Cardiac remodelling and exercise: What happens with ultra-endurance exercise?

Abstract

In 490 BC, an Athenian messenger, Pheidippides, was sent by his generals on a 246-km (153-mi) journey to Sparta to seek help fighting against the Persians in the Battle of Marathon. The ancient Greek historian Herodotus wrote that Pheidippides 'reached Sparta on the very next day after quitting the city of Athens'. Upon reading this, the British Air Force officer and long-distance runner John Foden wanted to find out if this feat was humanly possible. His success in completing the journey on foot within 36 hours led to the establishment of the Spartathlon, now considered one of the world's classic ultra-marathons. Pheidippides is perhaps even more well known for later running approximately 42.2 km, now the regular marathon distance, from Marathon to Athens to announce the Greek victory, before collapsing and dying from exhaustion on the completion of his mission. In this issue of the journal, Christou et al. 1 report on the acute changes in cardiac structure and function seen in 27 runners who successfully completed the Spartathlon race in September 2017 to uncover the cardiac changes that Pheidippides may have experienced following his journey across ancient Greece.

Molecular mechanisms of exercise contributing to tissue regeneration

“… 442 Myocardial fibrosis and coronary artery calcification have also been detected in ultra-endurance races. 443 , 444 In addition, the marked suppression of growth factors and hormones, including testosterone, IGF-1, and leptin, after ultra-endurance exercise has also reported, which is strongly associated with the magnitude of the energy deficit. 445 It has been realized that excessive exercise leads to immune imbalance and decrease in reactive oxygen species scavenging capacity, which has deleterious effects on health as well.…”

The Athlete’s Heart and Machine Learning: A Review of Current Implementations and Gaps for Future Research

“…"Wearables" was the smallest single group with fou (14%) studies [20,25,28,37]. The final six (21%) unassigned studies [4,19,24,33,36,39] wer Of the 49 studies that remained, 1 study was excluded from the review due to issues with accessing the full manuscript, leaving 48 studies to be included for full-text readings and to form the dataset for this review. However, during the full-text readings, a further 20 studies were excluded: 16 were excluded as they were deemed to be not relevant to the review, and the other 4 were excluded due to concerns about their quality, i.e., being vague and having an unclear description of either their methodology or approach used to develop their models, how the evaluation criteria were presented, and why certain metrics were used over others.…”

“…"Wearables" was the smallest single group with four (14%) studies [20,25,28,37]. The final six (21%) unassigned studies [4,19,24,33,36,39] were placed in the "Others" group as they did not meet the inclusion criteria for the previous groups. The studies within this group are focused on using methods that can be applied to a dataset to attribute one of two or more classes to each patient or participant.…”

“…Chatzakis et al [39] focused on developing an electronic health record, with a built-in decision support system, to support paediatric cardiovascular disease screening. Dockerill et al [33] utilised a case series approach to assess the hearts of 27 runners before and after an extreme running event whilst documenting the changes in the cardiac structure caused by an acute bout of exercise. Similarly, Kerkhof et al [4] investigated the changes in the heart of a select group: three division one undergraduate crew athletes explored the use of 'focused' echocardiography in screening athletes to assess their heart health and function.…”