Systemic Arterial Compliance Following Ultra-Marathon

Abstract

There is a growing interest in training for and competing in race distances that exceed the marathon; however, little is known regarding the vascular effects of participation in such prolonged events, which last multiple consecutive hours. There exists some evidence that cardiovascular function may be impaired following extreme prolonged exercise, but at present, only cardiac function has been specifically examined following exposure to this nature of exercise. The primary purpose of this study was to characterize the acute effects of participation in an ultra-marathon on resting systemic arterial compliance. Arterial compliance and various resting cardiovascular indices were collected at rest from 26 healthy ultra-marathon competitors using applanation tonometry (HDI CR-2000) before and after participation in a mountain trail running foot race ranging from 120–195 km which required between 20–40 continuous hours (31.2±6.8 h) to complete. There was no significant change in small artery compliance from baseline to post race follow-up (8.5±3.4–7.7±8.2 mL/mmHg^x100, p=0.65), but large artery compliance decreased from 16.1±4.4 to 13.5±3.8 mL/mmHg^x10 (p=0.003). Participation in extreme endurance exercise of prolonged duration was associated with acute reductions in large artery compliance, but the time course of this effect remains to be elucidated.

Key words

applanation tonometry - exercise - vasculature - physiology

• References

• 1 Alessio HM. Exercise-induced oxidative stress. Med Sci Sports Exerc 1993; 25: 218-224
• 2 Beltran A, McVeigh G, Morgan D, Glasser SP, Neutel JM, Weber M, Finkelstein SM, Cohn JN. Arterial compliance abnormalities in isolated systolic hypertension. Am J Hypertens 2001; 14: 1007-1011
• 3 Belz GG. Elastic properties and Windkessel function of the human aorta. Cardiovasc Drugs Ther 1995; 9: 73-83
• 4 Bhagat K, Vallance P. Inflammatory cytokines impair endothelium-dependent dilatation in human veins in vivo. Circulation 1997; 96: 3042-3047
• 5 Cameron JD, Dart AM. Exercise training increases total systemic arterial compliance in humans. Am J Physiol. 1994; 266 : H693-H701
• 6 Cohn JN, Finkelstein S, McVeigh G, Morgan D, LeMay L, Robinson J, Mock J. Noninvasive pulse wave analysis for the early detection of vascular disease. Hypertension 1995; 26: 503-508
• 7 DeVan AE, Anton MM, Cook JN, Neidre DB, Cortez-Cooper MY, Tanaka H. Acute effects of resistance exercise on arterial compliance. J Appl Physiol 2005; 98: 2287-2291
• 8 Edwards DG, Lang JT. Augmentation index and systolic load are lower in competitive endurance athletes. Am J Hypertens 2005; 18: 679-683
• 9 Failla M, Grappiolo A, Emanuelli G, Vitale G, Fraschini N, Bigoni M, Grieco N, Denti M, Giannattasio C, Mancia G. Sympathetic tone restrains arterial distensibility of healthy and atherosclerotic subjects. J Hypertens 1999; 17: 1117-1123
• 10 George K, Shave R, Oxborough D, Cable T, Dawson E, Artis N, Gaze D, Hew-Butler T, Sharwood K, Noakes T. Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking. Eur J Echocardiogr 2009; 10: 238-243
• 11 Harriss DJ, Atkinson G. Update – Ethical Standards in Sport and Exercise Science Research. Int J Sports Med 2011; 32: 819-821
• 12 HDI Pulsewave . HDI/Pulsewave CR-2000 Research CardioVasular Profiling System Operator's Manual 2001; 10-12
• 13 Kass DA, Saeki A, Tunin RS, Recchia FA. Adverse influence of systemic vascular stiffening on cardiac dysfunction and adaptation to acute coronary occlusion. Circulation 1996; 93: 1533-1541
• 14 Kim HJ, Lee YH, Kim CK. Biomarkers of muscle and cartilage damage and inflammation during a 200 km run. Eur J Appl Physiol 2007; 99: 443-447
• 15 Kingwell BA, Berry KL, Cameron JD, Jennings GL, Dart AM. Arterial compliance increases after moderate-intensity cycling. Am J Physiol 1997; 273: H2186-H2191
• 16 Knechtle B, Knechtle P, Lepers R. Participation and performance trends in ultra-triathlons from 1985 to 2009. Scand J Med Sci Sports 2010; E-pub, ahead of print
• 17 Knez WL, Coombes JS, Jenkins DG. Ultra-endurance exercise and oxidative damage: implications for cardiovascular health. Sports Med 2006; 36: 429-441
• 18 Kroger K, Lehmann N, Rappaport L, Perrey M, Sorokin A, Budde T, Heusch G, Jockel KH, Thompson PD, Erbel R, Mohlenkamp S. Carotid and peripheral atherosclerosis in male marathon runners. Med Sci Sports Exerc 2010; 43: 1142-1147
• 19 Laurent S, Boutouyrie P. Arterial stiffness: a new surrogate end point for cardiovascular disease?. J Nephrol 2007; 20 (Suppl. 12) S45-S50
• 20 Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-2605
• 21 Liang YL, Teede H, Kotsopoulos D, Shiel L, Cameron JD, Dart AM, McGrath BP. Non-invasive measurements of arterial structure and function: repeatability, interrelationships and trial sample size. Clin Sci (Lond) 1998; 95: 669-679
• 22 Maeda S, Tanabe T, Otsuki T, Sugawara J, Ajisaka R, Matsuda M. Acute exercise increases systemic arterial compliance after 6-month exercise training in older women. Hypertens Res 2008; 31: 377-381
