Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon

Abstract

ObjectivesThe effects of ultra-distance on cardiac remodeling and fibrosis are unclear. Moreover, there are no data reporting the kinetics of cardiac alterations throughout the event and during recovery. Our aim was to investigate the kinetics of biological markers including new cardiac fibrosis biomarkers suppression of tumorigenicity 2 (ST2) and galectin-3 (Gal-3) during and after an extreme mountain ultramarathon.MethodsFifty experienced runners participating in one of the most challenging mountain ultramarathons (330 km, D+ 25,000 m) were enrolled in our study. Blood samples were collected at four time points: before (Pre-), at 148 km (Mid-), at the finish line (Post-), and 3 days after the recovery period (Recov-).ResultsThe cardiac fibrosis biomarkers (ST2 and Gal-3) increased from Pre- to Mid-. During the second half, ST2 remained higher than pre-values as opposed to Gal-3. Necrosis, ischemia, and myocyte injury biomarkers increased until Mid- then decreased but remained higher at Recov- than Pre-values. Oxidative stress appeared at Mid-. Lipid peroxides remained higher at Recov- compared to Pre-. The maximal value in most of these biomarkers was observed at Mid- and not at Post-.ConclusionsThe present study supports biphasic kinetics of cardiac fibrosis biomarkers, with a relative recovery during the second half of the event that seems specific to this extreme event. Overall, performing at such an extreme ultramarathon seems less deleterious for the heart than shorter events.

Relationship between echocardiographic characteristics and cardiac biomarkers during long-distance trail running

“…All the echocardiographic examinations were digitally recorded and independently interpreted by a physician blinded to the clinical and biological status and race results. After the race, all the measurements were performed according to recommendations ( 30 ) and averaged over 3 cardiac cycles. Several 2-dimensional (2D) views were consistently recorded: parasternal long-axis view, parasternal short-axis view, and apical 2-, 3-, and 4-chamber views.…”

“…Recently, it has been observed that a troponin exercise-induced increase above the 99th percentile could be an early marker of mortality and cardiovascular events ( 27 ) notably in participants with hypertension ( 28 ). Nevertheless, these results remain to be discussed ( 7 , 26 , 29 , 30 ). To date, no study has reported a relationship between echocardiographic characteristics and cardiac biomarkers in long distance runners.…”