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Biological markers of cardiac damage are not related to measures of cardiac systolic and diastolic function using cardiovascular magnetic resonance (CMR) and echocardiography following an acute bout of prolonged endurance exercise.
  1. Mathew G Wilson1,*,
  2. Rory O'Hanlon2,
  3. Sanjay Prasad2,
  4. David Oxborough3,
  5. Richard Godfrey4,
  6. Francisco Alpendurada2,
  7. Gill Smith2,
  8. Joyce Wong2,
  9. Sandeep Basavarajaiah5,
  10. Sanjay Sharma5,
  11. Alan Nevill1,
  12. David Gaze6,
  13. Keith George7,
  14. Gregory Whyte7
  1. 1 Research Centre for Sport and Exercise Science, University of Wolverhampton, United Kingdom;
  2. 2 Department of Cardiac Magnetic Resonance Imaging, Royal Brompton and Harefield NHS Trust, United Kingdom;
  3. 3 University of Leeds, Leeds, United Kingdom;
  4. 4 Sport and Exercise Science, Brunel University, United Kingdom;
  5. 5 Department of Heart Muscle Disorders, Kings College London, United Kingdom;
  6. 6 Department of Clinical Biochemistry, St. Georges Hospital Medical School, United Kingdom;
  7. 7 Research Institute for Sport and Exercise Science, Liverpool John Moores University, United Kingdom
  1. Correspondence to: Mathew G Wilson, University of Wolverhampton, School of Sport, Performing Arts and Leisure, Walsall Campus, Gorway Road, Walsall, WS1 3BD, United Kingdom; mat.wilson{at}


Objectives: Seventeen male participants (age 33.5 ± 6.5 years [46-26 yrs], body mass 80 ± 9.2 kg [100-63 kg], height 1.81 ± 0.06 m [1.93-1.70 m]) ran a marathon to investigate the relationship between systolic function (using cardiac magnetic resonance; CMR) and diastolic function (using echocardiography) against biomarkers of cardiac damage.

Methods: Echocardiographic and cTnI/NT-pro-BNP data were collected 24h prior, immediately post- and 6h post-marathon. CMR data was collected 24h prior and at 6h post-marathon.

Results: Body mass was significantly reduced post-marathon (80 ± 9.2 vs. 78.8 ± 8.6 kg, p<0.001). There was a significant E/A reduction post-marathon (1.11 ± 0.34 vs. 1.72 ± 0.44; p<0.05), that remained depressed 6h post-marathon (1.49 ± 0.43; p<0.05). CMR demonstrated left ventricular (LV) end-diastolic and end-systolic volumes were reduced post-marathon, with a preserved stroke volume (SV). LV ejection fraction (EF) 6h post-marathon significantly increased (64.4% ± 4.2% vs. 67.4% ± 5%; p<0.05). There were significant elevations in cTnI (0.00 vs. 0.04 ± 0.03 μg/L; p<0.05) and NTproBNP (37.4 ± 24.15 vs. 59.34 ± 43.3; p<0.05) immediately post marathon. Eight runners had cTnI elevations immediately post-marathon above acute myocardial infarction cut off levels (AMI; ≥ 0.03 μg/L). No correlations between cTnI/NTproBNP and measures of diastolic function (E, A, E/A, IVRT, E deceleration time and E/E′) or measures of systolic function (SV or EF) were observed post- or 6h post marathon.

Conclusions: Biomarkers of cardiac damage following prolonged exercise are not associated with either systolic or diastolic functional measures.

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