Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run.

Niemelä, Kari; Palatsi, I.; Ikäheimo, Markku J.; Takkunen, Juha T.; Vuori, J J

doi:10.1161/01.cir.70.3.350

Cited by 102 publications

(88 citation statements)

References 45 publications

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“…Speci®cally, the left ventricular dimension during diastole remained reduced after 1 day of recovery, implying an altered preload. Similarly, Niemela et al (1984) have reported reduced fractional shortening at the ®nish after a 24-h race, returning to normal 2±3 days later and suggesting a depression of contractility. Sagnol et al (1990) have investigated the late eects of a 10-h triathlon on sympatho-adrenal and dopaminergic activity and have reported a decreased release of adrenaline from the adrenal medulla for several days after the race.…”

Section: Discussionmentioning

confidence: 77%

Metabolic and cardioventilatory responses during a graded exercise test before and 24?h after a triathlon

Gallais

Hayot

Hue³

et al. 1999

European Journal of Applied Physiology

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Previous studies have reported respiratory, cardiac and muscle changes at rest in triathletes 24 h after completion of the event. To examine the effects of these changes on metabolic and cardioventilatory variables during exercise, eight male triathletes of mean age 21.1 (SD 2.5) years (range 17-26 years) performed an incremental cycle exercise test (IET) before (pre) and the day after (post) an official classic triathlon (1.5-km swimming, 40-km cycling and 10-km running). The IET was performed using an electromagnetic cycle ergometer. Ventilatory data were collected every minute using a breath-by-breath automated system and included minute ventilation (V(E)), oxygen uptake (VO2), carbon dioxide production (VCO2), respiratory exchange ratio, ventilatory equivalent for oxygen (V(E)/VO2) and for carbon dioxide (V(E)/VCO2), breathing frequency and tidal volume. Heart rate (HR) was monitored using an electrocardiogram. The oxygen pulse was calculated as VO2/HR. Arterialized blood was collected every 2 min throughout IET and the recovery period, and lactate concentration was measured using an enzymatic method. Maximal oxygen uptake (VO2max) was determined using conventional criteria. Ventilatory threshold (VT) was determined using the V-slope method formulated earlier. Cardioventilatory variables were studied during the test, at the point when the subject felt exhausted and during recovery. Results indicated no significant differences (P > 0.05) in VO2max [62.6 (SD 5.9) vs 64.6 (SD 4.8) ml x kg(-1) x min(-1)], VT [2368 (SD 258) vs 2477 (SD 352) ml x min(-1)] and time courses of VO2 between the pre- versus post-triathlon sessions. In contrast, the time courses of HR and blood lactate concentration reached significantly higher values (P < 0.05) in the pre-triathlon session. We concluded that these triathletes when tested 24 h after a classic triathlon displayed their pre-event aerobic exercise capacity, bud did not recover pretriathlon time courses in HR or blood lactate concentration.

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Section: Discussionmentioning

confidence: 77%

Metabolic and cardioventilatory responses during a graded exercise test before and 24?h after a triathlon

Gallais

Hayot

Hue³

et al. 1999

European Journal of Applied Physiology

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“…Niemela et al 3 showed a 24% and 16% reduction in left ventricular stroke dimension and LVSF, respectively, in male ultramarathon runners after a 24-hour run. Douglas et al 2 described similar echocardiographic changes in participants in the Hawaii Ironman Triathlon.…”

Section: Discussionmentioning

confidence: 95%

“…Echocardiographic evidence of myocardial dysfunction immediately after competition in prolonged distance running events has been demonstrated in adult endurance athletes. 2,3 This depressed contractility, manifested as a decrease in left ventricular shortening fraction (LVSF), typically resolves within 24 hours after a race. Findings of left ventricular dysfunction after sustained running have also been corroborated in the laboratory setting.…”

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confidence: 99%

Cardiac Effects of a Competitive Road Race in Trained Child Runners

et al. 1997

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ABSTRACT.Background. Animal studies and investigations of adult endurance athletes indicate a transient depression of myocardial function after prolonged highintensity exercise.Purpose. To determine whether a similar decrease is observed in child distance runners after a 4-km competitive road race.Methods. Anthropometric measures, resting M-mode echocardiograms, maximal cycle exercise tests with estimation of cardiac output, and electrocardiograms were performed before a 4-km road race in nine run-trained boys (mean age, 12.2 years). Weight and resting echocardiogram and electrocardiogram were assessed immediately after the race. The entire test battery was repeated 24 hours later.Results. Small but significant decreases in mean body weight and left ventricular end-diastolic dimension were observed immediately after the race, but there were no changes in shortening fraction. These findings are consistent with the effects of dehydration. Measurements returned to prerace values by 24 hours of recovery. Peak work capacity, maximal stroke volume, and maximal cardiac output were similar on prerace and 24-hourpostrace testing. No electrocardiographic abnormalities were observed.Conclusions. No adverse cardiac effects were observed from a competitive 4-km road race in male child distance runners. Pediatrics 1997;100(3). URL: http:// www.pediatrics.org/cgi/content/full/100/3/e2; echocardiography, children, exercise.ABBREVIATIONS. LVSF, left ventricular shortening fraction; VTI, velocity time integral; LVED, left ventricular end diastolic dimension; bpm, beats per minute.T he emergence of the elite-level child athlete has raised concern regarding possible adverse physiologic and psychologic effects of intense sports training and competition during the growing years.1 Little scientific data are available, however, to evaluate the reality of these potential risks. Consequently, creating appropriate guidelines for safe participation by children in competitive sports remains difficult.Evidence does exist that high-intensity sports may impose significant acute stress on the cardiovascular system. Echocardiographic evidence of myocardial dysfunction immediately after competition in prolonged distance running events has been demonstrated in adult endurance athletes.2,3 This depressed contractility, manifested as a decrease in left ventricular shortening fraction (LVSF), typically resolves within 24 hours after a race. Findings of left ventricular dysfunction after sustained running have also been corroborated in the laboratory setting.4 Animal studies support the concept that transient myocardial fatigue after sustained high-intensity exercise may be expressed as depressed contractility, possibly related to alterations in calcium transport capacity of the sarcoplasmic reticulum. 5,6 This study was performed to determine whether cardiac functional alterations are evident after shorter distance competitions in trained child runners. Resting electrocardiograms and two-dimensional echocardiograms were performed before and immediate...

