TY - JOUR
T1 - Cardiovascular Remodeling Experienced by Real-World, Unsupervised, Young Novice Marathon Runners
AU - D’Silva, Andrew
AU - Bhuva, Anish N.
AU - van Zalen, Jet
AU - Bastiaenen, Rachel
AU - Abdel-Gadir, Amna
AU - Jones, Siana
AU - Nadarajan, Niromila
AU - Menacho Medina, Katia D.
AU - Ye, Yang
AU - Augusto, Joao
AU - Treibel, Thomas A.
AU - Rosmini, Stefania
AU - Ramlall, Manish
AU - Scully, Paul R.
AU - Torlasco, Camilla
AU - Willis, James
AU - Finocchiaro, Gherardo
AU - Papatheodorou, Efstathios
AU - Dhutia, Harshil
AU - Cole, Della
AU - Chis Ster, Irina
AU - Hughes, Alun D.
AU - Sharma, Rajan
AU - Manisty, Charlotte
AU - Lloyd, Guy
AU - Moon, James C.
AU - Sharma, Sanjay
N1 - Funding Information:
We thank the study participants for voluntarily giving their time and taking part in the study. We are also grateful to Virgin Money London Marathon for their support in recruitment of participants. We are grateful to the entire marathon study team performing investigations. In addition to the authors of this manuscript, The Marathon Study group included the following staff from St George?s University of London, University College London, Bart?s Health Trust, and other organizations: AB, SJ, JZ, AA-G, TT, SR, MR, Gabriella Captur, KM, JA, YY, NN, Nabila Mughul, Sunita Chauhan, Shino Kirokose, Tolu Akinola, Cheelo Simaanya, Lizette Cash, JW, David Hoare, James Malcolmson, Pamela de la Cruz, Annabelle Freeman, Delfin Encarnacion, Lesley Hart, Jack Kaufman, Frances Price, Rueben Dane, Karen Armado, Gemma Cruz, Lorna Carby, Tiago Fonseca, Fatima Niones, Zeph Fanton, Jim Pate, Joe Carlton, Sarah Anderson, Rob Hall, Sam Liu, Sonia Bains, Claire Kirkby, Pushpinder Kalra, Raghuveer Singh, Bode Ensam, Tee J. Yeo, RB, DC, Jacky Ah-Fong, Sue Brown, Sarah Horan, Ailsa McClean, Kyle Conley, Paul Scully, Luke Horsfield, Mark McLaren, Elizabeth Clough, Daniel Key, Riyaz Patel, and Sanjeev Bhattacharyya. We are grateful to Virgin Money London Marathon, particularly Hugh Brasher and Penny Dain, for their support with study advertisement and participant recruitment. From our supporters Cardiac Risk in the Young, we are particularly grateful to Steve Cox and Azra Loncarevic-Srmic for their additional support with administration and transport. Funding. This work was jointly supported and funded by the British Heart Foundation with a clinical research training fellowship grant (FS/15/27/31465 to AD) and Cardiac Risk in the Young. This work was also supported by COSMED (Rome, Italy) through the provision of cardiopulmonary exercise testing equipment and technical support. AB was supported by a doctoral research fellowship from the British Heart Foundation (FS/16/46/32187). JM and CM were directly and indirectly supported by the University College London Hospitals, NIHR Biomedical Research Centre and Biomedical Research Unit at St Bartholomew?s Hospital, respectively. The study funders and supporters had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© Copyright © 2020 D’Silva, Bhuva, van Zalen, Bastiaenen, Abdel-Gadir, Jones, Nadarajan, Menacho Medina, Ye, Augusto, Treibel, Rosmini, Ramlall, Scully, Torlasco, Willis, Finocchiaro, Papatheodorou, Dhutia, Cole, Chis Ster, Hughes, Sharma, Manisty, Lloyd, Moon and Sharma.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3/18
Y1 - 2020/3/18
N2 - Aims: Marathon running is a popular ambition in modern societies inclusive of non-athletes. Previous studies have highlighted concerning transient myocardial dysfunction and biomarker release immediately after the race. Whether this method of increasing physical activity is beneficial or harmful remains a matter of debate. We examine in detail the real-world cardiovascular remodeling response following competition in a first marathon. Methods: Sixty-eight novice marathon runners (36 men and 32 women) aged 30 ± 3 years were investigated 6 months before and 2 weeks after the 2016 London Marathon race in a prospective observational study. Evaluation included electrocardiography, cardiopulmonary exercise testing, echocardiography, and cardiovascular magnetic resonance imaging. Results: After 17 weeks unsupervised marathon training, runners revealed a symmetrical, eccentric remodeling response with 3–5% increases in left and right ventricular cavity sizes, respectively. Blood pressure (BP) fell by 4/2 mmHg (P < 0.01) with reduction in arterial stiffness, despite only 11% demonstrating a clinically meaningful improvement in peak oxygen consumption with an overall non-significant 0.4 ml/min/kg increase in peak oxygen consumption (P = 0.14). Conclusion: In the absence of supervised training, exercise-induced cardiovascular remodeling in real-world novice marathon runners is more modest than previously described and occurs even without improvement in cardiorespiratory fitness. The responses are similar in men and women, who experience a beneficial BP reduction and no evidence of myocardial fibrosis or persistent edema, when achieving average finishing times.
AB - Aims: Marathon running is a popular ambition in modern societies inclusive of non-athletes. Previous studies have highlighted concerning transient myocardial dysfunction and biomarker release immediately after the race. Whether this method of increasing physical activity is beneficial or harmful remains a matter of debate. We examine in detail the real-world cardiovascular remodeling response following competition in a first marathon. Methods: Sixty-eight novice marathon runners (36 men and 32 women) aged 30 ± 3 years were investigated 6 months before and 2 weeks after the 2016 London Marathon race in a prospective observational study. Evaluation included electrocardiography, cardiopulmonary exercise testing, echocardiography, and cardiovascular magnetic resonance imaging. Results: After 17 weeks unsupervised marathon training, runners revealed a symmetrical, eccentric remodeling response with 3–5% increases in left and right ventricular cavity sizes, respectively. Blood pressure (BP) fell by 4/2 mmHg (P < 0.01) with reduction in arterial stiffness, despite only 11% demonstrating a clinically meaningful improvement in peak oxygen consumption with an overall non-significant 0.4 ml/min/kg increase in peak oxygen consumption (P = 0.14). Conclusion: In the absence of supervised training, exercise-induced cardiovascular remodeling in real-world novice marathon runners is more modest than previously described and occurs even without improvement in cardiorespiratory fitness. The responses are similar in men and women, who experience a beneficial BP reduction and no evidence of myocardial fibrosis or persistent edema, when achieving average finishing times.
KW - athlete’s heart
KW - cardiorespiratory fitness
KW - cardiovascular remodeling
KW - endurance exercise
KW - marathon
KW - sports cardiology
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U2 - 10.3389/fphys.2020.00232
DO - 10.3389/fphys.2020.00232
M3 - Article
AN - SCOPUS:85082695171
VL - 11
JO - Frontiers in Physiology
JF - Frontiers in Physiology
SN - 1664-042X
M1 - 232
ER -