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The impact of repeated marathon running on cardiovascular function in the aging population
Erin Karlstedt1, Anjala Chelvanathan, Megan Da Silva
1Institute of Cardiovascular Sciences, St, Boniface Research Centre, University of Manitoba, Winnipeg, MB, Canada.
Insights
Marathon running in older adults causes temporary heart strain and reduced right ventricular function. Cardiac issues typically resolve within a week, with permanent injury being rare.
Area of Science:
- Cardiology
- Sports Medicine
- Geriatric Cardiology
Background:
- Marathon running can elevate cardiac biomarkers and cause temporary right ventricular dysfunction.
- The long-term effects of repeated marathon running on the aging heart are not well understood.
Purpose of the Study:
- To evaluate cardiac dysfunction in individuals over 50 after marathon completion.
- Utilized cardiac biomarkers, echocardiography, CT, and MRI to assess cardiac health.
Main Methods:
- 25 healthy volunteers over 50 years old participated.
- Cardiac biomarkers and echocardiography were done pre-race, immediately post-race, and one week later.
- Cardiac MRI was performed within 24 hours, and CT scans within 3 months post-race.
Main Results:
- Elevated cardiac troponin T (cTnT) was observed in all participants post-marathon.
- Right atrial and ventricular volumes increased, with decreased RV systolic function immediately after the race.
- These changes returned to baseline within one week; only two participants showed signs of myocardial fibrosis.
Conclusions:
- Marathon running in older adults leads to transient, reversible cardiac biomarker elevation and RV dysfunction.
- Myocardial fibrosis is uncommon in this group, but may indicate underlying coronary artery disease.
Background:
Several 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.
Objectives:
To 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.
Methods:
A 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.
Results:
All 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.
Conclusions:
Marathon 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.
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