Invited Session at ECSS Malmö 2015 "ECSS - ACSM Exchange Symposium: the Marathon and the Heart - the Good, the Bad, and the Unknown"

Dying on the Streets?
Roberts, W., Whyte, G.
University of Minnesota

Regular physical activity is good for health and heart. The marathon is popular in the running community with nearly 3,600 races around the world and over a half million finishes in the USA and 1.6 million finishes worldwide in 2012. There is much discussion surrounding the effects of marathon running on the heart; both acute and chronic. Are marathon runners dying in unexpected numbers during training and race participation? Are your highly active patients at increased risk for cardiac dysfunction or death? This session will look at cardiovascular changes associated with long term endurance training at the bench and diagnostic imaging level and the latest in road race medicine to save lives on the street during races. Like medications, there is likely an optimal exercise “dose” for health that may differ for marathon participation. This session will look at the cardiovascular risks and changes associated with marathon participation on race day and the potential heart changes over the course of long term training. There is concern that long term endurance training and marathon running may “overdose” the heart and lead to pathological coronary artery calcification levels, myofibrosis, and conduction system changes (atrial fibrillation). There is also the risk of exercise associated collapse with sudden cardiac arrest, and the session will address current race related strategies to reduce sudden cardiac death during races.