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Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run






Circulation 70(3): 350-356

Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run

The effect of extremely exhaustive exercise on left ventricular performance was studied echocardiographically in 13 experienced male ultramarathon runners who took part in a competitive 24 h run, completing distances of 114-227 km. Although the left ventricular end-diastolic dimension (EDD) was reduced by 7% (54 .+-. 5 to 50 .+-. 7 mm; P < 0.005), the end-systolic dimension (ESD) increased slightly (33 .+-. 5 to 34 .+-. 6 mm; NS [not significant]). As a consequence, the stroke dimension (21 .+-. 2 to 16 .+-. 2 mm; P < 0.005) and fractional shortening (38 .+-. 5% to 32 .+-. 5%; P < 0.005) declined by 24% and 16%, respectively. The reduction in fractional shortening was related to .DELTA.ESD (r = - 0.066; P < 0.05) but not to .DELTA.EDD (r = 0.22; NS). In spite of reduced afterload, the mean velocity of circumferential fiber shortening also decreased by an average of 9% (P < 0.01) in proportion to the distance completed (r = - 0.69; P < 0.01). The systolic blood pressure/ESD ratio was 21% lower after the race (4.2 .+-. 0.9 to 3.3 .+-. 0.6; P < 0.005). Body wt loss was not related to any alterations in left ventricular dimensions or ejection phase indexes. The stroke dimension and ejection phase indexes continued to decline within the last 6 h of the race but returned to the prerace level 2-3 days after the race. Total serum creatine kinase peaked at 3917-64,740 U/l (mean 27,427) and its MB percentage peaked at 2-6%. No ECG evidence of myocardial injury was seen immediately after the race. Highly strenuous prolonged exercise thus appears to result in impaired resting left ventricular function, in part because of a reversible depression in the contractile state. The possibility of cardiac fatigue suggests a need for strict selection of ultramarathon participants.


Accession: 005411495

PMID: 6744539

DOI: 10.1161/01.CIR.70.3.350



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