Transient Myocardial Tissue and Function Changes During a Marathon in Less Fit Marathon Runners

Lack of change in myocardial function and fibrosis following a 6-day ultra-endurance exercise: A case report

“…Exercise studies using CMR imaging have seldom been performed, and limited to exercise b 13 h, whereas our subject raced during 36 h [4,5,8,9]. The present case differs from other studies with a higher percentage of HRR and 14.6 h spent above 80% of maximal HR, that may be partly explained by the high temperature in the desert [7].…”

“…There is unequivocal evidence that strenuous endurance exercise acutely induces cardiac biomarker release, unrelated with the extent of change in left ventricle (LV) function [4][5][6][7], but related to those in right ventricle (RV) function [8]. Exercise studies using CMR imaging have seldom been performed, and limited to exercise b 13 h, whereas our subject raced during 36 h [4,5,8,9].…”

Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men

“…There is, however, a rapidly growing body of literature documenting potentially concerning cardiovascular responses to marathon racing, including cardiac troponin release, 26 subclinical cardiac dysfunction, 14 and myocardial edema. 13 These findings have generated logical concern about the overall health implications of marathon participation. 27 However, observations on transient physiological changes associated with a single intense race, most without apparent clinical relevance, are unlikely to reflect the overall effect of marathon participation on cardiovascular health.…”

“…12 Several recent studies have characterized the myocardial and biochemical responses to a single marathon run. [13][14][15] To date, the effects of the preparatory marathon training on cardiac structure and function have received comparatively little attention.…”

My patient wants to perform strenuous endurance exercise. What's the right advice?

“…When these do occur in older runners, post-marathon alterations follow a similar pattern compared to younger runners [43], and return to normal within 2wk [43]. Post-marathon occurrence [44] or persistence of cardiac alterations were found to be more frequent in less trained runners (<56km/wk) [41], although this evidence was contradicted in another study [35]. The long-term clinical consequences of repeated exposure to the abovementioned SEEinduced alterations remain to be clearly determined.…”