Transient cardiac dysfunction but elevated cardiac and kidney biomarkers 24 h following an ultra-distance running event in Mexican Tarahumara

Dirk L Christensen; Diana Espino; Rocío Infante-Ramírez; Mónica S Cervantes-Borunda; Rosa P Hernández-Torres; Antonio E Rivera-Cisneros; Daniel Castillo; Kate Westgate; Dijana Terzic; Soren Brage; Christian Hassager; Jens P Goetze; Jesper Kjaergaard

doi:10.1186/s13728-017-0057-5

Transient cardiac dysfunction but elevated cardiac and kidney biomarkers 24 h following an ultra-distance running event in Mexican Tarahumara

Extrem Physiol Med. 2017 Dec 11:6:3. doi: 10.1186/s13728-017-0057-5. eCollection 2017.

Affiliations

¹ Global Health Section, University of Copenhagen, Øster Farimagsgade 5, building 9, 1014 Copenhagen K, Denmark.
² MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
³ Faculty of Physical Education and Sport Sciences, Autonomous University of Chihuahua, Chihuahua, Mexico.
⁴ Faculty of Chemical Sciences, Autonomous University of Chihuahua, Chihuahua, Mexico.
⁵ Faculty of Nursing and Nutrition, Autonomous University of Chihuahua, Chihuahua, Mexico.
⁶ Faculty of Medicine, Autonomous University of Guadalajara, Jalisco, Mexico.
⁷ Faculty of Medicine, Autonomous University of Chihuahua, Chihuahua, Mexico.
⁸ Department of Clinical Biochemistry, Centre of Diagnostics, Copenhagen University Hospital, Rigshospitalet, Denmark.
⁹ Department of Cardiology, Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.

Abstract

Background: The Mexican Tarahumara are accustomed to running ultra-distance races. No data exist on the acute physiological changes following ultra-distance running and physiological-biomarker associations in this population. Thus, we aimed to investigate the acute impact (≤ 24 h) on functional and biochemical changes of the cardiac muscle and biochemical changes associated with kidney function following a 63-km ultra-distance race with an altitude difference of 1800 m in Mexican Tarahumara athletes.

Methods: Ten Tarahumara male athletes (mean ± SD age = 29.9 ± 6.6 years) volunteered to participate in the study. VO₂max was assessed by a sub-maximal step test individually calibrated combining heart rate and accelerometry. Standard transthoracic echocardiography methodology and venipuncture blood tests were carried out at four time points: pre-race, immediately post-race, 6 h, and 24 h post-race.

Results: Estimated mean VO₂max was 54.5 (± 8.8) mL O₂ min^-1 kg^-1 and average physiological activity intensity was 746 (± 143) J min^-1 kg ^-1 (~ 11.5 METs). When compared to pre-race values, significant changes in left ventricular ejection fraction (LVEF) and LV end-diastolic volume (- 15%, p < 0.001 for both parameters), cardiac output (39%, p < 0.001), and maximal longitudinal velocity (- 13%, p < 0.009) were seen post-race with LVEF also being decreased at < 6 h post-race (- 8%, p < 0.014). Plasma biomarkers mid-regional pro-atrial natriuretic peptide, copeptin-ultra sensitive, and high-sensitivity cardiac troponin T remained significantly elevated at 24 h post-race, and the two latter were inversely associated with LVEF (p < 0.04). Kidney dysfunction was indicated by increased post-race copeptin-ultra sensitive.

Conclusions: The athletes participating in this study had acute transient cardiac dysfunction as assessed by echocardiography but elevated cardiac and kidney biomarkers at 24 h following a 63-km race with extreme altitude variation.

Keywords: Cardiac biomarkers; Echocardiography; Kidney biomarkers; Tarahumara; Ultra-marathon.

Grants and funding

MC_UU_12015/3/MRC_/Medical Research Council/United Kingdom