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towards the awareness of healthy living, people are likely to participate in long-distance running activities, for example, the marathon. Though, despite the helpful cardiovascular effect on marathon running, little is known about the negative effect of long-term recurring marathon running to the heart. Cardiac markers among marathoners show potential myocardial injury that is suspected because of prolonged hypoxemia during the long long-distance running which might predispose to myocardial fibrosis (MF). In spite of the concerns about the possible effect of MF among runners, studies found that the occurrence is variables. Considering the increasing participation of marathon among amateur as well as recreational athletes of the productive population, there is a need for awareness and also further evaluation on the possibility of MF among marathoners. A pre-participation examination among older age adults with the potential of underlying heart and coronary disease should be considered before marathon participation.

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