Abstract
AimsMarathon 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.MethodsSixty-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.ResultsAfter 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 (P < 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 (P = 0.14).ConclusionIn 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.
Highlights
The final cohort of marathon completers consisted of 68 novice runners who underwent evaluations at study entry, 186 ± 4 days before the London Marathon in October 2015 and 16 ± 4 days after in May 2016 (Figure 2)
Though a 4/2 mmHg blood pressure (BP) reduction seems small, this is highly consistent with the effect of exercise on BP reported in large meta-analyses, which is comparable with the effect of antihypertensive medication (Cornelissen and Smart, 2013; Naci et al, 2018) and on aortic pulse wave velocity (Ashor et al, 2014)
Despite ongoing concerns regarding the cardiovascular safety of marathon running, this study demonstrates a reduction in BP and vascular stiffness in real-world, young, normotensive men and women
Summary
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. Subjects were considered for inclusion if they were aged 18–35 years old and had never run a marathon distance previously. Novice marathon runners within the specified age range, totaling 4,170, were identified through the database records of the organizers (Virgin Money London Marathon) and received notification of the study through a targeted e-mail advertisement 2 weeks after notification of their place in the 2016 London Marathon. The London Marathon is run over a predominantly flat course, through the capital city center around the river Thames, covering 42.2 km (26 miles and 385 yards).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
