Morbidities in the ultra-athlete and marathoner

Abstract

The cardiovascular benefits of habitual exercise are well documented. In the current era, more of the population is exceeding the recommendations for physical activity as the popularity of endurance events increases. Recent data have proposed a U-shaped relationship between exercise intensity and cardiovascular outcomes. Regular participation in endurance activities has been shown to result in structural and functional changes in the heart. This re-modelling may be the substrate for cardiac dysfunction or arrhythmias. The risk of sudden cardiac death may also be elevated; however, in most cases of sudden cardiac death, the cause can be linked to an underlying cardiac pathology where exercise acted as the trigger for a lethal arrhythmia. This article serves to review whether excessive exercise may result in harm in some athletes.

Acute Responses of Novel Cardiac Biomarkers to a 24-h Ultra-Marathon

“…It seems that LV dysfunction and long-term endurance exercise may imply a myocardial injury and were both responsible for an elevated release of the cardiac biomarkers [10,31]. Importantly, echocardiographic and cardiac biomarkers analyses in this study group, obtained after 48 h of completion of the ultra-marathon demonstrated that most of these indices of cardiac function had normalized.…”

“…There has been evidence that hypertrophic cardiomyopathy was a frequent cause of sudden cardiac death among endurance athletes, followed by cardiac anomalies, myocarditis, and arrythmogenic diseases [31]. Nevertheless, research results on ultra-marathon races were controversial and limited to observing the main cardiac biomarkers levels and their association with runners’ age, finish times [20], echocardiography [14], training status [21,32] or altitude variation [33].…”

“…Hence, a number of investigations have been conducted to determine the cardiovascular effects and risk factors of cardiac muscle injury in marathon and ultra-marathon runners [7,13,15,36,37]. Considering the fact that the risk of cardiac mortality increases among amateur long-distance runners [31], it seemed important to investigate markers that allow an early identification of increased cardiac risk. In previous studies of the assessment of myocardial dysfunction the conventional cardiac biomarkers (e.g., cTnT, CKMB, myoglobin, NTproBNP) have been analyzed [24,38,39,40].…”

Molecular Mechanisms of Nigella sativa- and Nigella sativa Exercise-Induced Cardiac Hypertrophy in Rats

“…Nevertheless, sudden cardiac arrest and fetal arrhythmias are often encountered in long-distance runners [ 32 ]. Vigorous or prolonged exercise activity frequently incurs the activation of pathological cardiac pathways and yields elevated biomarkers of cardiac damage [ 33 ]. Furthermore, some competitive long-distance runners developed exercise-induced hypertension, which was associated with an abnormal level of angiotensin-II [ 34 ].…”

Personality Traits Associated with the Risk of Exercise Dependence in Ultraendurance Athletes: A Cross-Sectional Study

“…The practice of ultraendurance sports has become increasingly popular in recent years, mostly for recreational athletes [37][38][39]. Additionally, there is extensive evidence that ultraendurance races and regular ultraendurance training may lead to long-term health problems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and skin problems [40,41]. As ED is characterized by continuous exercise despite significant and interfering physical problems that are likely to have been caused by intense exercising, it is essential to better understand the continuum and psychological and/or interactional mechanisms underlying ED in ultraendurance athletes to prevent both mental health issues and related health problems [42].…”