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Recreational marathon running does not cause exercise-induced left ventricular hypertrabeculation.

Andrew D'Silva1, Gabriella Captur2, Anish N Bhuva2

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Training for a first marathon does not induce left ventricular (LV) trabeculation in novice runners. This study found no significant changes in LV trabeculation after marathon preparation, suggesting current criteria may over-diagnose conditions in healthy individuals.

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Area of Science:

  • Cardiology
  • Exercise Physiology
  • Medical Imaging

Background:

  • Marathon running offers a unique model for studying short-term cardiovascular remodeling due to exercise.
  • The study investigates if intense running training can lead to exercise-induced left ventricular (LV) trabeculation.

Purpose of the Study:

  • To determine if marathon training induces left ventricular (LV) trabeculation in novice runners.
  • To assess changes in LV trabeculation using echocardiography and cardiac magnetic resonance imaging before and after a marathon.

Main Methods:

  • Prospective longitudinal study of 68 novice marathon runners (mean age 29.5 years).
  • Measurements of LV trabeculation indices were taken 6 months before and 2 weeks after the 2016 London Marathon.
  • Echocardiography and cardiac magnetic resonance imaging were utilized for assessments.

Main Results:

  • After 17 weeks of unsupervised marathon training, LV trabeculation indices remained largely unchanged.
  • While inter-observer agreement for trabeculation measurement was generally good, criteria for hypertrabeculation showed discordance.
  • LV hypertrabeculation was observed in healthy individuals without evidence of cardiomyopathy.

Conclusions:

  • Marathon training in novices does not appear to induce left ventricular (LV) trabeculation.
  • Further research is needed to ascertain if prolonged, high-dose exercise can create or reveal trabeculation.
  • Using established LV noncompaction cardiomyopathy criteria in healthy populations may lead to over-diagnosis.