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Erschienen in: Wiener klinische Wochenschrift 5-6/2016

01.03.2016 | original article

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

verfasst von: Dr. G. Montiel, T. Horn, Dr. R. Vafa, Dr. A. Solera, Prof. Dr. mult. W. Hollmann, Prof. Dr. H.G. Predel, Dr. C. Brinkmann

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 5-6/2016

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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.
Literatur
1.
Zurück zum Zitat Godfather RR, O’Neill JR. American women in marathon. Sports Med. 2007;37:294–98.CrossRef Godfather RR, O’Neill JR. American women in marathon. Sports Med. 2007;37:294–98.CrossRef
2.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
3.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
4.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
5.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
6.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
7.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
8.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
9.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
10.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
11.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
12.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
13.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
14.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
15.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
16.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
17.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
18.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
19.
Zurück zum Zitat 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.CrossRef 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.CrossRef
Metadaten
Titel
Echocardiographic and biochemical analysis of cardiac function and injury among female amateur runners post-marathon
verfasst von
Dr. G. Montiel
T. Horn
Dr. R. Vafa
Dr. A. Solera
Prof. Dr. mult. W. Hollmann
Prof. Dr. H.G. Predel
Dr. C. Brinkmann
Publikationsdatum
01.03.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 5-6/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0881-9

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