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Echocardiographic and biochemical analysis of cardiac function and injury among female amateur runners post-marathon

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Summary

Background

Numerous studies with male amateur runners have determined negative changes in their cardiac function/of their myocard following long endurance loads. This study aims to examine such potential changes in women, specifically, after running a marathon.

Methods

A total of 18 female amateur runners (39.5 ± 10.5 years) were examined before (T1), immediately after (T2) and 24 h post-marathon (T3). An echocardiography was performed using Tissue Doppler (TD) imaging. In addition, the concentration of cardiac troponin T (cTnT) and the activity of the myocardial muscle creatine kinase (CK-MB) were determined at T1 and T2.

Results

The echocardiographic parameters revealed impairment of the diastolic function, without, however, documenting a diastolic dysfunction (in accordance with the classification of Nagueh (J Am Soc Echocardiogr, 22:107–33, 2009)). The ratio of blood flow velocity through the mitral valve during early versus late diastole (MV E/A ratio), for example, decreased. The values measured at T3 were similar to those measured at T1. The ratio of early transmitral diastolic filling velocity and of the transmitral diastolic filling velocity by TD imaging (MV E/E’) did not indicate any change from T1 to T2, but a significant increase at T3 (in comparison with T1). The systolic function (measured by the left ventricular ejection fraction) did not change significantly. The cTnT concentration and CK-MB activity were significantly higher in T2 than in T1.

Conclusion

The data collected does not provide any solid evidence of pathological changes in the cardiac function of female amateur runners post-marathon, although the lab values indicate a strongly increased myocardial stimulation.

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References

  1. Godfather RR, O’Neill JR. American women in marathon. Sports Med. 2007;37:294–98.

    Article  Google Scholar 

  2. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes. Analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119:1085–92.

    Article  PubMed  Google Scholar 

  3. Hanssen H, Keithahn A, Hertel G, Drexel V, Stern H, Schuster T, Lorang D, Beer AJ, Schmidt-Trucksäss A, Nickel T, Weis M, Botnar R, Schwaiger M, Halle M. Magnetic resonance imaging of myocardial injury and ventricular torsion after marathon running. Clin Sci. 2011;120:143–52.

    Article  PubMed  Google Scholar 

  4. Hart E, Shave R, Middleton N, George K, Whyte G, Oxborough D. Effect of preload augmentation on pulsed wave and tissue Doppler echocardiographic indices of diastolic function after a marathon. J Am Soc Echocardiogr. 2007;20:1393–9.

    Article  PubMed  Google Scholar 

  5. Middleton N, Shave R, George K, Whyte G, Forster J, Oxborough D, Gaze D, Collinson P. Novel application of flow propagation velocity and ischaemia-modified albumin in analysis of post exercise cardiac function in man. Exp Physiol. 2006;91:511–9.

    Article  CAS  PubMed  Google Scholar 

  6. Oxborough D, Whyte G, Wilson M, O’Hanlon R, Birch K, Shave R, Smith G, Godfrey R, Prasad S, George K. A depression in left ventricular diastolic filling following prolonged strenuous exercise is associated with changes in left atrial mechanics. J Am Soc Echocardiogr. 2010;23:968–76.

    Article  PubMed  Google Scholar 

  7. Shave R, Dawson EA, Whyte G, George K, Ball D, Gaze DC, Collinson PO. Evidence of exercise-induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race. Int J Sports Med. 2002;23:489–94.

    Article  CAS  PubMed  Google Scholar 

  8. Shave R, George K, Whyte G, Middleton N, Hart E, Artis N, Oxborough D. A comparison of Doppler, tissue Doppler imaging, and strain rate imaging in the assessment of post-exercise left ventricular function. Appl Physiol Nutr Metab. 2009;34:33–9.

    Article  PubMed  Google Scholar 

  9. Knebel F, Schimke I, Schroeckh S, Peters H, Eddicks S, Schattke S, Brechtel L, Lock J, Wernecke KD, Dreger H, Grubitz S, Schmidt J, Baumann G, Borges AC. Myocardial function in older male amateur marathon runners: assessment by tissue Doppler echocardiography, speckle tracking, and cardiac biomarkers. J Am Soc Echocardiogr. 2009;22:803–9.

    Article  PubMed  Google Scholar 

  10. Fortescue EB, Shin AY, Greenes DS, Mannix RC, Agarwal S, Feldman BJ, Shah MI, Rifai N, Landzberg MJ, Newburger JW, Almond CS. Cardiac troponin increases among runners in the Boston Marathon. Ann Emerg Med. 2007;49:137–43.

    Article  PubMed  Google Scholar 

  11. Jassal DS, Krahn J, Ahmadie R, Fang T, Eschu G, Sharma S. Cardiac injury markers in non elite marathon runners. Int J Sports Med. 2009;30:75–9.

    Article  CAS  PubMed  Google Scholar 

  12. Neilan TG, Januzzi JL, Lee-Lewandrowski E. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston Marathon. Circulation. 2006;114:2325–33.

    Article  PubMed  Google Scholar 

  13. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ; Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.

    Article  PubMed  Google Scholar 

  14. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22:107–33.

    Article  PubMed  Google Scholar 

  15. Manier G, Wickers F, Lomenech AM, Cazorla G, Roudaut R. Echocardiographic assessment of myocardial performance after prolonged strenuous exercise. Eur Heart J. 1991;12:1183–8.

    Article  CAS  PubMed  Google Scholar 

  16. Mingels AM, Jacobs LH, Kleijnen VW, Laufer EM, Winkens B, Hofstra L, Wodzig WK, van Dieijen-Visser MP. Cardiac troponin T elevations, using highly sensitive assay, in recreational running depend on running distance. Clin Res Cardiol. 2010;99:385–91.

    Article  CAS  PubMed  Google Scholar 

  17. James S, Armstrong P, Califf R, Simoons ML, Venge P, Wallentin L, Lindahl B. Troponin T levels and risk of 30-day outcomes in patients with the acute coronary syndrome: prospective verification in the GUSTO-IV trial. Am J Med. 2003;115:178–84.

    Article  CAS  PubMed  Google Scholar 

  18. Cummins P, Young A, Auckland ML, Michie CA, Stone PCW, Shepstone BJ. Comparison of serum cardiac specific troponin-I with creatine kinase, creatine kinase-MB isoenzyme, tropomyosin, myoglobin and C-reactive protein release in marathon runners: cardiac or skeletal muscle trauma? Eur J Clin Invest. 1987;17:317–24.

    Article  CAS  PubMed  Google Scholar 

  19. Siegel AJ, Yang JSM, Dhanak E, Lewandrowski KB. Elevated serum cardiac markers in asymptomatic marathon runners after competition: is the myocardium stunned? Cardiolology. 1997;88:487–91.

    Article  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank A. Schmitz for her excellent technical assistance.

Conflict of interest

Georgina Montiel, Thiemo Horn, Ramin Vafa, Andrea Solera, Wildor Hollmann, Hans-Georg Predel as well as Christian Brinkmann declare that they have no conflict of interest.

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Correspondence to C. Brinkmann.

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Montiel, G., Horn, T., Vafa, R. et al. Echocardiographic and biochemical analysis of cardiac function and injury among female amateur runners post-marathon. Wien Klin Wochenschr 128, 193–197 (2016). https://doi.org/10.1007/s00508-015-0881-9

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  • DOI: https://doi.org/10.1007/s00508-015-0881-9

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