title: Cardiac and renal function in a large cohort of amateur marathon runners.
abstract: BACKGROUND
  Participation of amateur runners in endurance races continues to increase. Previous studies of marathon runners have raised concerns about exercise-induced myocardial and renal dysfunction and damage. In our pooled analysis, we aimed to characterize changes of cardiac and renal function after marathon running in a large cohort of mostly elderly amateur marathon runners.
  
  
  METHODS
  A total of 167 participants of the Berlin-Marathon (female n = 89, male n = 78; age = 50.3 ± 11.4 years) were included and cardiac and renal function was analyzed prior to, immediately after and 2 weeks following the race by echocardiography and blood tests (including cardiac troponin T, NT-proBNP and cystatin C).
  
  
  RESULTS
  Among the runners, 58% exhibited a significant increase in cardiac biomarkers after completion of the marathon. Overall, the changes in echocardiographic parameters for systolic or diastolic left and right ventricular function did not indicate relevant myocardial dysfunction. Notably, 30% of all participants showed >25% decrease in cystatin C-estimated glomerular filtration rate (GFR) from baseline directly after the marathon; in 8%, we observed a decline of more than 50%. All cardiac and renal parameters returned to baseline ranges within 2 weeks after the marathon.
  
  
  CONCLUSIONS
  The increase in cardiac biomarkers after completing a marathon was not accompanied by relevant cardiac dysfunction as assessed by echocardiography. After the race, a high proportion of runners experienced a decrease in cystatin C-estimated GFR, which is suggestive of transient, exercise-related alteration of renal function. However, we did not observe persistent detrimental effects on renal function.
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. bernd.hewing@charite.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hewing
authors.affiliation: Department of Medicine I, Cardiology, Helios Klinikum Emil von Behring, Berlin, Germany. sebastian.schattke@helios-kliniken.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schattke
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. sebastian.spethmann@charite.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Spethmann
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. wasiem.sanad@charite.de.
authors.forename: Wasiem
authors.initials: W
authors.lastname: Sanad
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. sabrina.schroeckh@charite.de.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Schroeckh
authors.affiliation: Department of Medical Chemistry und Pathochemistry, Charité-Universitätsmedizin Berlin, Berlin, Germany. ingolf.schimke@charite.de.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Schimke
authors.affiliation: Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. fabian.halleck@charite.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Halleck
authors.affiliation: Department of Nephrology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. harm.peters@charite.de.
authors.forename: Harm
authors.initials: H
authors.lastname: Peters
authors.affiliation: SMS Medical Institute, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.|Berlin Academy for Sport Medicine, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.|SCC Running Events GmbH, Berlin, Germany. lars.brechtel@medical-institute-berlin.de.
authors.forename: Lars
authors.initials: L
authors.lastname: Brechtel
authors.affiliation: SMS Medical Institute, Berlin, Germany. juergen.lock@scc-events.com.|Berlin Academy for Sport Medicine, Berlin, Germany. juergen.lock@scc-events.com.|SCC Running Events GmbH, Berlin, Germany. juergen.lock@scc-events.com.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Lock
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. gert.baumann@charite.de.
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. henryk.dreger@charite.de.
authors.forename: Henryk
authors.initials: H
authors.lastname: Dreger
authors.affiliation: Department of Medicine I, Cardiology, Helios Klinikum Emil von Behring, Berlin, Germany. adrian.borges@helios-kliniken.de.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
authors.affiliation: Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany. fabian.knebel@charite.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
mesh_terms: D000368:Aged; D054874:Athletic Performance / Q000502:physiology; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods*; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology; D012420:Running / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult