Cardiac and renal function in a large cohort of amateur marathon runners.

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Abstract

Participation of amateur runners in endurance races continues to increase. Previous studies of marathon runners have raised concerns about exercise-induced myocardial and renal dysfunction and damage. In our pooled analysis, we aimed to characterize changes of cardiac and renal function after marathon running in a large cohort of mostly elderly amateur marathon runners.

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Most cited references 24

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Assessment of right ventricular function using two-dimensional echocardiography.

Sanjiv Kaul, Chuwa Tei, James Hopkins … (1984)

With the use of two-dimensional echocardiography (2DE), we analyzed apical and subcostal four-chamber views for evaluation of right ventricular (RV) function in 30 individuals as compared to RV ejection fraction (RVEF) obtained by radionuclide angiography. In addition to previously reported parameters of changes in areas and chords, a new simple measurement of tricuspid annular excursion was correlated with RVEF. A close correlation was noted between tricuspid annular plane systolic excursion (TAPSE) and RVEF (r = 0.92). The RV end-diastolic area (RVEDA) and percentage of systolic change in area in the apical four-chamber view also showed close correlation with RVEF (r = -0.76 and 0.81); however, the entire RV endocardium could only be traced in about half of our patients. The end-diastolic transverse chord length and the percentage of systolic change in chord length in the apical view showed a poor correlation with RVEF. The correlation between RVEF and both areas and chords measured in the subcostal view was poor. It is concluded that the measurement of TAPSE offers a simple echocardiographic parameter which reflects RVEF. This measurement is not dependent on either geometric assumptions or traceable endocardial edges. When the endocardial outlines could be traced, the apical four-chamber view was superior to the subcostal view in assessment of RV function.

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Exercise-induced cardiac troponin elevation: evidence, mechanisms, and implications.

Rob Shave, Aaron L Baggish, Keith George … (2010)

Regular physical exercise is recommended for the primary prevention of cardiovascular disease. Although the high prevalence of physical inactivity remains a formidable public health issue, participation in exercise programs and recreational sporting events, such as marathons and triathlons, is on the rise. Although regular exercise training reduces cardiovascular disease risk, recent studies have documented elevations in cardiac troponin (cTn) consistent with cardiac damage after bouts of exercise in apparently healthy individuals. At present, the prevalence, mechanism(s), and clinical significance of exercise-induced cTn release remains incompletely understood. This paper will review the biochemistry, prevalence, potential mechanisms, and management of patients with exercise-induced cTn elevations. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon.

Tomas G Neilan, James L Januzzi, Elizabeth Lee-Lewandrowski … (2006)

Multiple studies have individually documented cardiac dysfunction and biochemical evidence of cardiac injury after endurance sports; however, convincing associations between the two are lacking. We aimed to determine the associations between the observed transient cardiac dysfunction and biochemical evidence of cardiac injury in amateur participants in endurance sports and to elicit the risk factors for the observed injury and dysfunction. We screened 60 nonelite participants, before and after the 2004 and 2005 Boston Marathons, with echocardiography and serum biomarkers. Echocardiography included conventional measures as well as tissue Doppler-derived strain and strain rate imaging. Biomarkers included cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP). All subjects completed the race. Echocardiographic abnormalities after the race included altered diastolic filling, increased pulmonary pressures and right ventricular dimensions, and decreased right ventricular systolic function. At baseline, all had unmeasurable troponin. After the race, > 60% of participants had increased cTnT > 99th percentile of normal (> 0.01 ng/mL), whereas 40% had a cTnT level at or above the decision limit for acute myocardial necrosis (> or = 0.03 ng/mL). After the race, NT-proBNP concentrations increased from 63 (interquartile range [IQR] 21 to 81) pg/mL to 131 (IQR 82 to 193) pg/mL (P 45 miles/wk, athletes who trained < or = 35 miles/wk demonstrated increased pulmonary pressures, right ventricular dysfunction (mid strain 16+/-5% versus 25+/-4%, P<0.001), myocyte injury (cTnT 0.09 versus < 0.01 ng/mL, P<0.001), and stress (NT-proBNP 182 versus 106 pg/mL, P<0.001). Completion of a marathon is associated with correlative biochemical and echocardiographic evidence of cardiac dysfunction and injury, and this risk is increased in those participants with less training.

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Author and article information

Journal

Journal ID (iso-abbrev): Cardiovasc Ultrasound

Title: Cardiovascular ultrasound

Publisher: Springer Science and Business Media LLC

ISSN (Electronic): 1476-7120

ISSN (Print): 1476-7120

Publication date (Electronic): Mar 21 2015

Volume: 13

Affiliations

[1 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. bernd.hewing@charite.de.

[2 ] Department of Medicine I, Cardiology, Helios Klinikum Emil von Behring, Berlin, Germany. sebastian.schattke@helios-kliniken.de.

[3 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. sebastian.spethmann@charite.de.

[4 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. wasiem.sanad@charite.de.

[5 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. sabrina.schroeckh@charite.de.

[6 ] Department of Medical Chemistry und Pathochemistry, Charité-Universitätsmedizin Berlin, Berlin, Germany. ingolf.schimke@charite.de.

[7 ] Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. fabian.halleck@charite.de.

[8 ] Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. harm.peters@charite.de.

[9 ] SMS Medical Institute, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.

[10 ] Berlin Academy for Sport Medicine, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.

[11 ] SCC Running Events GmbH, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.

[12 ] SMS Medical Institute, Berlin, Germany. juergen.lock@scc-events.com.

[13 ] Berlin Academy for Sport Medicine, Berlin, Germany. juergen.lock@scc-events.com.

[14 ] SCC Running Events GmbH, Berlin, Germany. juergen.lock@scc-events.com.

[15 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. gert.baumann@charite.de.

[16 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. henryk.dreger@charite.de.

[17 ] Department of Medicine I, Cardiology, Helios Klinikum Emil von Behring, Berlin, Germany. adrian.borges@helios-kliniken.de.

[18 ] Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. fabian.knebel@charite.de.

Article

Publisher Item ID: 10.1186/s12947-015-0007-6

DOI: 10.1186/s12947-015-0007-6

PMC ID: 4372316

PubMed ID: 25889047

SO-VID: e5a92b98-a660-4d68-854e-359385d07f5d

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Cardiac and renal function in a large cohort of amateur marathon runners.

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Abstract

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Most cited references 24

Assessment of right ventricular function using two-dimensional echocardiography.

Exercise-induced cardiac troponin elevation: evidence, mechanisms, and implications.

Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon.

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