Increased longitudinal contractility and diastolic function at rest in well-trained amateur Marathon runners: a speckle tracking echocardiography study

Sebastian Schattke,Gert Baumann,Fabian Knebel,Sabrina Schroeckh,Sebastian Spethmann,Lars Brechtel,Yan Xing,Adrian C Borges,Jürgen Lock

doi:10.1186/1476-7120-12-11

Abstract

BackgroundRegular physical activity reduces cardiovascular risk. There is concern that Marathon running might acutely damage the heart. It is unknown to what extent intensive physical endurance activity influences the cardiac mechanics at resting condition.MethodsEighty-four amateur marathon runners (43 women and 41 men) from Berlin-Brandenburg area who had completed at least one marathon previously underwent clinical examination and echocardiography at least 10 days before the Berlin Marathon at rest. Standard transthoracic echocardiography and 2D strain and strain rate analysis were performed. The 2D Strain and strain rate values were compared to previous published data of healthy untrained individuals.ResultsThe average global longitudinal peak systolic strain of the left ventricle was -23 +/- 2% with peak systolic strain rate -1.39 +/- 0.21/s, early diastolic strain rate 2.0 +/- 0.40/s and late diastolic strain rate 1.21 +/- 0.31/s. These values are significantly higher compared to the previous published values of normal age-adjusted individuals. In addition, no age-related decline of longitudinal contractility in well-trained athletes was observed.ConclusionsThere is increased overall longitudinal myocardial contractility at rest in experienced endurance athletes compared to the published normal values in the literature indicating a preserved and even supra-normal contractility in the athletes. There is no age dependent decline of the longitudinal 2D Strain values. This underlines the beneficial effects of regular physical exercise even in advanced age.

Highlights

There is an increasing participation in long-distance running events; there is clear evidence that regular physical activity reduces cardiovascular risk [1,2,3]. It is unknown if the intensity of physical activity and the beneficial effects correlate linearly and whether Marathon running is dangerous for the cardiovascular system [4]
This study aims to describe the normal resting values of systolic and diastolic left ventricular function assessed by speckle tracking in amateur marathon runners, to compare the age dependence in this cohort and to compare the values with recently published normal values in non athletics
Subject characteristics Eighty-four marathon runners, 43 women and 41 men participated in this study

Summary

Introduction

There is an increasing participation in long-distance running events; there is clear evidence that regular physical activity reduces cardiovascular risk [1,2,3]. For routine application of myocardial two-dimensional strain in clinical practice normal ranges have been defined and published recently [12,13] It has been shown, that global 2D strain and strain rate are independent to age, gender, heart rate and systolic blood pressure [12]. It is known that diastolic left ventricular dysfunction has a higher prevalence in elderly and it leads to age-related normal values of mitral inflow velocities and time intervals [15,16] In contrast to this observation a small study described that left ventricular compliance can be preserved in elderly by regular endurance training [17]

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