Łukasz A Małek1, Marzena Barczuk-Falęcka2, Konrad Werys3, Anna Czajkowska4, Anna Mróz5, Katarzyna Witek5, Matthew Burrage3, Wawrzyniec Bakalarski5, Dariusz Nowicki4, Danuta Roik2, Michał Brzewski2. 1. Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Poland. Electronic address: lukasz.malek@awf.edu.pl. 2. Department of Pediatric Radiology, Medical University of Warsaw, Poland. 3. Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Headington, Oxford, United Kingdom. 4. Faculty of Tourism and Recreation, Józef Piłsudski University of Physical Education in Warsaw, Poland. 5. Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Poland.
Abstract
PURPOSE: There is a direct reverse dose-effect relationship between the amount of physical activity and cardiovascular risk. It is unknown whether this is true for extreme, persistent endurance training. The aim of the study was to assess structural changes of the heart in long-time ultra-marathon runners with special focus on myocardial fibrosis using parametric mapping. METHOD: We studied a group of 30 healthy, male ultra-marathon runners (mean age 40.9 ± 6.6 yrs, median 9 yrs of running with frequent competitions) and 10 matched controls not engaged in any regular activities. All of them underwent cardiovascular magnetic resonance (CMR) with 3 T scanner including T1-mapping, late gadolinium enhancement (LGE) and extracellular volume (ECV) quantification. RESULTS: Athletes demonstrated significantly larger heart chambers and left ventricular (LV) mass. LV systolic function was unchanged. 73.3% of athletes fulfilled volumetric criteria for dilated cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy. Non-ischemic, small volume LGE was found in 8 athletes and in 1 control (27% vs. 10%, p = 0.40). It was localised at insertion points (5 athletes, 1 control) or in the septum or infero-lateral wall (3 athletes). Athletes with insertion point LGE had higher right ventricular end-diastolic volume index in comparison to athletes without LGE (p = 0.04), which suggests its relation to volume overload. There were no differences between athletes and non-athletes in terms of ECV values (26.1% vs. 25%, p = 0.29). CONCLUSIONS: Ultra-marathon runner's hearts demonstrate a high degree of structural remodelling, but there is no significant increase in focal or diffuse myocardial fibrosis.
PURPOSE: There is a direct reverse dose-effect relationship between the amount of physical activity and cardiovascular risk. It is unknown whether this is true for extreme, persistent endurance training. The aim of the study was to assess structural changes of the heart in long-time ultra-marathon runners with special focus on myocardial fibrosis using parametric mapping. METHOD: We studied a group of 30 healthy, male ultra-marathon runners (mean age 40.9 ± 6.6 yrs, median 9 yrs of running with frequent competitions) and 10 matched controls not engaged in any regular activities. All of them underwent cardiovascular magnetic resonance (CMR) with 3 T scanner including T1-mapping, late gadolinium enhancement (LGE) and extracellular volume (ECV) quantification. RESULTS: Athletes demonstrated significantly larger heart chambers and left ventricular (LV) mass. LV systolic function was unchanged. 73.3% of athletes fulfilled volumetric criteria for dilated cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy. Non-ischemic, small volume LGE was found in 8 athletes and in 1 control (27% vs. 10%, p = 0.40). It was localised at insertion points (5 athletes, 1 control) or in the septum or infero-lateral wall (3 athletes). Athletes with insertion point LGE had higher right ventricular end-diastolic volume index in comparison to athletes without LGE (p = 0.04), which suggests its relation to volume overload. There were no differences between athletes and non-athletes in terms of ECV values (26.1% vs. 25%, p = 0.29). CONCLUSIONS: Ultra-marathon runner's hearts demonstrate a high degree of structural remodelling, but there is no significant increase in focal or diffuse myocardial fibrosis.
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Authors: Michał Konwerski; Marek Postuła; Marzena Barczuk-Falęcka; Anna Czajkowska; Anna Mróz; Katarzyna Witek; Wawrzyniec Bakalarski; Aleksandra Gąsecka; Łukasz A Małek; Tomasz Mazurek Journal: Int J Environ Res Public Health Date: 2021-03-18 Impact factor: 3.390