction rather than a pathologicial cause is presumed. Also a transient decrease of cardiac function demonstrated by newer echocardiographic techniques (tissue Doppler or speckle tracking imaging, 3D echocardiography) after strenuous exercise often termed "cardiac fatigue" should not be considered necessarily as pathologic, as cardiac function also depends on hemodynamic load and heart rate. Furthermore, exercise-induced changes in cardiac function did not correlate with exercise-induced increases in cardiac biomarkers in most studies. The functional cardiac alterations can also be detected by magnetic resonance imaging (MRI) after Marathon runs. However, no signs of acute or chronic myocardial damage have been demonstrated in MRI studies in cardiovascular healthy athletes after running a Marathon, although especially in older athletes undetected cardiovascular diseases such as coronary artery disease or myocardial necrosis or fibrosis can be present. hi conclusion, according to recent studies. there seems to be a lack of evidence to support endurance exercise-induced cardiac damage in the healthy heart which is adapted tostrenous exercise by regular endurance training. Nevertheless, as running a Marathon results in a high cardiac load, a sufficient endurance training period as well as a preparticipation or regular medical screening to exclude relevant congenital or aquired cardiovascular diseases is recommended from a sports cardiology perspective to exclude relevant congenital or acquired cardiovascular diseases},
  language  = {de}
}
@article{KarlowatzScharhagRahnenfuehreretal.2011,
  author    = {Karlowatz, Ruth-Jessica and Scharhag, J{\"u}rgen and Rahnenfuehrer, J{\"o}rg and Schneider, Ulrich and Jakob, Ernst and Kindermann, Wilfried and Zang, Klaus Dieter},
  title     = {Polymorphisms in the IGF1 signalling pathway including the myostatin gene are associated with left ventricular mass in male athletes},
  series = {British journal of sports medicine : the journal of sport and exercise medicine},
  volume    = {45},
  journal   = {British journal of sports medicine : the journal of sport and exercise medicine},
  number    = {1},
  publisher = {BMJ Publ. Group},
  address   = {London},
  issn      = {0306-3674},
  doi       = {10.1136/bjsm.2008.050567},
  pages     = {36 -- 41},
  year      = {2011},
  abstract  = {Background Athlete's heart as an adaptation to long-time and intensive endurance training can vary considerably between individuals. Genetic polymorphisms in the cardiological relevant insulin-like growth factor 1 (IGF1) signalling pathway seem to have an essential influence on the extent of physiological hypertrophy. Objective Analysis of polymorphisms in the genes of IGF1, IGF1 receptor (IGF1R) and the negative regulator of the cardiac IGF1 signalling pathway, myostatin (MSTN), and their relation to left ventricular mass (LVM) of endurance athletes. Methods In 110 elite endurance athletes or athletes with a high amount of endurance training (75 males and 35 females) and 27 male controls, which were examined by echocardiographic imaging methods and ergometric exercise-testing, the genotypes of a cytosine-adenine repeat polymorphism in the promoter region of the IGF1 gene and a G/A substitution at position 3174 in the IGF1R gene were determined. Additionally, a mutation screen of the MSTN gene was performed. Results The polymorphisms in the IGF1 and the IGF1R gene showed a significant relation to the LVM for male (IGF1: p=0.003; IGF1R: p=0.01), but not for female athletes. The same applies to a previously unnoticed polymorphism in the 1 intron of the MSTN gene, whose deletion allele (AAA -> AA) appears to increase the myostatic effect (p=0.015). Moreover, combinations of the polymorphisms showed significant synergistic effects on the LVM of the male athletes. Conclusions The authors' results argue for the importance of polymorphisms in the IGF1 signalling pathway in combination with MSTN on the variant degree of physiological hypertrophy of male athletes.},
  language  = {en}
}
@article{ScharhagRosenbergerWalitzekKindermannetal.2012,
  author    = {Scharhag-Rosenberger, Friederike and Walitzek, Susanne and Kindermann, Wilfried and Meyer, Tim},
  title     = {Differences in adaptations to 1 year of aerobic endurance training individual patterns of nonresponse},
  series = {Scandinavian journal of medicine \& science in sports},
  volume    = {22},
  journal   = {Scandinavian journal of medicine \& science in sports},
  number    = {1},
  publisher = {Wiley-Blackwell},
  address   = {Malden},
  issn      = {0905-7188},
  doi       = {10.1111/j.1600-0838.2010.01139.x},
  pages     = {113 -- 118},
  year      = {2012},
  abstract  = {Lacking responses to endurance training (ET) have been observed for several variables. However, detailed analyses of individuals' responses are scarce. To learn more about the variability of ET adaptations, patterns of response were analyzed for each subject in a 1-year ET study. Eighteen participants [42 +/- 5 years, body mass index: 24 +/- 3 kg/m2, maximal oxygen uptake (VO2max): 38 +/- 5 mL/min/kg] completed a 1-year jogging/walking program on 3 days/week, 45 min/session at 60\% heart rate (HR) reserve. VO2max, resting HR (rHR), exercise HR (eHR) and individual anaerobic threshold (IAT) were determined by treadmill and cycling ergometry respectively. Intraindividual coefficients of variation were extracted from the literature to distinguish random changes from training responses. Eight participants showed improvements in all variables. In 10 participants, one or two variables did not improve (VO2max, rHR, eHR and IAT remained unchanged in four, four, three and one cases, respectively). At least one variable improved in each subject. Data indicate that ET adaptations might be detected in each individual using multiple variables of different adaptation levels and intensity domains. Nonresponse seems to occur frequently and might affect all variables. Further studies should investigate whether nonresponders improve with altered training. Furthermore, associations between patterns of nonresponse and health benefits from ET are worth considering.},
  language  = {en}
}
@article{ScharhagKindermann2009,
  author    = {Scharhag, J{\"u}rgen and Kindermann, Wilfried},
  title     = {Pitfalls in the differentiation between athlete's heart and hypertrophic cardiomyopathy},
  issn      = {1861-0684},
  doi       = {10.1007/s00392-009-0035-z},
  year      = {2009},
  language  = {en}
}