title: The role of three-dimensional echocardiography in the assessment of right ventricular dysfunction after a half marathon: comparison with cardiac magnetic resonance imaging.
abstract: BACKGROUND
  Although marathon running is associated with transient right ventricular (RV) systolic dysfunction as detected by two-dimensional transthoracic echocardiography, quantitative assessment of the right ventricle is difficult because of its complex geometry. Little is known about the use of real-time three-dimensional echocardiography (RT3DE) in the detection of cardiac dysfunction after a half marathon. The aim of this study was to assess the extent of RV dysfunction after the completion of a half marathon using cardiac biomarkers, RT3DE, and cardiac magnetic resonance imaging (CMR).
  
  
  METHODS
  A prospective study was performed in 15 individuals in 2009 participating in the Manitoba Half Marathon. Cardiac biomarkers (myoglobin, creatine kinase-MB and cardiac troponin T) were assessed and RT3DE and CMR were performed 1 week before, immediately after, and 1 week after the race.
  
  
  RESULTS
  At baseline, cardiac biomarkers and ventricular function were within normal limits. Immediately following the half marathon, all patients demonstrated elevated cardiac troponin T levels, with a median value of 0.37 ng/mL. RV ejection fraction, as assessed by RT3DE, decreased from 59 ± 4% at baseline to 45 ± 5% immediately following the race (P < .05). On CMR, RV end-diastolic volume increased after the half marathon, and the RV ejection fraction was reduced, at 47 ± 5% compared with 60 ± 2% at baseline (P < .05). There were strong linear correlations between RV ejection fraction assessed by RT3DE and CMR at baseline and after the half marathon (r = 0.69 and r = 0.87, P < .01, respectively).
  
  
  CONCLUSIONS
  Compared with CMR, RT3DE is a feasible and reproducible method of assessing transient RV dysfunction in athletes completing a half marathon.
authors.affiliation: Institute of Cardiovascular Sciences, St. Boniface Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Sacha R
authors.initials: SR
authors.lastname: Oomah
authors.forename: Negareh
authors.initials: N
authors.lastname: Mousavi
authors.forename: Navdeep
authors.initials: N
authors.lastname: Bhullar
authors.forename: Kanwal
authors.initials: K
authors.lastname: Kumar
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Walker
authors.forename: Matthew
authors.initials: M
authors.lastname: Lytwyn
authors.forename: Jane
authors.initials: J
authors.lastname: Colish
authors.forename: Anthony
authors.initials: A
authors.lastname: Wassef
authors.forename: Iain D C
authors.initials: ID
authors.lastname: Kirkpatrick
authors.forename: Sat
authors.initials: S
authors.lastname: Sharma
authors.forename: Davinder S
authors.initials: DS
authors.lastname: Jassal
mesh_terms: D000293:Adolescent; D000328:Adult; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012420:Running; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult