Long-Term Changes in Ventricular Function in Recreational Marathon Runners

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Long-term effects of strenuous exercise on cardiac function, particularly the right ventricle, are not fully understood.
• Plasma troponin levels can increase after endurance events, but their long-term implications remain unclear.

Purpose of the Study:

• To examine the association between marathon-induced troponin T elevation and right ventricular remodeling after a decade of consistent endurance training.
• To assess long-term changes in right and left ventricular function in male marathon runners.

Main Methods:

• A longitudinal observational cohort study (Pro-MagIC) followed 152 male marathon runners for 10 years.
• Cardiac biomarkers and 3D echocardiography were measured at multiple time points: prerace, immediately postrace, and at 1, 3 days, and 10 years postrace.
• Analysis focused on right ventricular ejection fraction, left ventricular ejection fraction, and left ventricular filling pressures.

Main Results:

• Right ventricular ejection fraction transiently decreased post-marathon but recovered to baseline levels by 3 days and remained stable at 10-year follow-up.
• No association was found between acute exercise-induced troponin T increase and long-term right or left ventricular ejection fraction.
• Left ventricular ejection fraction and diastolic function showed changes but remained within normal physiological limits at 10-year follow-up.

Conclusions:

• Repetitive strenuous exercise and marathon competition do not appear to cause long-term right ventricular dysfunction in recreational male athletes.
• While acute cardiac biomarker elevations occur, they do not predict long-term adverse cardiac remodeling in this population.
• Endurance athletes maintain cardiac function within normal limits despite significant training loads over a decade.