Delayed enhancement of the intraventricular septum following an extraordinary endurance exercise.
Cardiac fatigue and elevations in cardiac biomarkers have been described following prolonged exertion in endurance athletes. We comprehensively evaluated a highly trained 46-year-old man attempting a North American transcontinental run in a record time of 45 consecutive days. After running 1460 km and ascending over 2600 m, the run was ended prematurely on day 17 following a leg injury; in support of the event, the subject cycled an additional 1580 km. Echocardiography and biomarker analysis performed pre-event and while running revealed no decrement in systolic function and undetectable levels of troponin I and T. Post-event cardiac MRI demonstrated the interval appearance of delayed enhancement of gadolinium at the inferior insertion of the right ventricle and in the interventricular septum-a novel finding that may represent subtle inflammation secondary to a combined exercise and altitude effect.
University of Texas-Southwestern, Dallas, Texas, USA. paul.bhella@gmail.com
Paul S
PS
Bhella
Jacob P
JP
Kelly
Ronald
R
Peshock
Benjamin D
BD
Levine
D000532:Altitude Sickness / Q000175:diagnosis* / Q000503:physiopathology*; D001642:Bicycling / Q000502:physiology*; D003287:Contrast Media / Q000008:administration & dosage; D004452:Echocardiography; D054459:Elasticity Imaging Techniques; D005682:Gadolinium; D006346:Heart Septum / Q000503:physiopathology*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009205:Myocarditis / Q000175:diagnosis / Q000503:physiopathology; D010807:Physical Endurance / Q000502:physiology*; D012420:Running / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology*
D003287:Contrast Media; D005682:Gadolinium