Frontiers in Physiology (Mar 2020)

Cardiovascular Remodeling Experienced by Real-World, Unsupervised, Young Novice Marathon Runners

  • Andrew D’Silva,
  • Anish N. Bhuva,
  • Anish N. Bhuva,
  • Jet van Zalen,
  • Rachel Bastiaenen,
  • Amna Abdel-Gadir,
  • Amna Abdel-Gadir,
  • Siana Jones,
  • Niromila Nadarajan,
  • Katia D. Menacho Medina,
  • Katia D. Menacho Medina,
  • Yang Ye,
  • Joao Augusto,
  • Thomas A. Treibel,
  • Thomas A. Treibel,
  • Stefania Rosmini,
  • Stefania Rosmini,
  • Manish Ramlall,
  • Manish Ramlall,
  • Paul R. Scully,
  • Paul R. Scully,
  • Camilla Torlasco,
  • James Willis,
  • Gherardo Finocchiaro,
  • Efstathios Papatheodorou,
  • Harshil Dhutia,
  • Della Cole,
  • Irina Chis Ster,
  • Alun D. Hughes,
  • Rajan Sharma,
  • Charlotte Manisty,
  • Charlotte Manisty,
  • Guy Lloyd,
  • Guy Lloyd,
  • James C. Moon,
  • James C. Moon,
  • Sanjay Sharma

DOI
https://doi.org/10.3389/fphys.2020.00232
Journal volume & issue
Vol. 11

Abstract

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AimsMarathon 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.MethodsSixty-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.ResultsAfter 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).ConclusionIn 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.

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