byJustin Jackson, Medical Xpress

Credit: Unsplash/CC0 Public Domain

A collaboration of researchers in Switzerland, Germany, and the US tracked cardiac function in recreational marathon runners over a 10-year span. Repeated endurance training and racing aligned with stable right ventricular ejection fraction, while postrace troponin T increases were not associated with long-term ventricular function changes.

Moderate to vigorous physical activity correlates with health and longevity, and patients are unlikely to be told to get less exercise while getting a check-up. There is some concern focused on intense high-volume endurance exercise regarding ventricle-related fatigue, dysfunction, and tissue injury.

Previous studies have examined postexercise increases in plasma cardiac troponin and short-term reductions in right ventricular ejection fraction. Limited long-term evidence has left uncertainty around whether repeated strenuous endurance contributes to adverse ventricular remodeling and conditions described as exercise-induced arrhythmogenic right ventricular cardiomyopathy.

In the study, "Long-Term Changes in Ventricular Function in Recreational Marathon Runners,"publishedinJAMA Cardiology, researchers conducted a longitudinal observational cohort study to investigate the marathon-induced increase in troponin T and its association with right ventricular remodeling after 10 years of repetitive bouts of strenuous exercise.

Male marathon runners were enrolled at a single center in Germany, with full follow-up participation reaching 30 runners with a mean age of 43. Assessment points included 2 weeks before a 2009 marathon, within 1 hour after finishing, 1 day after, 3 days after, and a 10-year follow-up.

Cardiac biomarkers and 3-dimensional echocardiography were assessed prerace, immediate postrace, day 1 postrace, day 3 postrace, and at a 10-year follow-up. Echocardiography included M-mode, B-mode, Doppler modalities, tissue Doppler analysis, and real-time 3-dimensional echocardiography.

Blood samples measuredtroponin Tusing a high-sensitivity assay. Cardiopulmonary exercise testing at the 10-year follow-up included continuous electrocardiogram recording for arrhythmia detection.

Body mass index was calculated from measured weight and height, body fat was calculated from 7 skinfold measurements, and trained staff recorded blood pressure in the supine position, with hypertension defined according to European Society of Cardiology guidelines.

Right ventricular ejection fraction declined after the marathon. Recovery appeared by 3 days postrace, and the right ventricular ejection fraction remained stable at 10-year follow-up.

Troponin T increase after the marathon showed no association with right or left ventricular ejection fraction change at 10-year follow-up.

Researchers reported that marathon-induced acute troponin T increase did not function as a prognostic indicator of right ventricular ejection fraction after 10 years of endurance training and competition. Repetitive strenuous exercise training and endurance competitions showed no long-term deterioration of right ventricular function in these recreational endurance athletes.

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More information Michael Johannes Schindler et al, Long-Term Changes in Ventricular Function in Recreational Marathon Runners, JAMA Cardiology (2025). DOI: 10.1001/jamacardio.2025.4456 Journal information: JAMA Cardiology