How Healthy Were the Arteries of Phidippides?

Abstract

Subacute and chronic cardiac adaptations to marathon running may increase risk for sudden death. Herein, it is proposed that cardiac arrhythmogenic remodeling resulting from prolonged strenuous exertion may also have a systemic vascular component. Marathon running reduces coronary perfusion pressure and causes acute endothelial damage, possibly via altering concentrations of circulating angiogenic growth factors with novel vasoregulatory properties. Marathon runners have increased arterial stiffness and augmented pressure from wave reflections contributing to a widening of pulse pressure. Pulsatile hemodynamics may contribute to target organ damage. Moreover, each of these vascular maladaptations (increased arterial stiffness, augmented pressure from wave reflections, and widened pulse pressure) has been associated with atrial fibrillation and may provide a substrate for lethal arrhythmogenesis in the marathon runner. Clin. Cardiol. 2012 DOI: 10.1002/clc.21009The author has no funding, financial relationships, or conflicts of interest to disclose.This article first published online 28 November 2011. It has since changed. The term “coronary pulse pressure” has been changed to “coronary perfusion pressure.”

Gender Difference in the Acute Influence of a 2-Hour Run on Arterial Stiffness in Trained Runners

“…Hypertension rates and prevalence of other biological cardiovascular right factors are reduced in athletes compared with sedentary individuals. Thus the transient increases in blood pressure, inflammation, and other factors listed by Heffernan (2011) during prolonged and intensive exercise may not be as harmful to the arteries of endurance athletes as indicated when considered within the context of overall favorable chronic effects. In support, van de Laar et al (2010) in a cohort study of 373 subjects showed that lifetime vigorous but not light-to-moderate physical activity predicted reduced rates for arterial stiffness.…”

“…Heffernan (2011) has proposed that the cyclic stress imposed by heavy exertion reduces coronary perfusion pressure, causes acute endothelial damage, and alters angiogenic growth factors, all of which lead to increased arterial stiffness. Studies, however, do not consistently support this assertion.…”

“…Several studies have reported acute decreases in arterial stiffness measures following short-term cardiorespiratory exercise (Casey, Nichols, & Braith, 2008;Collier et al, 2010;Heffernan et al, 2006;Ranadive et al, 2011;Tordi, Mourot, Colin, & Regnard, 2010), but the acute effect of prolonged and intensive exercise on arterial stiffness is largely unstudied. Concern has been expressed that marathoners may experience chronic increases in central blood pressure and artery stiffness due to repeated exercise training bouts that cause large increases in inflammation, oxidative stress, blood flow, and blood pressure (Heffernan, 2011;Laurent et al, 2011). In one study, PWV and pulse pressure were higher in a group of male and female marathon runners compared with recreationally active controls (Vlachopoulos et al, 2010b).…”

Influence of body composition and physical fitness on arterial stiffness after marathon running

“…The beneficial effects of regular exercise and the potential cardiovascular risk of acute prolonged exercise have been discussed as the “paradox of exercise,” and previous studies have tried to put the risk of marathon running into perspective . Whether or not prolonged excessive endurance exercise negatively affects vascular function is a matter of ongoing debate …”

“…6 Whether or not prolonged excessive endurance exercise negatively affects vascular function is a matter of ongoing debate. 7 Arterial stiffness quantified by the assessment of the carotid-femoral pulse wave velocity (PWV) is considered to be a valid vascular biomarker. PWV has proven its predictive power for cardiovascular and all-cause mortality in populations of different age and health status.…”