Key result
Unsupervised training for a first marathon in young novice runners induced modest symmetrical biventricular dilation and a 4/2 mmHg reduction in blood pressure, without significant improvements in peak oxygen consumption.
Why the study?
Whether marathon running as a method of increasing physical activity is beneficial or harmful remains debated, following reports of transient myocardial dysfunction and biomarker release immediately post-race.
Does unsupervised marathon training induce beneficial or harmful cardiovascular remodeling in young novice runners?
Observational (n=68)
No
Does unsupervised marathon training induce beneficial or harmful cardiovascular remodeling in young novice runners?
Mean Difference: 3.1
Absolute Event Rate: 94.3% vs 91.2%
p-value: p=<0.01
Unsupervised marathon training in young novice runners induces modest, beneficial cardiovascular remodeling, including reduced blood pressure and arterial stiffness, without evidence of myocardial damage.
Modest eccentric remodeling occurs without fitness gains in unsupervised novices; leaves open whether supervised training produces clinically meaningful adaptations.
Aims Marathon running is a popular ambition in modern societies inclusive of non-athletes. Previous studies have highlighted concerning transient myocardial dysfunction and biomarker release immediately after the race. Whether this method of increasing physical activity is beneficial or harmful remains a matter of debate. We examine in detail the cardiovascular remodelling response following competition in a first marathon. Methods Sixty-eight novice marathon runners aged 30 ±3 years were investigated 6 months before and 2 weeks after the 2016 London Marathon race in a prospective observational study. Evaluation included electrocardiography, cardiopulmonary exercise testing, echocardiography and cardiovascular magnetic resonance imaging. Results After 17 weeks unsupervised marathon training, runners revealed a symmetrical, eccentric remodelling response with 3-5% increases in left and right ventricular cavity sizes, respectively. Blood pressure fell by 4/2 mmHg with reduction in arterial stiffness, despite only 11% demonstrating a clinically meaningful improvement in peak oxygen consumption. Conclusion In the absence of supervised training, exercise-induced cardiovascular remodelling in real-world novice marathon runners is more modest than previously described and occurs even without improvement in cardiorespiratory fitness. The responses are similar in men and women, who experience a beneficial blood pressure reduction and no evidence of myocardial fibrosis or persistent oedema, when achieving average finishing times.
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D’Silva et al. (2020) conducted an observational in Healthy novice marathon runners (n=68). Marathon training and completion vs. Baseline (pre-training) was evaluated on Indexed left ventricular end-diastolic volume (iLV EDV) (MD 3.1 ml/m2, p=<0.01). Unsupervised training for a first marathon in young novice runners induced modest symmetrical biventricular dilation and a 4/2 mmHg reduction in blood pressure, without significant improvements in peak oxygen consumption.
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