D'Silva Andrew, Bhuva Anish N, van Zalen Jet, Bastiaenen Rachel, Abdel-Gadir Amna, Jones Siana, Nadarajan Niromila, Menacho Medina Katia D, Ye Yang, Augusto Joao, Treibel Thomas A, Rosmini Stefania, Ramlall Manish, Scully Paul R, Torlasco Camilla, Willis James, Finocchiaro Gherardo, Papatheodorou Efstathios, Dhutia Harshil, Cole Della, Chis Ster Irina, Hughes Alun D, Sharma Rajan, Manisty Charlotte, Lloyd Guy, Moon James C, Sharma Sanjay
Cardiology Clinical and Academic Group, St George's, University of London, London, United Kingdom.
Institute for Cardiovascular Science, University College London, London, United Kingdom.
Front Physiol. 2020 Mar 18;11:232. doi: 10.3389/fphys.2020.00232. eCollection 2020.
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.
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.
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 ( < 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 ( = 0.14).
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.
马拉松跑步是现代社会中包括非运动员在内的人们普遍追求的目标。先前的研究强调了赛后立即出现的短暂性心肌功能障碍和生物标志物释放问题。这种增加身体活动的方式是有益还是有害仍存在争议。我们详细研究了首次参加马拉松比赛后现实世界中的心血管重塑反应。
在一项前瞻性观察研究中，对68名年龄为30±3岁的新手马拉松跑者（36名男性和32名女性）在2016年伦敦马拉松比赛前6个月和赛后2周进行了调查。评估包括心电图、心肺运动测试、超声心动图和心血管磁共振成像。
经过17周的无监督马拉松训练后，跑者表现出对称的离心性重塑反应，左、右心室腔大小分别增加3% - 5%。血压下降了4/2 mmHg（P<0.01），动脉僵硬度降低，尽管只有11%的人在峰值耗氧量方面有临床意义的改善，总体峰值耗氧量非显著性增加0.4 ml/min/kg（P = 0.14）。
在没有监督训练的情况下，现实世界中的新手马拉松跑者运动诱导的心血管重塑比先前描述的更为适度，甚至在心肺适能没有改善的情况下也会发生。男性和女性的反应相似，在达到平均完赛时间时，他们的血压有益降低，且没有心肌纤维化或持续性水肿的证据。
