Key result
Participation in a 64-day, 4486 km ultramarathon significantly increased left ventricular mass (from 158.5 g at baseline to 167 g; p<0.001) without signs of adverse cardiovascular remodeling.
Why the study?
It was unknown whether participating in a multi-stage ultramarathon held over 64 consecutive days and 4486 km led to changes in cardiac structure and function.
Does participation in a multi-stage ultramarathon alter cardiac structure and function in runners?
Observational (n=20)
Does participation in a multi-stage ultramarathon alter cardiac structure and function in runners?
p-value: p=< 0.001
High exercise-induced cardiac volume load during a multi-stage ultramarathon results in physiological structural adaptation (reversible increase in LV mass) without adverse cardiovascular remodeling.
Reversible LV mass increase occurs without adverse remodeling in extreme endurance running; leaves open long-term clinical implications for athletes.
AIMS: To investigate whether participation in the Trans Europe Foot Race 2009 (TEFR), an ultramarathon race held over 64 consecutive days and 4486 km, led to changes in cardiac structure and function. METHODS: Cardiac magnetic resonance imaging was performed in 20 of 67 participating runners (two women; mean ± SD age 47.8 ± 10.4 years) at three time points (baseline scan at 294 ± 135 km (B), scan two at 1735 ± 86 km (T1) and scan three at 3370 ± 90 km (T2)) during the TEFR. Imaging included an assessment of left ventricular structure (mass) and function (strain). In parallel, cardiac troponin I, NT-pro-BNP, myostatin and GDF11 were determined in venous blood samples. A subsample of ten runners returned for a follow-up scan eight months after the race. RESULTS: Left ventricular mass increased significantly (B, 158.5 ± 23.8 g; T1, 165.1 ± 23.2 g; T2, 167 ± 24.6 g; p < 0.001) over the course of the race, although no significant change was seen in the remaining structural and functional parameters. Serum concentrations of cardiac troponin I and NT-proBNP significantly increased 1.5 - and 3.5-fold, respectively, during the first measurement interval, with no further increase thereafter (cardiac troponin I, 6.8 ± 3.1 (B), 16.9 ± 10.4 (T1) and 17.1 ± 9.7 (T2); NT-proBNP, 30.3 ± 22.8 (B), 135.9 ± 177.5 (T1) and 111.2 ± 87.3 (T2)), whereas the growth markers myostatin and GDF11 did not change. No association was observed with functional parameters, including the ejection fraction and the volume of both ventricles. The follow-up scans showed a reduction to baseline values (left ventricular mass 157 ± 19.3 g). CONCLUSIONS: High exercise-induced cardiac volume load for >2 months in ultra-endurance runners results in a physiological structural adaptation with no sign of adverse cardiovascular remodelling.
No takes yet. Share an insight, caveat, or question.
Klenk et al. (2019) conducted an observational in Healthy ultra-endurance runners (n=20). Multi-stage ultramarathon (Trans Europe Foot Race 2009) vs. Baseline was evaluated on Changes in left ventricular mass (p=< 0.001). Participation in a 64-day, 4486 km ultramarathon significantly increased left ventricular mass (from 158.5 g at baseline to 167 g; p<0.001) without signs of adverse cardiovascular remodeling.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: