Evaluation of Carotid artery Elasticity Functional Changes in Amateur Marathon Runners

The aim of this study was to analyze the mid- and long-term changes in carotid artery structure and function in amateur marathon runners by applying the vascular quality intima-media thickness technique in conjunction with quantitative arterial stiffness testing. Fifty-five cases of amateur marathon runners recruited in somewhere in 2019 (marathon group) and 43 cases of healthy volunteers in the same period (control group) were included. Two tests were performed on all the subjects (completed in 2019 and 2024, respectively). The quality intima-media thickness technique was used to measure the thickness of bilateral carotid intima-media thickness, and QAS was used to measure the elasticity parameters of the carotid arteries bilaterally, including the dilatation coefficient, compliance coefficient, stiffness coefficients (α and β), and pulse wave velocity. Demographic and clinical data including age, gender, heart rate, blood pressure (systolic and diastolic), body mass index, running age, and monthly running volume were collected from the subjects. We compared the differences in intima-media thickness and elasticity parameters between the two groups and analyzed the medium- and long-term changes in carotid artery parameters between the two groups; a logistic regression model was used to analyze factors associated with changes in intima-media thickness and elasticity parameters in the marathon group after 5 years. During the 5-year study period, comparison between the marathon group 5 years ago and 5 years later and comparison between the control group 5 years ago and 5 years later were performed. Carotid intima-media thickness, α, β, and pulse wave velocity increased, while dilatation coefficient and compliance coefficient decreased, with all differences being statistically significant (p<0.05). In 2019, comparisons between the marathon group and the control group showed no statistically significant differences in intima-media thickness, α, β, pulse wave velocity, dilatation coefficient, or compliance coefficient (p>0.05). The intima-media thickness, α, β, and pulse wave velocity increased and the dilatation coefficient and compliance coefficient decreased in the 2024 marathon group compared with the control group, and the differences were statistically significant (p<0.05). Univariate logistic regression models analyzed the relationship among age, running duration, monthly running volume, and changes in carotid intima-media thickness and elasticity parameters 5 years after marathon participation. Repeatability tests showed good intra- and inter-observer agreement. Marathon exercise leads to thickening and increased stiffness of the carotid intima-media thickness in athletes, and the application of quality intima-media thickness combined with quantitative arterial stiffness allows for early and dynamic visualization of this change.