#87 - Exercise and sports cardiology with Professor Paul D. Thompson

Dr Glenn McConell chats with Professor Paul D. Thompson who is Chief of Cardiology, Emeritus at Hartford Hospital, Hartford, CT and Professor of Medicine, Emeritus at the University of Connecticut. He has published over 500 peer reviewed journal articles, was a past President of the American College of sports medicine (ACSM) and was a impressively fast marathon runner. This is the third of a series of podcast episodes on sport cardiology (See Professor Benjamin Levine and Associate Professor Andre La Gerche’s episodes). We covered a lot of ground. There is a greater prevalence of atrial fibrillation in athletes (is it due to larger hearts?). We discussed possible reasons why coronary artery calcium/calcification is higher in athletes. He recommends 8000 steps done vigorously per day. Exercise is very important for your health. What exercise to do depends on your goals and health status. See time stamps further much more. We discuss his free substack called 500 rules of cardiology.
0:00. Introduction
2:40. Previous IE podcast episodes on sports cardiology
5:30. Worked with ex physiol legend David Costill
8:00. Ex physiol legend Bengt Saltin
9:00. More than 500 publications, importance of collaboration
10:45. Can exercise have negative effects on the heart?
13:00. More atrial fibrillation in athletes (due to larger hearts?)
20:30. Genetics and exercise
25:15. Was excellent marathoner
27:30. Exercise and right ventricle “fatigue”
32:00. Genetics, exercise and longevity
34:10. Cut off points/prevalence of increased risk of atrial fibrillation
36:26. Atrial fibrillation, blood thinners and strokes
39:30. Daily aspirin and heart risk
42:42. Why coronary artery calcium/calcification (CAC) higher in athletes?
48:40. Sex differences
51:03. Less heart beats per day in endurance athletes
53:40. Athletes, higher CAC and cardiovascular events
56:15. Exercise reduces cardiovascular events
58:30. Almost never restricts exercise in patients
1:00:20. Rationale to train hard
1:02:30. Most bang for your buck if less fit to start with
1:05:30. Cadence and turbulence in artery
1:09:30. Better athletes have more heart issues
1:11:40. Exercise intensity and coronary calcification
1:13:55. Walking and the heart
1:18:00. Fit handle operations/illnesses better
1:20:17. Statins and muscle pain /cholesterol
1:24:15. Medications vs lifestyle in diabetes
1:26:32. Metformin and exercise adaptations
1:27:15. Sudden death during exercise
1:29:25. Coronary narrowing and heart attacks
1:31:45. Best athletes have larger aortas
1:35:20. Intermittent fasting /ketosis
1:38:45. Exercise intensity and heart adaptations
1:39:40. Pay attention to symptoms
1:41:55. Broke his hip in a bike accident, cycles now
1:43:25. Exercise training early in life /epigenetics
1:47:05. Drugs and exercise performance
1:49:20. Environmental factors: eg walking to school
1:51:52. Cardiac sex differences re exercise
1:54:05. Wise advice
1:58:45. Be mindful of the media’s take on exercise
2:00:25. Takeaway messages
2:02:12. His free substack 500 rules of cardiology
2:02:59. Outro

Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
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Not medical advice