The Effects of Ultra Marathon on Myocardial Hypertrophy

Naimah Alamin, Steven Hammer Ph.D, and Jim Agnew M.D. Ph.D
Indian River State College, Ft. Pierce, FL
Abstract

Ultra- marathon events are a growing trend in todays society. However, little is known
regarding cardiovascular effects of extreme, prolonged exercise. The possible effects of chronic
exercise may result in hypertrophy and or dilation. Increase in the size and thickness of all four
cardiac chambers could be due to the volume and pressure load imposed by repeated bouts of
exercise (Gerche et al. 2013). This study examined changes in chamber electrical activity due to
ultra-marathon running that can be used to detect hypertrophy and/or dilation. This was done
using Electrocardiography (ECG). The ECG criteria for diagnosing hypertrophy are very
insensitive (sensitivity ~ 50 %), which means that participants with hypertrophy might not be
detected by the ECG criteria. However, the criteria are very specific (specificity > 90%) which
means that if the criteria are met, it is very likely that hypertrophy is present (Hancock et al.
2009). The results indicates that clinical hypertrophy examined in the pre-race and post-race
values with the values of the pre and post exceeding the border line measurement in the
determinant of clinical hypertrophy. ECG measurements indicating RAE showed above clinically
normal value of 2.5 mm in leads II, III and aVf. However no significant changes were noted over
the distance measures. Examining p-wave duration in lead II for extended duration indicating
LAE showed normal pre-race values with some of the 100 mile runners reaching the cutoff
criteria of 0.12 sec. by the end of the race. RVH was noted as boarder line normal pre-race with
an increasing trend towards clinically significant RVH with many of the runners showing clinical
criteria at 100 miles. Measurements to indicate LVH showed most runners meet the criteria
pre-race with an increasing trend up to the 100 mile distance. These results show clinically
significant changes in the heart of the Ultra Marathon runners, which tend to increase with
increasing mileage run. What is not known at this point is if these changes cause permanent
changes in the heart structure and if these changes can lead to an increased incidence of
cardiac related disorders later in life.