Transient cardiac dysfunction but elevated cardiac and kidney biomarkers 24 h following an ultra-distance running event in Mexican Tarahumara

Abstract

BackgroundThe Mexican Tarahumara are accustomed to running ultra-distance races. No data exist on the acute physiological changes following ultra-distance running and physiological-biomarker associations in this population. Thus, we aimed to investigate the acute impact (≤ 24 h) on functional and biochemical changes of the cardiac muscle and biochemical changes associated with kidney function following a 63-km ultra-distance race with an altitude difference of 1800 m in Mexican Tarahumara athletes.MethodsTen Tarahumara male athletes (mean ± SD age = 29.9 ± 6.6 years) volunteered to participate in the study. VO2max was assessed by a sub-maximal step test individually calibrated combining heart rate and accelerometry. Standard transthoracic echocardiography methodology and venipuncture blood tests were carried out at four time points: pre-race, immediately post-race, 6 h, and 24 h post-race.ResultsEstimated mean VO2max was 54.5 (± 8.8) mL O2 min−1 kg−1 and average physiological activity intensity was 746 (± 143) J min−1 kg −1 (~ 11.5 METs). When compared to pre-race values, significant changes in left ventricular ejection fraction (LVEF) and LV end-diastolic volume (− 15%, p < 0.001 for both parameters), cardiac output (39%, p < 0.001), and maximal longitudinal velocity (− 13%, p < 0.009) were seen post-race with LVEF also being decreased at < 6 h post-race (− 8%, p < 0.014). Plasma biomarkers mid-regional pro-atrial natriuretic peptide, copeptin-ultra sensitive, and high-sensitivity cardiac troponin T remained significantly elevated at 24 h post-race, and the two latter were inversely associated with LVEF (p < 0.04). Kidney dysfunction was indicated by increased post-race copeptin-ultra sensitive.ConclusionsThe athletes participating in this study had acute transient cardiac dysfunction as assessed by echocardiography but elevated cardiac and kidney biomarkers at 24 h following a 63-km race with extreme altitude variation.Electronic supplementary materialThe online version of this article (10.1186/s13728-017-0057-5) contains supplementary material, which is available to authorized users.

Two-peaked increase of serum myosin heavy chain-α after triathlon suggests heart muscle cell death

“…The results concerning skeletal muscle damage, temporary decline of kidney function and inflammation markers after the Kalmar Ironman 2016 are in line with previous research in athletes engaging in either triathlon12 13 or other types of endurance sports such as marathon11 19 or ultradistance running 20. Given the amount of exercise, the results are neither surprising nor do they lead to any debate about long-term consequences.…”

Physiology and Pathophysiology in Ultra-Marathon Running

“…As ultramarathon is a prolonged endurance exercise relying on aerobic energy transfer system, it is not surprising that a large body of the literature has focused on the exercise physiology of cardiovascular system. Due to the increase in creatine kinase, several studies investigated a potential heart damage through an ultra-marathon due to an increase in cardiac biomarkers such as creatine kinase, creatine kinase-MB, cardiac troponin I and N-terminal pro-brain natriuretic peptides after an ultra-marathon (Table 9 ; Roth et al, 2007 ; Kim et al, 2014 ; Christensen et al, 2017 ). A 90-km ultra-marathon also leads to a an increase in C-reactive protein as has been reported for heart attack patients (Strachan et al, 1984 ).…”

“…A 90-km ultra-marathon also leads to a an increase in C-reactive protein as has been reported for heart attack patients (Strachan et al, 1984 ). However, the changes in these biomarkers are all transient (Christensen et al, 2017 ).…”

“…Echocardiography can detect a reduction of the left (Niemela et al, 1984 ; Krzeminski et al, 2016 ; Maufrais et al, 2016 ) as well as the right ventricular (Oxborough et al, 2011 ; Lord et al, 2015 , 2016b ; Maufrais et al, 2016 ; Rothwell et al, 2018 ) function after an ultra-marathon. The changes in cardiac troponin I during an ultra-marathon are inversely associated with left ventriculare ejection fraction determined with echokardiography (Christensen et al, 2017 ).…”

Russians are the fastest and the youngest in the “Comrades Marathon”

“…(Knechtle et al, 2018;Nikolaidis, Onywera, et al, 2017)). On the other hand, studies on training and physiological characteristics of ultra-marathon runners rarely used large samples (Christensen et al, 2017;Da Ponte et al, 2018;Klapcinska et al, 2013) which were incompatible to study the role of nationality or age. The relatively small number of finishers from most nationalities did not allow the examination of a potential relationship of nationality with the APP.…”