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Right ventricular adaptations and arrhythmias in amateur ultra-endurance athletes


Objective Ultra-endurance sports are becoming increasingly popular in middle-aged amateur athletes. Right ventricular (RV) arrhythmogenic remodelling has been described in high-level endurance athletes, like professional cyclists. The clinical relevance for amateurs is unknown.

Design We investigated male amateur runners of the 2011 Grand Prix of Bern, a popular 10-mile race in Switzerland. Participants were stratified according to their former participations in long-distance competitions: active controls (leisure-time runners), marathon runners and ultra-endurance athletes (78 and 100 km runners, long-distance triathletes). RV function and morphology were assessed by echocardiography, including two-dimensional speckle tracking. Primary endpoint was RV global strain. Ventricular ectopy was assessed by 24 h ambulatory Holter monitoring. Results were adjusted for lifetime training hours.

Results 97 normotensive athletes were included in the final analysis. The mean age was 42±8 years. Compared with active controls and marathon runners, ultra-endurance athletes had significantly more lifetime training hours and participated more often in competitions. Groups showed no differences with regard to RV global strain (–21.8±2.9 vs −23.3±2.8 vs −21.7±2.3%; p=0.973) and RV end-diastolic area (22.1±2.9 vs 22.9±4.2 vs 23.2±3.5 cm2; p=0.694). The number of premature ventricular contractions (PVCs) was weakly associated with the RV size (r=0.208; p=0.042). Overall ventricular ectopy was low (0–486 PVCs/24 h) and equally distributed between the groups.

Conclusions In our small sample of amateur athletes, long-term ultra-endurance sport practice was not associated with RV dysfunction or complex ventricular arrhythmias.

  • Endurance
  • Cardiology Physiology
  • Exercise Physiology

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