Abstract
BackgroundParticipation of amateur runners in endurance races continues to increase. Previous studies of marathon runners have raised concerns about exercise-induced myocardial and renal dysfunction and damage. In our pooled analysis, we aimed to characterize changes of cardiac and renal function after marathon running in a large cohort of mostly elderly amateur marathon runners.MethodsA total of 167 participants of the BERLIN-MARATHON (female n = 89, male n = 78; age = 50.3 ± 11.4 years) were included and cardiac and renal function was analyzed prior to, immediately after and 2 weeks following the race by echocardiography and blood tests (including cardiac troponin T, NT-proBNP and cystatin C).ResultsAmong the runners, 58% exhibited a significant increase in cardiac biomarkers after completion of the marathon. Overall, the changes in echocardiographic parameters for systolic or diastolic left and right ventricular function did not indicate relevant myocardial dysfunction. Notably, 30% of all participants showed >25% decrease in cystatin C-estimated glomerular filtration rate (GFR) from baseline directly after the marathon; in 8%, we observed a decline of more than 50%. All cardiac and renal parameters returned to baseline ranges within 2 weeks after the marathon.ConclusionsThe increase in cardiac biomarkers after completing a marathon was not accompanied by relevant cardiac dysfunction as assessed by echocardiography. After the race, a high proportion of runners experienced a decrease in cystatin C-estimated GFR, which is suggestive of transient, exercise-related alteration of renal function. However, we did not observe persistent detrimental effects on renal function.Electronic supplementary materialThe online version of this article (doi:10.1186/s12947-015-0007-6) contains supplementary material, which is available to authorized users.
Highlights
Participation of amateur runners in endurance races continues to increase
There was a significant increase of hemoglobin, hematocrit, protein and sodium in the blood immediately after the marathon indicating dehydration (Table 2)
Levels of CRP were within the normal range immediately after the race, but significantly lower compared to baseline values (Table 3)
Summary
Participation of amateur runners in endurance races continues to increase. Previous studies of marathon runners have raised concerns about exercise-induced myocardial and renal dysfunction and damage. Participation of non-elite, recreational runners (including elderly participants) in long-distance running events such as full or half marathons has increased in recent years. Sport related deaths occur very rarely, several previous studies have reported detrimental, exerciseinduced effects on myocardial function as assessed by echocardiography, cardiac magnet resonance imaging (CMR) or elevated cardiac biomarkers such as troponin or NT-proBNP after running a marathon [2,3,4,5,6,7] It is not fully determined yet whether changes in cardiac parameters solely represent a transient physiological response to the exercise or may even signify persistent cardiac structural changes and dysfunction [8,9]. Transient increases of serum creatinine, cystatin C and urea nitrogen, indicating renal dysfunction, have been described after completion of a marathon [6,10,11]
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