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Updated: May 27, 2026

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
08:42

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

Published on: October 22, 2014

How healthy were the arteries of Phidippides?

Kevin S Heffernan

    Clinical Cardiology
    |November 30, 2011
    PubMed

    Insights

    Marathon running may lead to cardiac and vascular changes that increase sudden death risk. These adaptations, including arterial stiffness and altered blood flow, may promote dangerous heart rhythms.

    Area of Science:

    • Cardiovascular Physiology
    • Exercise Science
    • Sports Medicine

    Background:

    • Subacute and chronic cardiac adaptations from marathon running may elevate sudden cardiac death risk.
    • Prolonged strenuous exertion can induce cardiac arrhythmogenic remodeling with potential systemic vascular involvement.

    Discussion:

    • Marathon running can decrease coronary perfusion pressure and cause endothelial damage, potentially by altering angiogenic growth factors.
    • Increased arterial stiffness, augmented wave reflections, and widened pulse pressure are observed in marathon runners.
    • These vascular maladaptations are linked to atrial fibrillation and may create a substrate for lethal arrhythmias.

    Key Insights:

    • Marathon running induces vascular changes like arterial stiffness and altered hemodynamics.
    • These vascular changes are associated with increased risk of cardiac arrhythmias, including atrial fibrillation.
    • The systemic vascular component of cardiac remodeling in marathon runners warrants further investigation.

    Outlook:

    • Further research should explore the precise mechanisms linking vascular maladaptations to arrhythmogenesis in endurance athletes.
    • Developing targeted interventions to mitigate vascular risks in marathon runners is crucial.
    • Long-term studies are needed to fully understand the chronic cardiovascular consequences of marathon running.

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