Athletes engaging in a chronic intense endurance exercise are at increased risk of developing supraventricular and ventricular arrhythmias [ [1] ]. Permanent alterations in myocardial function and structure, including myocardial fibrosis, are present in a high proportion of veteran endurance athletes and suspected to be a substrate for arrhythmias [ 2 , 3 ]. However, little is known about the acute effect of ultra-endurance (UE) exercise on short term myocardial inflammation and fibrosis in younger subjects. Here, we report data regarding myocardial function and structure in a 32 year old woman (VO2max: 50 mL·kg−1·min−1) who took part in the Marathon des Sables, a 6-stage 236 km race (stage length: 34–81.5-km) across the Sahara Desert (Morocco) with food autonomy. Cardiac biomarker analysis and cardiac magnetic resonance (Siemens Magnetom Aera, 1.5 T) were performed before and 4 days postrace. Assessment of myocardial inflammation was performed using a black blood T2-weighted triple inversion recovery Turbo Spin Echo sequence. Late Gadolinium Enhancement (LGE) Imaging was performed 10 min after gadolinium injection (40 mL, Multihance, Bracco) and provided short axes, long axes and 4 chamber views using a two-dimension (2D) inversion-recovery gradient echo sequence. Tissue Doppler and 2D Speckle Tracking Echocardiography (STE) (Vivid Q and Vivid 9, General Electric-Healthcare) were performed before the race, on the 2nd and 5th race days, and 4 day postrace. Heart rate (HR) was continuously monitored using a heart rate sensor device (Actiheart, Cambridge Neurotechnology) and expressed as a percentage of HR reserve (HRR), calculated as the difference between resting HR and maximal HR measured during a maximal exercise test (200 bpm). Results are reported in Table 1. Hyper sensitive Troponine T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (ECLIA, Roche Diagnostics) were within the normal limits and little changed after the race (5 to 6 ng·L−1 and 24 to 27 ng·L−1 respectively). Mean heart rate ranged between 58% of HRR during the 81 km-stage to 83% during the last 42.2 km stage. Concerning CMR imaging, the comparison of the T2 ratio between the myocardial signal intensity and the latissimus dorsi muscle signal intensity before (1.46) and after (1.54) the race did not indicate any sign of global or local myocardial inflammation as a value >1.9 is required for the diagnosis of global myocardial oedema or inflammation [ [4] ]. LGE images showed no sign of myocardial fibrosis development after the race

Direct Link: https://doi.org/10.1016/j.ijcard.2014.10.075

Journal: International journal of cardiology. 2015 Jan 20;179:20-2

Keywords: athletes, cardiac magnetic resonance, echocardiography, Heart Rate, myocardial function, ultra-endurance exercise,

Applications: Heart Rate,

CamNtech Reference: AH15058

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