Circulation, Vol 70, 350-356, Copyright © 1984 by American Heart Association
KO Niemela, IJ Palatsi, MJ Ikaheimo, JT Takkunen and JJ Vuori
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 hr run, completing distances of
114 to 227 km. Although the left ventricular end-diastolic dimension (EDD)
was reduced by 7% (54 +/- 5 to 50 +/- 7 mm; p less than .005), the
end-systolic dimension (ESD) increased slightly (33 +/- 5 to 34 +/- 6 mm;
NS). As a consequence, the stroke dimension (21 +/- 2 to 16 +/- 2 mm; p
less than .005) and fractional shortening (38 +/- 5% to 32 +/- 5%; p less
than .005) declined by 24% and 16%, respectively. The reduction in
fractional shortening was related to delta ESD (r = -.66; p less than .05)
but not to delta EDD (r = .22; NS). In spite of reduced afterload, the mean
velocity of circumferential fiber shortening also decreased by an average
of 9% (p less than .01) in proportion to the distance completed (r = -.69;
p less than .01). The systolic blood pressure/ESD ratio was 21% lower after
the race (4.2 +/- 0.9 to 3.3 +/- 0.6; p less than .005). Body weight 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 hr of the race but returned to the
prerace level 2 to 3 days after the race. Total serum creatine kinase
peaked at 3917 to 64740 U/liter (mean 27427) and its MB percentage peaked
at 2% to 6%.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run
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