Top sport: safe for your heart

After Ajax player Abdelhak Nouri collapsed on the field, the topic of how healthy playing high-intensity sports really is came up again. Sports physician Bram Bessem studied hundreds of students, looking for the answer.
By Anne Floor Lanting / Translation by Sarah van Steenderen

It happens to students, too. In 2007, a 21-year-old rower with Gyas died during training. Since then, all first-year competitive rowers with the Groningen rowing clubs are preventively checked for heart defects at the Athletic Medical Centre at the UMCG. Sports physician Bram Bessem says that is a wise choice. ‘When a young athlete dies from cardiac arrest, it’s usually because of a congenital heart defect’, he explains.

But the question is: how should cardiograms be read? Because a top athlete’s heart looks quite different from that of a ‘regular’ athlete. How can we prevent missing defects, or causing panic among people who should have to trouble exercising?


It’s certainly not the exercise itself which is dangerous, says Bessem. Rather, the physical exertion is too great a strain on the heart, giving it that little push that leads to death. ‘Top athletes with a congenital heart defect could also die on the couch at home’, says Bessem. ‘But the risk of something happening during exercising is two to three times as big.’

Bessem studied the effects an intense, nine-month rowing season had on the hearts of 69 first-year competitive Gyas and Aegir rowers. He compared the cardiograms taken before and after the season, and discovered that nine months of intense training caused few changes in the students’ hearts. ‘The cardiograms hardly differed from each other.

Before the start of the season, the rowers’ hearts showed exercise-related changes, such as a thicker cardiac muscle and a relatively low resting heart rate.’ He expects the difference to be bigger in non-athletes who would then start an intense exercise regimen.

1,436 students

Bessem also studied the cardiograms of 1,436 students of various sports programmes in Groningen. He compared the amount of hours they exercised a week to the changes to their hearts that were visible on an ECG and discovered that the development an athlete’s heart goes through is a gradual process.

According to Bessem, it is difficult to decide when exactly a normal heart becomes an athlete’s heart. ‘The first signs show up when someone has exercised for more than 3,000 hours. That’s when there is a significant increase in the number of changes we can see in the cardiogram of an athlete’s heart.’

But these changes certainly aren’t health risks. ‘Athlete’s hearts are healthy, but sometimes athlete’s heart cardiograms are difficult to distinguish from cardiograms showing a heart defect’, the sports physician explains.


He also discovered important difference between the ECGs of male and female students. The results are important in how sports physicians assess ECGs. Everyone who does sports at a top level has to have their heart checked. But Bessem would like to prevent anomalies seen in cardiograms to be interpreted as heart defects.

‘Women have a relatively higher resting heart rate than men. This says absolutely nothing about their athletic performance, but it does mean that we should look at these hearts differently during cardiac tests.’








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