Long-term health issues in ultraendurance runners: should we be concerned?

• Published in: BMJ Open Sport & Exercise Medicine Vol. 7; no. 3; p. e001131
• Main Authors: Scheer, Volker, Rojas-Valverde, Daniel
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 20.07.2021; BMJ Publishing Group
• Subjects: Asymptomatic; Athletes; Biomarkers; Cardiac arrhythmia; Chronic illnesses; Exercise physiology; Inflammation; Kidney diseases; Marathons; Participation; Rhabdomyolysis; Running; Sports injuries; Systematic review; Ultramarathon
• ISSN: 2055-7647; 2055-7647
• DOI: 10.1136/bmjsem-2021-001131

Cardiovascular implications UER may have negative effects on cardiovascular health such as acute alterations in biomarkers of cardiac damage (eg, cardiac troponin-I, ventricular natriuretic peptide)5 and potential long-term cardiac issues such as ventricular dysfunction, myocardial remodelling, atrial fibrillation, myocardial fibrosis or right ventricle exercise-induced cardiomyopathy later in life. UER represents 96.9% of the total AKI cases among endurance athletes; some of the risk factors for AKI development include prior ingestion of nonsteroidal anti-inflammatory drugs, dehydration, heat strain, competing at moderate altitude and high physical load.3 Occasionally, severe AKI is observed, combined with rhabdomyolysis and altered renal function, which may last for weeks or months. The effect of prolonged lifetime running on musculoskeletal health is not well understood, particularly when starting at a young age representing an increased lifetime risk of developing stress fractures with a lifetime prevalence of 14% compared with adults.8 Long-term studies are needed for evaluating risk factors leading to musculoskeletal injuries, and the role of training volume/intensity is essential on these potential chronic conditions.