Abstract
This single-blind and cross-sectional study evaluated the role of Rho-kinase (ROCK) as a biomarker of the cardiovascular remodelling process assessed by echocardiography in competitive long-distance runners (LDRs) during the training period before a marathon race. Thirty-six healthy male LDRs (37.0 ± 5.3 years; 174.0 ± 7.0 height; BMI: 23.8 ± 2.8; O2-peak: 56.5 ± 7.3 mL·kg−1·min−1) were separated into two groups according to previous training level: high-training (HT, n = 16) ≥ 100 km·week−1 and low-training (LT, n = 20) ≥ 70 and < 100 km·week−1. Also, twenty-one healthy nonactive subjects were included as a control group (CTR). A transthoracic echocardiography was performed and ROCK activity levels in circulating leukocytes were measured at rest (48 h without exercising) the week before the race. The HT group showed a higher left ventricular mass index (LVMi) and left atrial volume index (LAVi) than other groups (p < 0.05, for both); also, higher levels of ROCK activity were found in LDRs (HT = 6.17 ± 1.41 vs. CTR = 1.64 ± 0.66 (p < 0.01); vs. LT = 2.74 ± 0.84; (p < 0.05)). In LDRs a direct correlation between ROCK activity levels and LVMi (r = 0.83; p < 0.001), and LAVi (r = 0.70; p < 0.001) were found. In conclusion, in male competitive long-distance runners, the load of exercise implicated in marathon training is associated with ROCK activity levels and the left cardiac remodelling process assessed by echocardiography.
Highlights
Physical exercise plays a fundamental role in cardiovascular disease prevention and significantly reduces global mortality [1]
The cardiac remodelling process can occur early during the training process [4]. Trained runners experience these changes with greater prevalence and intensity, which in most cases are benign and reversible [2]—a condition called “athlete’s heart” [5] that includes increased bi-ventricular diameter, left ventricle (LV) parietal thickness, LV mass and bi-atrial volume with systolic and normal diastolic function [6]
The majority of these changes are a physiological adaptation to exercise; some patterns may overlap with channelopathies or cardiomyopathies [7]; LV hypertrophy criteria are present in as many as 70% of highly trained athletes [8], and only 12% showed criteria for right ventricular hypertrophy [9]
Summary
Physical exercise plays a fundamental role in cardiovascular disease prevention and significantly reduces global mortality [1] This benefit is associated with different mechanisms linked to structural changes or “adaptation” of the heart [2]. Trained runners experience these changes with greater prevalence and intensity, which in most cases are benign and reversible [2]—a condition called “athlete’s heart” [5] that includes increased bi-ventricular diameter, left ventricle (LV) parietal thickness, LV mass and bi-atrial volume with systolic and normal diastolic function [6]. The majority of these changes are a physiological adaptation to exercise; some patterns may overlap with channelopathies or cardiomyopathies [7]; LV hypertrophy criteria are present in as many as 70% of highly trained athletes [8], and only 12% showed criteria for right ventricular hypertrophy [9]
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