title: Inflammation and atrial remodeling after a mountain marathon.
abstract: Endurance athletes have an increased risk of atrial fibrillation. We performed a longitudinal study on elite runners of the 2010 Jungfrau Marathon, a Swiss mountain marathon, to determine acute effects of long-distance running on the atrial myocardium. Ten healthy male athletes were included and examined 9 to 1 week prior to the race, immediately after, and 1, 5, and 8 days after the race. Mean age was 34.9 ± 4.2 years, and maximum oxygen consumption was 66.8 ± 5.8 mL/kg*min. Mean race time was 243.9 ± 17.7 min. Electrocardiographic-determined signal-averaged P-wave duration (SAPWD) increased significantly after the race and returned to baseline levels during follow-up (128.7 ± 10.9 vs. 137.6 ± 9.8 vs. 131.5 ± 8.6 ms; P < 0.001). Left and right atrial volumes showed no significant differences over time, and there were no correlations of atrial volumes and SAPWD. Prolongation of the SAPWD was accompanied by a transient increase in levels of high-sensitivity C-reactive protein, proinflammatory cytokines, total leucocytes, neutrophil granulocytes, pro atrial natriuretic peptide and high-sensitivity troponin. In conclusion, marathon running was associated with a transient conduction delay in the atria, acute inflammation and increased atrial wall tension. This may reflect exercise-induced atrial myocardial edema and may contribute to atrial remodeling over time, generating a substrate for atrial arrhythmias.
authors.affiliation: University Clinic for Cardiology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Wilhelm
authors.forename: T
authors.initials: T
authors.lastname: Zueger
authors.forename: S
authors.initials: S
authors.lastname: De Marchi
authors.forename: S F
authors.initials: SF
authors.lastname: Rimoldi
authors.forename: N
authors.initials: N
authors.lastname: Brugger
authors.forename: R
authors.initials: R
authors.lastname: Steiner
authors.forename: C
authors.initials: C
authors.lastname: Stettler
authors.forename: J-M
authors.initials: JM
authors.lastname: Nuoffer
authors.forename: C
authors.initials: C
authors.lastname: Seiler
authors.forename: M
authors.initials: M
authors.lastname: Ith
mesh_terms: D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood; D064752:Atrial Remodeling / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism; D004562:Electrocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008297:Male; D009504:Neutrophils; D011446:Prospective Studies; D012420:Running / Q000502:physiology*; D014336:Troponin / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014463:Ultrasonography
chemical_list: D015850:Interleukin-6; D014336:Troponin; D014409:Tumor Necrosis Factor-alpha; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein