title: Right ventricular adaptations and arrhythmias in amateur ultra-endurance athletes.
abstract: OBJECTIVE
  Ultra-endurance sports are becoming increasingly popular in middle-aged amateur athletes. Right ventricular (RV) arrhythmogenic remodelling has been described in high-level endurance athletes, like professional cyclists. The clinical relevance for amateurs is unknown.
  
  
  METHODS
  We investigated male amateur runners of the 2011 Grand Prix of Bern, a popular 10-mile race in Switzerland. Participants were stratified according to their former participations in long-distance competitions: active controls (leisure-time runners), marathon runners and ultra-endurance athletes (78 and 100 km runners, long-distance triathletes). RV function and morphology were assessed by echocardiography, including two-dimensional speckle tracking. Primary endpoint was RV global strain. Ventricular ectopy was assessed by 24 h ambulatory Holter monitoring. Results were adjusted for lifetime training hours.
  
  
  RESULTS
  97 normotensive athletes were included in the final analysis. The mean age was 42±8 years. Compared with active controls and marathon runners, ultra-endurance athletes had significantly more lifetime training hours and participated more often in competitions. Groups showed no differences with regard to RV global strain (-21.8±2.9 vs -23.3±2.8 vs -21.7±2.3%; p=0.973) and RV end-diastolic area (22.1±2.9 vs 22.9±4.2 vs 23.2±3.5 cm(2); p=0.694). The number of premature ventricular contractions (PVCs) was weakly associated with the RV size (r=0.208; p=0.042). Overall ventricular ectopy was low (0-486 PVCs/24 h) and equally distributed between the groups.
  
  
  CONCLUSIONS
  In our small sample of amateur athletes, long-term ultra-endurance sport practice was not associated with RV dysfunction or complex ventricular arrhythmias.
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rimensberger
authors.affiliation: Division of Echocardiography, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland.
authors.forename: Frederik
authors.initials: F
authors.lastname: Carlen
authors.affiliation: Division of Echocardiography, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Brugger
authors.affiliation: Division of Echocardiography, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wilhelm
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods; D015716:Electrocardiography, Ambulatory / Q000379:methods; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods; D015588:Observer Variation; D010807:Physical Endurance / Q000502:physiology; D012420:Running / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Cardiology Physiology; Endurance; Exercise Physiology