Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men

Zilinski, Jodi; Contursi, Miranda; Isaacs, Stephanie; DeLuca, James R.; Lewis, Gregory D.; Weiner, Rory B.; Hutter, Adolph M.; d’Hemecourt, Pierre A.; Troyanos, Christopher; Dyer, K. Sophia; Baggish, Aaron L.

doi:10.1161/circimaging.114.002487

Cited by 57 publications

(48 citation statements)

References 36 publications

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“…4 The relationship of LV diastolic function to exercise-induced pulmonary congestion has been elucidated in several articles which show that diastolic relaxation is greater in high-capacity aerobic athletes and enhances their ability to withstand very high cardiac outputs during maximal exercise while preserving a low pulmonary venous pressure. 4,5 Recent studies demonstrate a training effect on LV diastolic relaxation, indicating that high levels of aerobic exercise are possible because of improved diastolic relaxation in well-trained athletes. 6,7 …”

Section: Circulatory and Respiratory Changes With Exercisementioning

confidence: 99%

Pulmonary Aspects of Exercise and Sports

Bové

2016

Methodist DeBakey Cardiovascular Journal

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Although the lungs are a critical component of exercise performance, their response to exercise and other environmental stresses is often overlooked when evaluating pulmonary performance during high workloads. Exercise can produce capillary leakage, particularly when left atrial pressure increases related to left ventricular (LV) systolic or diastolic failure. Diastolic LV dysfunction that results in elevated left atrial pressure during exercise is particularly likely to result in pulmonary edema and capillary hemorrhage. Data from race horses, endurance athletes, and triathletes support the concept that the lungs can react to exercise and immersion stress with pulmonary edema and pulmonary hemorrhage. Immersion in water by swimmers and divers can also increase stress on pulmonary capillaries and result in pulmonary edema. Swimming-induced pulmonary edema and immersion pulmonary edema in scuba divers are well-documented events caused by the fluid shifts that occur with immersion, elevated pulmonary venous pressure during extreme exercise, and negative alveolar pressure due to inhalation resistance. Prevention strategies include avoiding extreme exercise, avoiding over hydration, and assuring that inspiratory resistance is minimized. Figure 1. Pulmonary capillary wedge pressure (PCWP) measured during increasing exercise intensity, determined by oxygen consumption (VO 2 ), in well-trained (circles) and average-trained (squares) men with a mean age of 29.6. Note that the well-trained subjects preserved normal levels of PCWP until they reached high levels of exercise, while the average-trained men demonstrated increases in PCWP at lower levels of exercise intensity. Adapted from Stickland et al. 4MDCVJ | XII (2) 2016 94 houstonmethodist.org/debakey-journal of interstitial hemorrhage and fluid accumulation following a high workload in one horse that developed EIPH. West et al. 9 suggested that two factors contributed to this problem in horses: (1) They were likely to have a congenital weakness of pulmonary capillaries that resulted in capillary rupture at high pulmonary venous and capillary pressure, and (2) they developed high pulmonary venous pressure due to failure of the left ventricle with subsequent elevation of LV end diastolic pressure during high workloads.Human studies of lung responses to high workloads 10 corroborate the studies of West et al. to some extent. Zavorsksy et al. 11 studied individuals under several different workloads and performed lung imaging to document the presence or absence of lung edema. Radiographic image readers were blinded to the exposures and reported visual evidence of lung fluid. In individuals undergoing a diagnostic graded exercise test, no evidence of lung edema was noted. However, 15% of individuals who ran on a treadmill at 70% of maximum capacity for 2 hours demonstrated evidence of pulmonary edema, as did 65% of those who ran at maximum capacity for 7 minutes. Similar findings were noted in female athletes.12 Pingitore et al. examined 48 athletes before and aft...

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Section: Circulatory and Respiratory Changes With Exercisementioning

confidence: 99%

Pulmonary Aspects of Exercise and Sports

Bové

2016

Methodist DeBakey Cardiovascular Journal

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“…10,11 Furthermore, a 9-year follow-up of 114 young (age, 22±4 years) Olympic athletes with evidence of physiological cardiac remodeling (athlete's heart) at baseline demonstrated no evidence of abnormalities in global or regional left ventricular structure and function and cardiovascular symptoms or events. 12 In this issue of Circulation: Cardiovascular Imaging, Zilinski et al 13 addressed the potential cardiovascular health benefits of marathon training in 45 middle-aged apparently healthy male recreational (nonelite) athletes. During the structured 18-week marathon-training program, exercise volume doubled from 14 to 24 miles per week, and running speed was mainly performed in aerobic condition, which explains that training primarily improved aerobic capacity but not so much maximal exercise capacity.…”

Section: See Article By Zilinski Et Almentioning

confidence: 99%

“…These adaptive changes were also accompanied by an improved risk factor profile. 13 Furthermore, Zilinski et al 13 distinguished more experienced (n=22; >5 marathons; mean, 14±11) from less experienced recreational runners (n=23; ≤5 marathons; mean, 1±1). With similar training mileage during the 2 months prior to enrollment (ie, 14±12 miles per week), both groups were comparable at baseline with respect to cardiorespiratory exercise testing data, all (but one) echocardiographic variables and risk factor values, possibly as a result of detraining.…”

Section: See Article By Zilinski Et Almentioning

confidence: 99%

Myocardial Adaptation in Response to Marathon Training

Möhlenkamp

Halle

2015

Circ: Cardiovascular Imaging

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“…Cardiovascular system determines the body performance capability, and is the weakest unit in exercise adaptation [1][2][3]. For years the contractile myocardium has been an object of research of adaptation processes in clinical practice and in experiment [4-10, et al].…”

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Spatial Organization Types of Sinoatrial Node in Dogs with Different Body Functional Reserve Levels

Vasyagina¹,

Biryukova²

2016

Sovrem Tehnol Med

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The aim of the investigation was to reveal the spatial organization types of sinoatrial nodes in animals with different levels of body functional reserve after a single maximal exercise.Materials and Methods. The research was carried out on 24 male mongrel dogs. Treadmill run under laboratory conditions was used to model a single maximal exercise. The exercise time was individual for each animal due to its cardio-respiratory system. A body functional reserve level was determined by the running time to refusal and the heart rate (HR) during the exercise. We studied the sinoauricular area structure using light and transmission electron microscopy. Tissue organization of myocardium was analyzed using the methods of stereology.Results. According to HR dynamics, we distinguished two main types of functional response to maximal (excessive) exercise: type I, high HR during the running, and type II, low HR. The response types on exercise also differed in the running time and resting HR (p<0.05).Based on stereological test findings we described the peculiarities of spatial organization of conductive and contractile myocardium in animals with different functional responses characterized by various ratios of the main tissue components. Stereological parameters in type I animals were similar to those in intact animals of a control group. Conductive and contractile myocardium in type II animals significantly differed in a relative volume of cardiomyocytes and connective tissue components from those in controls and type I animals.Conclusion. The results of morphological studies of sinoauricular region in animals with different levels of functional body reserve compared to physiological parameters enable to predict the structural changes in the sinoatrial node area after an excess motor load.

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Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men

Abstract: Background-Myocardial

Cited by 57 publications

References 36 publications

Pulmonary Aspects of Exercise and Sports

Pulmonary Aspects of Exercise and Sports

Myocardial Adaptation in Response to Marathon Training

Spatial Organization Types of Sinoatrial Node in Dogs with Different Body Functional Reserve Levels

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