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“…After 24 -26 h of exercise, previous studies observed a depressed diastolic function (5,24,29,30,35). However, conflicting results were observed on systolic function because ejection fraction (EF) was either decreased (24, 29, 35) or unchanged (5, 30).…”

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confidence: 99%

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

Maufrais

Millet

Schuster

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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Maufrais C, Millet GP, Schuster I, Rupp T, Nottin S. Progressive and biphasic cardiac responses during extreme mountain ultramarathon. Am J Physiol Heart Circ Physiol 310: H1340 -H1348, 2016. First published February 26, 2016 doi:10.1152/ajpheart.00037.2016.-Investigations on the cardiac function consequences of mountain ultramarathon (MUM) Ͼ100 h are lacking. The present study assessed the progressive cardiac responses during the world's most challenging MUM (Tor des Géants; Italy; 330 km; 24,000 m of cumulative elevation gain). Resting echocardiographic evaluation of morphology, function, and mechanics of left and right ventricle (LV and RV) including speckle tracking echocardiography was conducted in 15 male participants (46 Ϯ 13 yr) before (pre), during (mid; 148 km), and after (post) the race. Runners completed the race in 126 Ϯ 15 h. From pre to post, the increase in stroke volume (SV) (103 Ϯ 19 vs. 110 Ϯ 23 vs. 116 Ϯ 21 ml; P Ͻ 0.001 at pre, mid, and post) was concomitant to the increase in LV early filling (peak E; 72.9 Ϯ 15.7 vs. 74.6 Ϯ 13.1 vs. 82.1 Ϯ 11.5 cm/s; P Ͻ 0.05). Left and right atrial end-diastolic areas, RV end-diastolic area, and LV enddiastolic volume were 12-19% higher at post compared with pre (P Ͻ 0.05). Resting heart rate and LV systolic strain rates demonstrated a biphasic adaptation with an increase from pre to mid (55 Ϯ 8 vs. 72 Ϯ 11 beats/min, P Ͻ 0.001) and a return to baseline values from mid to post (59 Ϯ 8 beats/min). Significant correlations were found between pre-topost percent changes in peak E and LV end-diastolic volume (r ϭ 0.63, P Ͻ 0.05) or RV (r ϭ 0.82, P Ͻ 0.001) or atrial end-diastolic areas (r ϭ 0.83, P Ͻ 0.001). An extreme MUM induced a biphasic pattern of heart rate in parallel with specific cardiac responses characterized by a progressive increase in diastolic filling, biventricular volumes, and SV. IT IS WELL DOCUMENTED THAT prolonged intense exercise, such as a marathon or Ironman triathlon, transitorily alters cardiac function (7,13,20,22,23,28,42). A range of 3-15 h exercising induces transient left ventricular (LV) global systolic (20, 42) and diastolic (7,23,28) dysfunctions. This phenomenon, named exercise-induced cardiac fatigue (EICF), is generally associated with the release of biochemical markers of myocardial damage (13,22).Whereas the impact of races such as marathons or Ironman triathlons has been extensively described, few studies have explored cardiac function after ultraendurance exercise. After 24 -26 h of exercise, previous studies observed a depressed diastolic function (5,24,29,30,35). However, conflicting results were observed on systolic function because ejection fraction (EF) was either decreased (24, 29, 35) or unchanged (5, 30). Recently, we evaluated the cardiac function consequences of a mountain ultramarathon (MUM) (i.e., 38 Ϯ 5 h). It is important to note that an important decrease in velocity (e.g., large deceleration) has been reported in the MUM of the present study (34), caused by the combination of extreme distance and sleep d...

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Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run.

Cited by 102 publications

References 45 publications

Metabolic and cardioventilatory responses during a graded exercise test before and 24?h after a triathlon

Metabolic and cardioventilatory responses during a graded exercise test before and 24?h after a triathlon

Cardiac Effects of a Competitive Road Race in Trained Child Runners

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

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