Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

Abstract

BackgroundRegular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing.Methods/ DesignIn the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year.ResultsHere we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2%) Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011.DiscussionFindings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress and brain damage.Trial registrationclinicaltrials.gov NCT01428778

Physical activity and incidence of atrial fibrillation: A systematic review and meta-analysis

“…One notable ongoing study is the Berlin Beat of Running study, which is a prospective observational study which enrolled endurance athletes and followed up participants after 1 year for cardiac arrhythmia and brain lesions. [34] In conclusion, we found no significant increase in AF with a higher level of physical activity. This was the case considering the intensity, frequency of exercise as well as the case for athletes or sportsmen.…”

MRI Brain Changes After Marathon Running: Results of the Berlin Beat of Running Study

“…As previously reported [17], the original power calculation aimed for 110 participants in order to test the primary hypothesis (assuming that atrial fibrillation is found more frequently in endurance runners). For categorical data, absolute and relative frequencies were computed.…”

“…The primary endpoint of the study was defined as the frequency of cardiac arrhythmias in experienced marathon runners [16]. As one of the secondary endpoints, we observed the frequency of MRI-detected brain lesions before and immediately after a marathon race [17]. Here, we report the frequency of (clinically silent) acute ischemic, vasogenic or other brain lesions within two days after a marathon race.…”

“…The "Berlin Beat of Running" study is a prospective, observational, investigator-initiated study [17], approved by the Charité Ethics Committee (EA4/042/11). In short, 110 study participants underwent an assessment of vital parameters, a clinical neurological ex-amination and brain MRI within 22-74 h before and 20-58 h after the 38 th BMW BERLIN-MARATHON.…”

Factores de riesgo del comportamiento y preparación de aficionados inscritos a carreras atléticas de fondo de 18 a 64 años en Bogotá, Colombia, 2014

“…Los organizadores de carreras en el mundo como los maratones de Boston, Londres, Berlín, entre otros, realizan un tamizaje de riesgo o evaluaciones previas a los atletas, para detectar y reducir el riesgo cardiovascular 12,15,16 . Ante los eventos en las diferentes carreras, Maron reportó por primera vez que la incidencia de muerte súbita variaba entre 0,54 y 2,1 eventos por cada 100.000 participantes, con mayor afectación entre la sexta y octava década 7 .…”