AUTHOR=Le Goff Caroline , Viallon Magalie , Kaux Jean-François , Andonian Pierre , Moulin Kevin , Seidel Laurence , Giardini Guido , Gergelé Laurent , Croisille Pierre , Cavalier Etienne , Millet Gregoire P. 

TITLE=Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.790551

DOI=10.3389/fcvm.2022.790551

ISSN=2297-055X

ABSTRACT=Objectives: The effects of ultra-distance on cardiac remodeling and fibrosis are unclear. Moreover, there is no data reporting the kinetics of cardiac alterations throughout the event and during the recovery. Our aim was to investigate the kinetics of biological markers including new cardiac fibrosis biomarkers (ST2 and Gal-3) during and after an extreme mountain ultramarathon. 
Methods: Fifty experienced runners participating in one of the most challenging mountain ultramarathons (330 km, D+ 25000 m) were enrolled in our study. Blood samples were collected at four time points: before (Pre-), at 148 km (Mid-), at the finish line (Post-) and 3 days after the recovery period (Recov-).
Results: Cardiac fibrosis biomarkers (ST2 and Gal-3) increased from Pre- to Mid-. During the second half, ST2 remained higher than pre-values as opposed to Gal-3. Necrosis, ischemia and myocyte injury biomarkers increased until Mid- then decreased but remained higher at Recov- than Pre-values. An oxidative stress appeared at Mid-. Lipid peroxides remained higher at Recov- compared to Pre-. The maximal value in most of these biomarkers was observed at Mid- and not at Post-
Conclusions: The present study supports a biphasic kinetics of cardiac fibrosis biomarkers, with a relative recovery during the second half of the event that seems specific to this extreme event. Overall, performing such extreme ultramarathon seems less deleterious for the heart than shorter events.