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Cardiac structure and function in response to a multi-stage marathon over 4486 km.

Christopher Klenk1, Horst Brunner2, Thomas Nickel3

  • 1Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, Medical Faculty, University of Basel, Switzerland.

European Journal of Preventive Cardiology
|August 23, 2021
PubMed
Summary

Ultra-endurance running, like the Trans Europe Foot Race, caused physiological heart changes in runners. Left ventricular mass increased during the race but returned to normal, showing no adverse cardiac remodeling.

Keywords:
Hypertrophycardiac magnetic resonance imagingcardiac remodellinglong-distance runningmyocardial injury

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Physiology

Background:

  • Ultramarathon running involves extreme endurance challenges.
  • The Trans Europe Foot Race (TEFR) spanned 64 days and 4486 km.
  • Understanding cardiac adaptations to prolonged ultra-endurance exercise is crucial.

Purpose of the Study:

  • To assess cardiac structure and function changes in ultra-endurance runners.
  • To investigate the impact of the TEFR on cardiac parameters.
  • To determine if prolonged extreme exercise leads to adverse cardiovascular remodeling.

Main Methods:

  • Cardiac MRI was used to evaluate left ventricular mass and function in 20 runners during the TEFR.
  • Blood samples were analyzed for cardiac biomarkers (troponin I, NT-pro-BNP) and growth factors (myostatin, GDF11).
  • Follow-up scans were conducted eight months post-race for a subset of participants.

Main Results:

  • Left ventricular mass significantly increased during the race (p < 0.001).
  • Cardiac troponin I and NT-pro-BNP levels rose significantly in the early stages but plateaued.
  • No significant changes were observed in other structural/functional parameters, and follow-up scans showed a return to baseline mass.

Conclusions:

  • Prolonged ultra-endurance exercise induces physiological cardiac structural adaptation.
  • The observed cardiac changes appear adaptive rather than indicative of adverse remodeling.
  • The heart can recover to baseline parameters after extreme endurance events.