The impact of repeated marathon running on cardiovascular function in the aging population

Abstract

BackgroundSeveral studies have correlated elevations in cardiac biomarkers of injury post marathon with transient and reversible right ventricular (RV) systolic dysfunction as assessed by both transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). Whether or not permanent myocardial injury occurs due to repeated marathon running in the aging population remains controversial.ObjectivesTo assess the extent and severity of cardiac dysfunction after the completion of full marathon running in individuals greater than 50 years of age using cardiac biomarkers, TTE, cardiac computed tomography (CCT), and CMR.MethodsA total of 25 healthy volunteers (21 males, 55 ± 4 years old) from the 2010 and 2011 Manitoba Full Marathons (26.2 miles) were included in the study. Cardiac biomarkers and TTE were performed one week prior to the marathon, immediately after completing the race and at one-week follow-up. CMR was performed at baseline and within 24 hours of completion of the marathon, followed by CCT within 3 months of the marathon.ResultsAll participants demonstrated an elevated cTnT post marathon. Right atrial and ventricular volumes increased, while RV systolic function decreased significantly immediately post marathon, returning to baseline values one week later. Of the entire study population, only two individuals demonstrated late gadolinium enhancement of the subendocardium in the anterior wall of the left ventricle, with evidence of stenosis of the left anterior descending artery on CCT.ConclusionsMarathon running in individuals over the age of 50 is associated with a transient, yet reversible increase in cardiac biomarkers and RV systolic dysfunction. The presence of myocardial fibrosis in older marathon athletes is infrequent, but when present, may be due to underlying occult coronary artery disease.

Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT

“…This observation is of major importance as coronary calcification is an independent risk factor for all-cause mortality and cardiovascular events [18]. In contrast to the study published by Mohlenkamp, the median CS in our cohort was lower (0 vs. [19]. Coronary atherosclerosis was only detected in 2 athletes.…”

Right and Left Ventricular Function and Mass in Male Elite Master Athletes

“…Studies evaluating the clinical impact of long-term intensive endurance training and competition in high-level elite master athletes are rare. [17][18][19][20] In addition, information about training volume (hours per week) and history (years) are often lacking, and cardiopulmonary exercise testing with quantification of the aerobic capacity by measuring maximal oxygen uptake (Vo 2 max) and power output for an assessment of sport-specific performance in professional elite endurance athletes with a long training history have not been performed so far. [17][18][19] Therefore, the aim of this study was to examine the cardiac structure and function with special emphasis on the RV by contrast-enhanced cardiovascular magnetic resonance (CMR) and complementary echocardiographic tissue Doppler imaging and strain data in long-term active, elite endurance master athletes including world class athletes.…”

Atrial fibrillation and physical activity

“…A nem versenyző kontrollokhoz képest az edzettebb, 1-4, illetve ötnél több versenyen részt vett, 42 év körüli maratonisták tágabb bal pitvarral rendelkeznek (25,30, illetve 35 ml/m 2 ), a pronatriureticus hormon (Pro-ANP) szintek 1,04, 1,42 és 1,67 nmol/l, s ezek a 10 mérföldes futóverseny után mindenkinél emelkedettek voltak, és magyarázhatják a PF-re való hajlamot [13]. Osranek és mtsai szerint a 32 ml/m 2 pitvarvolumen a PF-re hajlamosság határa [14].…”

“…Mind a 25 futón emelkedett a cTnT, a jobb szív-üreg volumenei nőttek, a jobb kamra szisztolés funkciója csökkent azonnal a futás után, de egy héttel utána visszatértek az eredeti értékek. Két futónál gyűlt fel a gadolí-nium a bal kamra mellső fala subendocardiumában, a jobb mellső leszálló coronariaág szűkületére utalva [30].…”