Changes of intima-media thickness in marathon runners: A mid-term follow-up

Objective Carotid intima-media thickness (IMT) is used to assess cardiovascular risk and progression of atherosclerosis. It is known that regular physical activity of moderate intensity has beneficial effects on the vasculature. However, it is still discussed controversially whether prolonged exercise, including participation in exhaustive competitive sports such as long-distance races, has also beneficial effects or might even be harmful regarding the cardiovascular system. Patients and methods Thirty-eight male marathon runners (45.8 ± 7.3 years) were investigated twice (2009 and 2013) for their carotid IMT (using ultrasound techniques), anthropometrics and clinical chemistry. Additionally, training volume (running kilometres per year) and competition participation (half marathon, marathon and ultramarathon) within this follow-up period were assessed. Results During 3.8 ± 0.4 years of follow-up, runners performed 1587 (850–2500) training kilometres per year and participated in a total of 7 (4–12) long distance competitions. IMT increased in total by 0.05 ± 0.09 mm or annually by 0.013 ± 0.023 mm, respectively. Higher increase in IMT over that period was associated with higher fasting blood glucose (beta = .355, p = .045) at baseline examination. Effects of training volume and number of competitions on the progression of IMT could not be demonstrated in our longitudinal analysis. Conclusions Higher blood glucose levels are associated with detrimental effects on vasculature in otherwise healthy male marathon runners. Regular marathon training, including competition participation over at least several years, was not associated with detrimental effects on IMT or, vice versa, seems not to provide beneficial effects on vasculature.

[1]  T. Jørgensen,et al.  Work and leisure time sitting and inactivity: Effects on cardiorespiratory and metabolic health , 2016, European journal of preventive cardiology.

[2]  A. Gerche The Potential Cardiotoxic Effects of Exercise. , 2016 .

[3]  H. Heidbuchel,et al.  Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie? , 2015, British Journal of Sports Medicine.

[4]  I-Min Lee,et al.  Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. , 2015, JAMA internal medicine.

[5]  R. Oberhoffer,et al.  Acute Effects of Submaximal Endurance Training on Arterial Stiffness in Healthy Middle‐ and Long‐Distance Runners , 2015, Journal of clinical hypertension.

[6]  J. O’Keefe,et al.  Dose of jogging and long-term mortality: the Copenhagen City Heart Study. , 2015, Journal of the American College of Cardiology.

[7]  T. Naqvi,et al.  Carotid intima-media thickness and plaque in cardiovascular risk assessment. , 2014, JACC. Cardiovascular imaging.

[8]  S. Blair,et al.  Leisure-time running reduces all-cause and cardiovascular mortality risk. , 2014, Journal of the American College of Cardiology.

[9]  D. Warburton,et al.  Long-term ultra-marathon running and arterial compliance. , 2014, Journal of science and medicine in sport.

[10]  A. Ivey,et al.  Temporal Response of Arterial Stiffness to Ultra-Marathon , 2014, International Journal of Sports Medicine.

[11]  C. Held,et al.  Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. , 2013, European heart journal.

[12]  Lu Gao,et al.  Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data , 2012, The Lancet.

[13]  Jan Bogaert,et al.  Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. , 2012, European heart journal.

[14]  K. Heffernan How Healthy Were the Arteries of Phidippides? , 2012, Clinical cardiology.

[15]  A. Pressler,et al.  Acute and chronic effects of marathon running on the retinal microcirculation. , 2011, Atherosclerosis.

[16]  J. Viikari,et al.  Association of Physical Activity With Vascular Endothelial Function and Intima-Media Thickness , 2011, Circulation.

[17]  A. Pressler,et al.  72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon. , 2011, Medicine and science in sports and exercise.

[18]  K. Jöckel,et al.  Carotid and peripheral atherosclerosis in male marathon runners. , 2011, Medicine and science in sports and exercise.

[19]  Christodoulos Stefanadis,et al.  Arterial stiffness and wave reflections in marathon runners. , 2010, American journal of hypertension.

[20]  Christopher B. Kendall,et al.  Incidence of subclinical atherosclerosis as a marker of cardiovascular risk in retired professional football players. , 2010, The American journal of cardiology.

[21]  G. Boysen,et al.  European Guidelines on Cardiovascular Disease Prevention , 2009, International journal of stroke : official journal of the International Stroke Society.

[22]  E. Vicaut,et al.  Country-Based Reference Values and Impact of Cardiovascular Risk Factors on Carotid Intima-Media Thickness in a French Population: The ‘Paroi Artérielle et Risque Cardio-Vasculaire’ (PARC) Study , 2009, Cerebrovascular Diseases.

[23]  Klaus Mann,et al.  Running: the risk of coronary events : Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. , 2008, European heart journal.

[24]  Christopher B. Kendall,et al.  Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[25]  J. Ganame,et al.  Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment. , 2007, European heart journal.

[26]  Matthias W. Lorenz,et al.  Prediction of Clinical Cardiovascular Events With Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis , 2007, Circulation.

[27]  J. Sharman,et al.  The effect of exercise on large artery haemodynamics in healthy young men , 2005 .

[28]  P. Prati,et al.  The San Daniele 2 Project: protocol description and population characteristics. , 2003, Italian heart journal : official journal of the Italian Federation of Cardiology.

[29]  H. Heidbuchel,et al.  High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. , 2003, European heart journal.

[30]  Hirofumi Tanaka,et al.  Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men. , 2002, Journal of applied physiology.

[31]  J. Ménard,et al.  Vascular and cardiac remodeling in world class professional cyclists. , 1998, American heart journal.

[32]  D. Levy,et al.  Prediction of coronary heart disease using risk factor categories. , 1998, Circulation.

[33]  A. Zanchetti,et al.  Similarities and differences in structural and functional changes of left ventricle and carotid arteries in young borderline hypertensives and in athletes , 1996, Journal of hypertension.

[34]  D. Ku,et al.  Hemodynamics and atherosclerosis. Insights and perspectives gained from studies of human arteries. , 1988, Archives of pathology & laboratory medicine.

[35]  D. Costill,et al.  Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. , 1974, Journal of applied physiology.

[36]  Massimo F. Piepoli,et al.  2016 European Guidelines on cardiovascular disease prevention in clinical practice , 2017, International Journal of Behavioral Medicine.

[37]  A. Pressler,et al.  Associations between Borg’s rating of perceived exertion and physiological measures of exercise intensity , 2012, European Journal of Applied Physiology.

[38]  R. J. Shephard,et al.  Cardiac Arrest during Long-Distance Running Races , 2012 .

[39]  R. Shephard Nonalcoholic Beer Reduces Inflammation and Incidence of Respiratory Tract Illness , 2012 .

[40]  K. George,et al.  Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[41]  A S Jackson,et al.  Prediction accuracy of body density, lean body weight, and total body volume equations. , 1977, Medicine and science in sports.