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


, : Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run. Circulation 70(3): 350-356

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.

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Accession: 005411495

PMID: 6744539

DOI: 10.1161/01.CIR.70.3.350

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