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. 2020 Sep 15:315:67-71.
doi: 10.1016/j.ijcard.2020.04.081. Epub 2020 Apr 29.

Recreational marathon running does not cause exercise-induced left ventricular hypertrabeculation

Andrew D'Silva  1 , Gabriella Captur  2 , Anish N Bhuva  2 , Siana Jones  3 , Rachel Bastiaenen  4 , Amna Abdel-Gadir  2 , Sabiha Gati  5 , Jet van Zalen  6 , James Willis  7 , Aneil Malhotra  8 , Irina Chis Ster  9 , Charlotte Manisty  2 , Alun D Hughes  3 , Guy Lloyd  2 , Rajan Sharma  8 , James C Moon  2 , Sanjay Sharma  10
Affiliations

Recreational marathon running does not cause exercise-induced left ventricular hypertrabeculation

Andrew D'Silva et al. Int J Cardiol. .

Abstract

Background: Marathon running in novices represents a natural experiment of short-term cardiovascular remodeling in response to running training. We examine whether this stimulus can produce exercise-induced left ventricular (LV) trabeculation.

Methods: Sixty-eight novice marathon runners aged 29.5 ± 3.2 years had indices of LV trabeculation measured by echocardiography and cardiac magnetic resonance imaging 6 months before and 2 weeks after the 2016 London Marathon race, in a prospective longitudinal study.

Results: After 17 weeks unsupervised marathon training, indices of LV trabeculation were essentially unchanged. Despite satisfactory inter-observer agreement in most methods of trabeculation measurement, criteria defining abnormally hypertrabeculated cases were discordant with each other. LV hypertrabeculation was a frequent finding in young, healthy individuals with no subject demonstrating clear evidence of a cardiomyopathy.

Conclusion: Training for a first marathon does not induce LV trabeculation. It remains unclear whether prolonged, high-dose exercise can create de novo trabeculation or expose concealed trabeculation. Applying cut off values from published LV noncompaction cardiomyopathy criteria to young, healthy individuals risks over-diagnosis.

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Conflict of interest statement

Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The study funders and supporters had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Figures

Fig. 1
Fig. 1
Comparison of changes in left ventricular trabeculation indices. Boxplots (left) and density curves (right) indicate trabeculation measurements at baseline (pink) and post marathon (blue). Trabeculation indices measured were Chin X/Y ratio (A & B), Jenni NC/C ratio (C & D), Petersen NC/C ratio (E & F), Jacquier percentage trabeculated mass (G & H), Captur maximal apical (I & J) and mean global fractal dimensions (K & L). Red lines mark the published diagnostic thresholds for suspected cases of left ventricular non-compaction. Included in the boxplots is the mean difference with 95% confidence intervals. CI, confidence interval; FD, fractal dimension; LV, left ventricle; Max, maximum. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Venn diagram of the examined LVNC criteria at the post marathon visit. Captur criteria in this diagram is defined as a mean fractal dimension of >1.26.
See this image and copyright information in PMC

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