Subscribe to RSS
Arterial Function after a 246 km Ultra-marathon Running Race
There is little research about the effects of ultra-endurance exercise on arterial morphological and functional properties. The aim was to assess the acute changes of the carotid-femoral pulse wave velocity and carotid doppler-derived parameters following an ultra-marathon race as well as the intima-media thickness of the carotid artery in ultra-marathon runners. Twenty athletes were examined at baseline and within 10 mins after a 246 km running race. Measurements included carotid-femoral pulse wave velocity, peak-systolic and end-diastolic velocities of carotid artery blood flow, pulsatility and resistivity indices and blood biochemical parameters. The intima-media thickness of the right and left carotid artery was measured before the race. Arterial stiffness and carotid artery intima media thickness at rest remained within known normal limits. The ultra-marathon race significantly increased carotid-femoral pulse wave velocity by 22.6% and pulsatility index by 10.2%. There was a decrease in body weight by 3.35% and an increase of all biochemical markers of muscle damage after the race. Additionally, C-reactive protein was correlated with both pulsatility and resistivity indices post-race. This study shows that immediately after a 246 km ultra-marathon running race, acute increase of arterial stiffness and vascular resistance were evident. The carotid artery thickness of ultra-marathon runners was within normal range.
Key wordspulse wave velocity - carotid artery hemodynamics - ultra-marathon - arterial elastic properties - arterial stiffness
Received: 19 August 2020
Accepted: 16 March 2021
26 April 2021 (online)
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Kim YJ, Shin YO, Lee JB. et al. The effects of running a 308 km ultra-marathon on cardiac markers. Eur J Sport Sci 2014; 14: S92-S97
- 2 Christou G, Pagourelias D, Anifanti M. et al. Exploring the determinants of the cardiac changes after ultra-long duration exercise: The echocardiographic Spartathlon study. Eur J Prev Cardiol 2020; 27: 1467-1477 DOI: 10.1177/2047487319898782.
- 3 Townsend R. Arterial stiffness: Recommendations and standardization. Pulse 2016; 4: 3-7
- 4 O’Rourke M, Pauca A, Jiang XJ. Pulse wave analysis. Br J Clin Pharmacol 2001; 51: 507-522
- 5 Townsend R, Wilkinson I, Schiffrin E. et al. Recommendations for improving and standardizing vascular research on arterial stiffness. a scientific statement from the American Heart Association. Hypertension 2015; 66: 698-722 DOI: 10.1161/HYP.0000000000000033.
- 6 Hametner B, Wassertheurer S. Pulse waveform analysis: Is it ready for prime time?. Curr Hypertens Rep 2017; 19: 73 DOI: 10.1007/s11906-017-0769-3.
- 7 O’Leary DH, Polak JF, Kronmal RA. et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340: 14-22
- 8 Lorenz MW, Markus HS, Bots ML. et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis. Circulation 2007; 115: 459-467
- 9 Engelen L, Ferreira I, Stehouwer CD. et al. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. Eur Heart J 2013; 34: 2368-2380
- 10 Sharman JE, McEniery CM, Campbell RI. et al. The effect of exercise on large artery haemodynamics in healthy young men. Eur J Clin Invest 2005; 35: 738-744
- 11 Vlachopoulos C, Kardara D, Anastasakis A. et al. Arterial stiffness and wave reflections in marathon runners. Am J Hypertens 2010; 23: 974-979
- 12 Burr JF, Bredin SSD, Phillips A. et al. Systemic arterial compliance following ultra-marathon. Int J Sports Med 2012; 33: 224-229
- 13 Abergel E, Linhart A, Chatellier G. et al. Vascular and cardiac remodeling in world class professional cyclists. Am Heart J 1998; 136: 818-823
- 14 Rowley NJ, Dawson EA, Birk GK. et al. Exercise and arterial adaptation in humans: Uncoupling localized and systemic effects. J Appl Physiol (1985) 2011; 110: 1190-1195
- 15 Hurst RT, Nelson MR, Kendall CB. et al. Carotid intimal-medial thickness in active professional American football players aged 23–35 years. Am J Cardiol 2012; 109: 897-900
- 16 Suzuki K, Peake J, Nosaka K. et al. Changes in markers of muscle damage, inﬂammation and HSP70 after an Ironman Triathlon race. Eur J Appl Physiol 2006; 98: 525-534
- 17 Lang RM, Badano LP, Mor-Avi V. et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28: 1-39 e14
- 18 Asmar R, Benetos A, Topouchian J. et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 1995; 26: 485-490
- 19 Mancia G, Fagard R, Narkiewicz K. et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281-1357
- 20 Van Bortel LM, Laurent S, Boutouyrie P. et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30: 445-448
- 21 Maldonado J, Pereira T, Resende M. et al. Usefulness of the ankle-brachial index in assessing vascular function in normal individuals. Rev Port Cardiol 2008; 27: 465-476
- 22 Stein JH, Korcarz CE, Hurst RT. et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: A consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 2008; 21: 93-111
- 23 Tahmasebpour HR, Buckley AR, Cooperberg PL. et al. Sonographic examination of the carotid arteries. Radiographics 2005; 25: 1561-1575
- 24 Frauchiger B, Schmid HP, Roedel C. et al. Comparison of carotid arterial resistive indices with intima-media thickness as sonographic markers of atherosclerosis. Stroke 2001; 32: 836-841
- 25 Gosling RG, King DH. Arterial assessment by Doppler shift ultrasound. Proc R Soc Med 1974; 167: 447-449
- 26 Oughton JA, Rose S, Galloway G. et al. Carotid ultrasound pulsatility indices and cardiovascular risk in Australian women. J Med Imaging Radiat Oncol 2015; 59: 20-25
- 27 Pourcelot L. Applications cliniques de l’examen Doppler transcutane. Coloques de l’Inst Natl Sante’ Rech Med 1974; 34: 213-240
- 28 Simova I. Intima-media thickness: Appropriate evaluation and proper measurement. e-Journal of Cardiology Practice 2015; 13: 1
- 29 Bittencourt C, Izar M, Schwerz V. et al. Effects of high-intensity training of professional runners on myocardial hypertrophy and subclinical atherosclerosis. PloS One 2016; 11: e0166009 DOI: 10.1371/journal.pone.0166009.
- 30 Au JS, Shenouda N, Oikawa SY. et al. Carotid artery longitudinal wall motion is unaffected by 12 weeks of endurance, sprint interval or resistance exercise training. Ultrasound Med Biol 2020; 46: 992-1000
- 31 Taylor BA, Zaleski AL, Capizzi JA. et al. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open 2014; 4: e004498 DOI: 10.1136/bmjopen-2013-004498.
- 32 Sotiriou P, Kouidi E, Karagiannis A. et al. Arterial adaptations in athletes of dynamic and static sports disciplines – a pilot study. Clin Physiol Funct Imaging 2019; 39: 183-191
- 33 Müller J, Dahm H, Lorenz ES. et al. Changes of intima-media thickness in marathon runners: a mid-term follow-up. Eur J Prev Cardiol 2017; 24: 1336-1342
- 34 Tanaka H, Dinenno FA, Monahan KD. et al. Aging, habitual exercise, and dynamic arterial compliance. Circulation 2000; 102: 1270-1275
- 35 Tanaka H, Seals DR, Monahan KD. et al. Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men. J Appl Physiol (1985) 2002; 92: 1458-1464
- 36 Doonan RJ, Mutter A, Egiziano G. et al. Differences in arterial stiffness at rest and after acute exercise between young men and women. Hypertens Res 2013; 36: 226-231
- 37 Kim HJ, Lee YH, Kim CK. Biomarkers of muscle and cartilage damage and inflammation during a 200 km run. Eur J Appl Physiol 2007; 99: 443-447
- 38 Bernardi L, Passino C, Robergs R. et al. Acute and persistent effects of a 46-kilometre wilderness trail run at altitude: cardiovascular autonomic modulation and baroreflexes. Cardiovasc Res 1997; 34: 273-280
- 39 Burr JF, Phillips AA, Drury TC. et al. Temporal response of arterial stiffness to ultra-marathon. Int J Sports Med 2014; 35: 658-663
- 40 Mutter AF, Cooke AB, Saleh O. et al. A systematic review on the effect of acute aerobic exercise on arterial stiffness reveals a differential response in the upper and lower arterial segments. Hypertens Res 2016; 16: 1-27
- 41 Cerqueira E, Marinho DA, Neiva HP. et al. Inflammatory effects of high and moderate intensity exercise – a systematic review. Front Physiol 2020; 10: 1550 DOI: 10.3389/fphys.2019.01550.
- 42 Li M, Tan Y, Stenmark KR. et al. High pulsatility flow induces acute endothelial inflammation through overpolarizing cells to activate NF-κB. Cardiovasc Eng Technol 2013; 4: 26-38
- 43 Ozelsancak R, Torun D, Koc Z. et al. Relationship between renal resistive index and inflammation in untreated hypertensive patients. Int Heart J 2009; 50: 753-761
- 44 Knechtle B, Knechtle P, Wirth A. et al. A faster running speed is associated with a greater body weight loss in 100-km ultra-marathoners. J Sports Sci 2012; 30: 1131-1140
- 45 Rüst C, Knechtle B, Knechtle P. et al. Body mass change and ultraendurance performance: A decrease in body mass is associated with an increased running speed in male 100-km ultramarathoners. J Strength Cond Res 2012; 26: 1505-1516
- 46 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817