Investigation of Cardiac Function and Cardiovascular Risk Factors in Marathon Runners- The Munich Marathon Study

Regular exercise leads to an improvement of cardiovascular risc factors in patients with coronary heart disease, atherosclerosis and metabolic disorders. Aerobic exercise has anti-inflammatory effects. In contrast, the exertional exercise of marathon running causes an acute pro-inflammatory impulse. This may lead to myocardial injury and, in case of preexisting plaques, may result in plaque rupture and acute myocardial infarction.

The researchers aim to define the critical role of inflammatory markers and cardiovascular risk factors as a predictor of an increased risk for myocardial and endothelial dysfunction in marathon runners.

The study groups are divided into average trained runners (40 km/week), average trained obese runners and highly trained runners (> 70km/week). Training programmes are supervised by professional coaches. Individual scientific marathon contests are organized for the assessments.

Diagnostic tools include measurements of pulse wave velocity and heart rate turbulence, echocardiography and, for the first time, MRI-scans pre- and post marathon running. Additionally, cardiovascular markers such as endothelial progenitor cells (EPCs)and adiponectin are measured. Inflammatory markers include c-reactive protein (CRP), interleukins and tumor necrosis factor.

Inclusion criteria

• Men aged 30-60 years
• Obese subjects: BMI > 27 and waist circumference > 102cm

Exclusion criteria

• manifested heart disease
• insulin dependent diabetes mellitus
• multiple drug therapy
• GFR < 60 ml/min.
• claustrophobia
• metal implants