Left Ventricular Hypertrophy and Myocardial Work in Amateur Marathon Runners

Juncheng Wang¹Haiyan Tian¹Qinghong Zeng²Sheng Cao^3*Yanggan Wang^1*

• ¹Zhongnan Hospital of Wuhan University, Wuhan, China
• ²Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, China
• ³Wuhan University Renmin Hospital, Wuhan, China

Aims To investigate the left ventricular hypertrophy (LVH) and myocardial work, and their association in amateur marathon runners. Methods Amateur marathon runners were categorized into LVH and non-LVH groups according to international guidelines and further classified by gender. Healthy individuals without established exercise habits served as the control group. The global work index (GWI), global constructive work (GCW), global work efficiency (GWE), and global wasted work (GWW) were calculated using the pressure-strain loop methodology. The Firth logistic regression model was used to analyze the factors influencing LVH. Spearman correlation analysis was utilized to examine the relationship between running characteristics and myocardial work parameters. Results Compared with the control group, both the non-LVH and LVH groups exhibited significant enlargement of the left atrium and left ventricle (LV), increased wall thickness, and elevated LV mass, with the LVH group showing more pronounced changes. The non-LVH group demonstrated the highest GWI and GCW, while the LVH group exhibited the lowest GWE and GWW. Regression analysis indicated that the weekly running distance is associated with LVH (OR = 1.97, CI: 1.37-3.48) in male runners. In the overall runner cohort, the weekly running distance was negatively correlated with GWE (r = -0.37, P = 0.002) and positively correlated with GWW (r = 0.34, P = 0.004). Conclusion Excessive remodeling leading to LVH may be associated with decreased myocardial work efficiency in amateur marathon runners. The weekly running distance may be a factor influencing LVH and myocardial work.