Abstract
Background. Endurance sports practice has significantly increased over the last decades, with a growing proportion of master athletes. However, concerns exist regarding the potential proarrhythmic effects induced by ultra-endurance sports. This study aimed to analyse the acute effects of an ultramarathon race on atrial remodelling and supraventricular arrhythmias in a population of master athletes. Methods. Master athletes participating in an ultramarathon (50 km, 600 m of elevation gain) with no history of heart disease were recruited. A single-lead ECG was recorded continuously from the day before to the end of the race. Echocardiography and 12-lead resting ECG were performed before and immediately at the end of the race. Results. The study sample consisted of 68 healthy non-professional master athletes. Compared with baseline, P wave voltage was higher after the race (p < 0.0001), and more athletes developed ECG criteria for right atrial enlargement (p < 0.0001). Most of the athletes (97%) had ≥1 premature atrial beats (PAB) during the 24-h monitoring, also organised in triplets (17%) and non-sustained supraventricular tachycardias (NSSVTs) (19%). In contrast, exercise-induced PABs, triplets, and NSSVTs were rare. One athlete developed acute atrial fibrillation during the race. After the race, no significant differences were found in biatrial dimensions. Biatrial function, estimated by peak atrial longitudinal and contraction strains, were normal both before and after the race. Conclusions. In master athletes running an ultramarathon, acute exercise-induced atrial dysfunction was not detected, and exercise-induced supraventricular arrhythmias were uncommon. These results did not confirm the hypothesis of an acute atrial dysfunction induced by ultra-endurance exercise.
Highlights
Moderate exercise has well-recognised favourable effects on the cardiovascular system, but there is an incomplete understanding of the entire dose–response relationship [1,2,3]
right atrium enlargement (RAE) and left atrium enlargement (LAE) were found in 7.4% and 32.4% of the athletes, respectively
No significant differences were found in PR interval, P wave duration, or LAE
Summary
Moderate exercise has well-recognised favourable effects on the cardiovascular system, but there is an incomplete understanding of the entire dose–response relationship [1,2,3]. High-intensity exercise sessions may cause a transient rise in cardiac and inflammatory biomarkers, acute inflammation, increased atrial wall tension, and atrial dysfunction [16,17] These modifications are reversible, it has been postulated that atrial damage may develop after years of intense physical exercise, generating a substrate for atrial arrhythmias [16,17]. This study aimed to analyse the acute effects of an ultramarathon race on atrial remodelling and supraventricular arrhythmias in a population of master athletes. In master athletes running an ultramarathon, acute exercise-induced atrial dysfunction was not detected, and exercise-induced supraventricular arrhythmias were uncommon. These results did not confirm the hypothesis of an acute atrial dysfunction induced by ultra-endurance exercise
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