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Research paper
Published online: 2019-12-09
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The “athlete’s heart” features in amateur male marathon runners

Zuzanna Lewicka-Potocka, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Anna Maria Kaleta, Karolina Dorniak, Ludmiła Daniłowicz-Szymanowicz, Marcin Fijałkowski, Izabela Nabiałek-Trojanowska, Wojciech Ratkowski, Wojciech Potocki, Grzegorz Raczak
DOI: 10.5603/CJ.a2019.0110
·
Pubmed: 31909474

open access

Ahead of print
Original articles
Published online: 2019-12-09

Abstract

Background: Training on a professional level can lead to cardiac structural adaptations called the “athlete’s heart”. As marathon participation requires intense physical preparation, the question arises whether the features of “athlete’s heart” can also develop in recreational runners.

Methods: The study included 34 males (mean age 40 ± 8 years) who underwent physical examination, a cardiopulmonary exercise test and echocardiographic examination (ECHO) before a marathon. ECHO results were compared with the sedentary control group, reference values for an adult male population and those for highly-trained athletes. Runners with abnormalities revealed by ECHO were referred for cardiac magnetic resonance imaging (CMR).

Results: The mean training distance was 56.5 ± 19.7 km/week, peak oxygen uptake was 53.7 ± 6.9 mL/kg/min and the marathon finishing time was 3.7 ± 0.4 h. Compared to sedentary controls, amateur athletes presented larger atria, increased left ventricular (LV) wall thickness, larger LV mass and basal right ventricular (RV) inflow diameter (p < 0.05). When compared with ranges for the general adult population, 56% of participants showed increased left atrial volume, indexed to body surface area (LAVI), 56% right atrial area and interventricular septum thickness, while 47% had enlarged RV proximal outflow tract diameter. In 50% of cases, LAVI exceeded values reported for highly-trained athletes. Due to ECHO abnormalities, CMR was performed in 6 participants, which revealed hypertrophic cardiomyopathy in 1 runner.

Conclusions: “Athlete’s heart” features occur in amateur marathon runners. In this group, ECHO reference values for highly-trained elite athletes should be considered, rather than those for the general population and even then LAVI can exceed the upper normal value.

Abstract

Background: Training on a professional level can lead to cardiac structural adaptations called the “athlete’s heart”. As marathon participation requires intense physical preparation, the question arises whether the features of “athlete’s heart” can also develop in recreational runners.

Methods: The study included 34 males (mean age 40 ± 8 years) who underwent physical examination, a cardiopulmonary exercise test and echocardiographic examination (ECHO) before a marathon. ECHO results were compared with the sedentary control group, reference values for an adult male population and those for highly-trained athletes. Runners with abnormalities revealed by ECHO were referred for cardiac magnetic resonance imaging (CMR).

Results: The mean training distance was 56.5 ± 19.7 km/week, peak oxygen uptake was 53.7 ± 6.9 mL/kg/min and the marathon finishing time was 3.7 ± 0.4 h. Compared to sedentary controls, amateur athletes presented larger atria, increased left ventricular (LV) wall thickness, larger LV mass and basal right ventricular (RV) inflow diameter (p < 0.05). When compared with ranges for the general adult population, 56% of participants showed increased left atrial volume, indexed to body surface area (LAVI), 56% right atrial area and interventricular septum thickness, while 47% had enlarged RV proximal outflow tract diameter. In 50% of cases, LAVI exceeded values reported for highly-trained athletes. Due to ECHO abnormalities, CMR was performed in 6 participants, which revealed hypertrophic cardiomyopathy in 1 runner.

Conclusions: “Athlete’s heart” features occur in amateur marathon runners. In this group, ECHO reference values for highly-trained elite athletes should be considered, rather than those for the general population and even then LAVI can exceed the upper normal value.

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Keywords

echocardiography, cardiac magnetic resonance, athlete’s heart, marathon runners; sport cardiology, hypertrophic cardiomyopathy

About this article
Title

The “athlete’s heart” features in amateur male marathon runners

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Research paper

Published online

2019-12-09

DOI

10.5603/CJ.a2019.0110

Pubmed

31909474

Keywords

echocardiography
cardiac magnetic resonance
athlete’s heart
marathon runners
sport cardiology
hypertrophic cardiomyopathy

Authors

Zuzanna Lewicka-Potocka
Alicja Dąbrowska-Kugacka
Ewa Lewicka
Anna Maria Kaleta
Karolina Dorniak
Ludmiła Daniłowicz-Szymanowicz
Marcin Fijałkowski
Izabela Nabiałek-Trojanowska
Wojciech Ratkowski
Wojciech Potocki
Grzegorz Raczak

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