• 23 Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation 2006; 113: 657-663
• 24 McVeigh GE, Bratteli CW, Morgan DJ, Alinder CM, Glasser SP, Finkelstein SM, Cohn JN. Age-related abnormalities in arterial compliance identified by pressure pulse contour analysis: aging and arterial compliance. Hypertension 1999; 33: 1392-1398
• 25 Middleton N, Shave R, George K, Whyte G, Hart E, Atkinson G. Left ventricular function immediately following prolonged exercise: A meta-analysis. Med Sci Sports Exerc 2006; 38: 681-687
• 26 Miyachi M, Kawano H, Sugawara J, Takahashi K, Hayashi K, Yamazaki K, Tabata I, Tanaka H. Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study. Circulation 2004; 110: 2858-2863
• 27 Mohlenkamp S, Lehmann N, Breuckmann F, Brocker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jockel KH, Erbel R. Marathon Study Investigators, Heinz Nixdorf Recall Study Investigators. Running: the risk of coronary events: Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J 2008; 29: 1903-1910
• 28 Murrell CJ, Cotter JD, George K, Shave R, Wilson L, Thomas K, Williams MJ, Ainslie PN. Syncope is unrelated to supine and postural hypotension following prolonged exercise. Eur J Appl Physiol 2011; 111: 469-476
• 29 Najjar SS, Schulman SP, Gerstenblith G, Fleg JL, Kass DA, O'Connor F, Becker LC, Lakatta EG. Age and gender affect ventricular-vascular coupling during aerobic exercise. J Am Coll Cardiol 2004; 44: 611-617
• 30 Nickel KJ, Acree LS, Gardner AW. Effects of a single bout of exercise on arterial compliance in older adults. Angiology 2011; 62: 33-37
• 31 Otsuki T, Maeda S, Sugawara J, Kesen Y, Murakami H, Tanabe T, Miyauchi T, Kuno S, Ajisaka R, Matsuda M. Age-related reduction of systemic arterial compliance relates to decreased aerobic capacity during sub-maximal exercise. Hypertens Res 2006; 29: 759-765
• 32 Rakobowchuk M, Stuckey MI, Millar PJ, Gurr L, Macdonald MJ. Effect of acute sprint interval exercise on central and peripheral artery distensibility in young healthy males. Eur J Appl Physiol 2009; 105: 787-795
• 33 Resnick LM, Militianu D, Cunnings AJ, Pipe JG, Evelhoch JL, Soulen RL, Lester MA. Pulse waveform analysis of arterial compliance: relation to other techniques, age, and metabolic variables. Am J Hypertens 2000; 13: 1243-1249
• 34 Rossow L, Fahs CA, Guerra M, Jae SY, Heffernan KS, Fernhall B. Acute effects of supramaximal exercise on carotid artery compliance and pulse pressure in young men and women. Eur J Appl Physiol 2010; 110: 729-737
• 35 Schwartz JG, Merkel-Kraus S, Duval S, Harris K, Peichel G, Lesser JR, Knickelbine T, Flygenring B, Longe TR, Pastorius C, Roberts WR, Oesterle SC, Schwartz RS. Does long term endurance running enhance or inhibit coronary artery plaque formation?. JACC 2010; [abstract]
• 36 Scott JM, Esch BT, Shave R, Warburton DE, Gaze D, George K. Cardiovascular consequences of completing a 160-km ultramarathon. Med Sci Sports Exerc 2009; 41: 26-34
• 37 Sharman JE, McEniery CM, Campbell RI, Coombes JS, Wilkinson IB, Cockcroft JR. The effect of exercise on large artery haemodynamics in healthy young men. Eur J Clin Invest 2005; 35: 738-744
• 38 Skenderi KP, Tsironi M, Lazaropoulou C, Anastasiou CA, Matalas AL, Kanavaki I, Thalmann M, Goussetis E, Papassotiriou I, Chrousos GP. Changes in free radical generation and antioxidant capacity during ultramarathon foot race. Eur J Clin Invest 2008; 38: 159-165
• 39 Sunagawa K, Maughan WL, Burkhoff D, Sagawa K. Left ventricular interaction with arterial load studied in isolated canine ventricle. Am J Physiol 1983; 245: H773-H780
• 40 Vlachopoulos C, Dima I, Aznaouridis K, Vasiliadou C, Ioakeimidis N, Aggeli C, Toutouza M, Stefanadis C. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 2005; 112: 2193-2200
• 41 Vlachopoulos C, Kardara D, Anastasakis A, Baou K, Terentes-Printzios D, Tousoulis D, Stefanadis C. Arterial stiffness and wave reflections in marathon runners. Am J Hypertens 2010; 23: 974-979
• 42 Wilkinson IB, MacCallum H, Cockcroft JR, Webb DJ. Inhibition of basal nitric oxide synthesis increases aortic augmentation index and pulse wave velocity in vivo. Br J Clin Pharmacol 2002; 53: 189-192
• 43 Wilson MG, O'Hanlon R, Prasad S, Deighan A, Macmillan P, Oxborough D, Godfrey RJ, Smith G, Maceira A, Sharma S, George KP, Whyte G. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol 2011; 110: 1622-1626
• 44 Wittrock M, Scholze A, Compton F, Schaefer JH, Zidek W, Tepel M. Noninvasive pulse wave analysis for the determination of central artery stiffness. Microvasc Res 2009; 77: 109-112
• 45 Wu G, Tian H, Han K, Xi Y, Yao Y, Ma A. Potassium magnesium supplementation for four weeks improves small distal artery compliance and reduces blood pressure in patients with essential hypertension. Clin Exp Hypertens 2006; 28: 489-497
• 46 Yasmin McEniery CM, Wallace S, Mackenzie IS, Cockcroft JR, Wilkinson IB. C-reactive protein is associated with arterial stiffness in apparently healthy individuals. Arterioscler Thromb Vasc Biol 2004; 24: 969-974