Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run.

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Abstract
The effect of extremely exhaustive exercise on left ventricular performance was studied echocardiographically in 13 experienced male ultramarathon runners who took part in a competitive 24 hr run, completing distances of 114 to 227 km. Although the left ventricular end-diastolic dimension (EDD) was reduced by 7% (54 +/- 5 to 50 +/- 7 mm; p less than .005), the end-systolic dimension (ESD) increased slightly (33 +/- 5 to 34 +/- 6 mm; NS). As a consequence, the stroke dimension (21 +/- 2 to 16 +/- 2 mm; p less than .005) and fractional shortening (38 +/- 5% to 32 +/- 5%; p less than .005) declined by 24% and 16%, respectively. The reduction in fractional shortening was related to delta ESD (r = -.66; p less than .05) but not to delta EDD (r = .22; NS). In spite of reduced afterload, the mean velocity of circumferential fiber shortening also decreased by an average of 9% (p less than .01) in proportion to the distance completed (r = -.69; p less than .01). The systolic blood pressure/ESD ratio was 21% lower after the race (4.2 +/- 0.9 to 3.3 +/- 0.6; p less than .005). Body weight loss was not related to any alterations in left ventricular dimensions or ejection phase indexes. The stroke dimension and ejection phase indexes continued to decline within the last 6 hr of the race but returned to the prerace level 2 to 3 days after the race. Total serum creatine kinase peaked at 3917 to 64740 U/liter (mean 27427) and its MB percentage peaked at 2% to 6%.(ABSTRACT TRUNCATED AT 250 WORDS)