Post-exertional increase in first-phase ejection fraction in recreational marathon runners
Luca Faconti1, Iain Parsons1,2, Bushra Farukh1
1Department of Clinical Pharmacology, King's College London, British Heart Foundation Centre, London, UK.
JRSM Cardiovascular Disease
|June 4, 2020
Summary
Recreational marathon running significantly increased first-phase ejection fraction, a novel measure of cardiac contractility, by approximately 48% post-race. Conventional cardiac performance measures remained unchanged, indicating a specific physiological adaptation to endurance exercise.
Area of Science:
- Cardiology
- Exercise Physiology
- Echocardiography
Background:
- Marathon running's acute effects on cardiac performance are debated.
- First-phase ejection fraction (FPEF) is a novel echocardiographic measure of left ventricular contractility and systolic-diastolic coupling.
- FPEF has not been previously studied in the context of endurance exercise.
Purpose of the Study:
- To assess FPEF following recreational marathon running.
- To evaluate changes in standard echocardiographic indices of systolic and diastolic function post-marathon.
- To investigate the cardiac response to marathon running using novel and conventional measures.
Main Methods:
- Twenty-five recreational marathon runners were assessed before and immediately after a marathon.
- Central hemodynamics were measured using applanation tonometry.
- Cardiac performance was evaluated using M-mode, 2D Doppler, tissue-Doppler imaging, and speckle-tracking echocardiography; FPEF was calculated as the percentage change in left ventricular volume from end-diastole to peak aortic flow.
Main Results:
- Aortic systolic blood pressure decreased significantly post-race (P < 0.001).
- First-phase ejection fraction increased by approximately 48% (16.3 ± 3.9% to 22.9 ± 2.5%, P < 0.001).
- Conventional systolic function indices showed no significant changes; the E/e' ratio increased (P < 0.01), suggesting altered diastolic function.
Conclusions:
- Recreational marathon running leads to a substantial increase in first-phase ejection fraction.
- This increase in FPEF occurs without significant changes in other conventional measures of cardiac systolic function.
- Further physiological research is needed to understand the mechanisms behind the observed increase in FPEF after marathon running.
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