Effects of medium- and long-distance running on cardiac damage markers in amateur runners: a systematic review, meta-analysis, and metaregression

Rubio-Arias, Jacobo Á.; Andreu, Luis; Martínez-Aranda, Luis Manuel; Martínez-Rodríguez, Alejandro; Manonelles, Pedro; Ramos-Campo, Domingo Jesús

doi:10.1016/j.jshs.2019.10.003

Cited by 9 publications

(18 citation statements)

References 45 publications

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“…Another potential caveat stems from the fact that we did not measure some specific markers of cardiac damage, notably circulating cardiac troponin (c-Tn). In this regard, although serum levels of cTn (either cTn-I or c-Tn-T), a marker of injury in acute coronary syndrome, are frequently elevated 24 h post-marathon in amateur runners ( 38 ) this transient increase in cTn probably reflects the cytosolic release of the biomarker, which is due to altered cardiomyocyte metabolism ( 39 ), not true necrosis, as suggested by a study using delayed enhancement cardiac magnetic resonance imaging ( 40 ). Previous research has also shown that marathon-induced elevations in cTn are not associated with cardiac functional changes, inflammation or fibrosis ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis

Wolff¹,

Picco²,

Diaz-Gonzalez

et al. 2022

Front. Cardiovasc. Med.

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BackgroundControversy exists on the actual occurrence of exercise-induced cardiac fatigue (EICF) with ultraendurance exercise, as well as on whether factors such as age or training status might predispose to this condition. The present study aimed to assess the occurrence of EICF among recreational ultramarathon runners, as well as to determine potential predictive factors.MethodsNineteen male recreational runners (42 ± 12yrs) participated in a 55-km trial race at moderate altitude (1,800–2,500 m). Participants were evaluated before and after the race using Doppler echocardiography and myocardial deformation analysis. EICF was determined as a reduction >5% of either left ventricular global longitudinal strain (LVGLS) or right ventricular free wall strain (RVFWS). Demographical (age, body mass index), training (training experience, volume and intensity), competition (finishing time, relative intensity) and biochemical variables (blood lactate, creatine kinase [CK] and CK-MB) were assessed as predictors of EICF.ResultsA significant reduction in LVGLS (20.1 ± 2.1% at baseline vs. 18.8 ± 2.4% at post-race, p = 0.026), but not in RVFWS (27.4 ± 7.0 vs. 24.6 ± 5.3%, p = 0.187), was observed after the race. EICF was present in 47 and 71% of the participants attending to the decrease in LVGLS and RVFWS, respectively. No associations were found between any of the analyzed variables and EICF except for age, which was associated with the magnitude of decrement of RVFWS (r = 0.58, p = 0.030).ConclusionsUltramarathon running at moderate altitude seems to induce EICF in a considerable proportion of recreational athletes.

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Section: Discussionmentioning

confidence: 99%

Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis

Wolff¹,

Picco²,

Diaz-Gonzalez

et al. 2022

Front. Cardiovasc. Med.

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“…During the serial analyses, we observed that biomarker modifications occur earlier during the race than echocardiographic parameters. Despite these acute abnormalities, all the participants performed annually an average of five long-distance running race each year, and no long-term impact was observed 10 years after the race, suggesting that the modifications are reversible ( 34 ). Moreover, the progressive increase in urea and creatinine at the 21st km suggests a potential acute kidney injury that occurred during the race even if we were not able to exclude a muscle contribution and/or hydration level influence.…”

Section: Discussionmentioning

confidence: 99%

Relationship between echocardiographic characteristics and cardiac biomarkers during long-distance trail running

Jouffroy

Hergault

Antero

et al. 2022

Front. Cardiovasc. Med.

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BackgroundEven if the beneficial cardiovascular effects of moderate exercise are recognized, effects of prolonged and intense exercise are still debated. This study aims to detect cardiovascular changes associated with long endurance running by assessing the relationship between echocardiographic parameters and cardiac biomarkers during long-distance trail running.MethodsWe performed a prospective observational study that included 20 participants who were all amateur runners (median age of 41 years old, still alive after a 7-year clinical follow-up) from 80-km trail running. All the participants underwent an echocardiographic examination and venous blood sampling before the race, at the intermediate refreshment checkpoints of the race (21st and 53rd km), and within 10 min after arrival.ResultsMitral E/A velocity ratio and mitral TDI e’ wave were significantly decreased at the 21st km to arrival (p < 0.05). Mitral S wave and global longitudinal strain (GLS) were significantly decreased from the 53rd km to arrival (p < 0.05 for 53rd and 80th km). As compared to baseline, T-troponin and NT-proBNP were significantly increased at the 21st km in all the participants, but T-troponin values were systematically increased above the significative threshold. Diastolic echocardiographic abnormalities were mainly observed among participants with highest NT-proBNP (> 77 ng.l–1) values at the 21st km. As compared to baseline, mitral e’ wave was significantly decreased (–35%) in participants with highest values of NT-proBNP. Similarly, GLS was also depressed among participants with highest troponin values at the 53rd km (p = 0.01 for 53rd km and p = 0.04 for arrival).ConclusionDuring the long-distance trail running, the early LV decrease in diastolic echocardiographic parameters is associated with increase in NT pro-BNP blood levels, and the decrease in LV systolic echocardiographic parameters later is associated with increase in T-troponin blood levels.

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“…Consequences of recent viral or bacterial infections and/or other pre-existing conditions may promote AKI and associated long-term consequences [38]. Intriguingly, in a recent meta-study of amateur runners (with races ranging from 10 km up to ultramarathons; mean age and range: 41 years, 15.7-63.4 years), both younger age and higher body mass index were correlated with greater cTnI release [70], possibly due to greater cardiac demands secondary to more intense efforts and larger body size. In contrast, reduced myocardial stress could be associated with slower running speed and/or chronic exercise adaptations to exercise among veteran endurance athletes.…”

Section: Aging Pre-existing Diseases and Nonsteroidal Anti-inflammato...mentioning

confidence: 99%

Could Repeated Cardio-Renal Injury Trigger Late Cardiovascular Sequelae in Extreme Endurance Athletes?

et al. 2022

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Regular exercise confers multifaceted and well-established health benefits. Yet, transient and asymptomatic increases in markers of cardio-renal injury are commonly observed in ultra-endurance athletes during and after competition. This has raised concerns that chronic recurring insults could cause long-term cardiac and/or renal damage. Indeed, extreme endurance exercise (EEE) over decades has sometimes been linked with untoward cardiac effects, but a causal relation with acute injury markers has not yet been established. Here, we summarize the current knowledge on markers of cardiac and/or renal injury in EEE athletes, outline the possible interplay between cardiac and kidney damage, and explore the roles of various factors in the development of potential exercise-related cardiac damage, including underlying diseases, medication, sex, training, competition, regeneration, mitochondrial dysfunction, oxidative stress, and inflammation. In conclusion, despite the undisputed health benefits of regular exercise, we speculate, based on the intimate link between heart and kidney diseases, that in rare cases excessive endurance sport may induce adverse cardio-renal interactions that under specific, hitherto undefined conditions could result in persistent cardiac damage. We highlight future research priorities and provide decision support for athletes and clinical consultants who are seeking safe strategies for participation in EEE training and competition.

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Effects of medium- and long-distance running on cardiac damage markers in amateur runners: a systematic review, meta-analysis, and metaregression

Cited by 9 publications

References 45 publications

Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis

Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis

Relationship between echocardiographic characteristics and cardiac biomarkers during long-distance trail running

Could Repeated Cardio-Renal Injury Trigger Late Cardiovascular Sequelae in Extreme Endurance Athletes?

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