Coronary arteries and aortic arch vessels in long-term active ultra-marathon runners and non-athletic controls

Physiological structural and functional changes to the heart in response to prolonged exercise training include enlargement of the heart chambers and/or mild left ventricular hypertrophy [1]. Available studies bring equivocal results regarding the change in diameter of the coronary arteries (CA) as elements of the athlete’s heart [2, 3]. We decided to analyse the changes in diameters of CA and aortic arch vessels in long-term active ultra-marathon runners in comparison to non-athletic controls.
This prospective analysis included 20 healthy male long-term ultra-marathon runners (median age: 40 years, range: 28–54) and 10 male healthy controls who volunteered to participate in the study (median age: 36 years, range: 32–53). The runners had at least 7 years of documented continuous training at a high level (running at least 70 km/week) with frequent starts in ultra-marathons (mostly longer than 100 km). Healthy controls were all sedentary men (recreational sport activity only not exceeding 2 h per week).
To assess the diameters of the arteries departing from the aortic arch and coronary arteries, all patients underwent the post-contrast VIBE and self-navigated free-breathing whole-heart sequence registration using a coronary MR-angiography (whole heart) Siemens Magnetom Skyra 3 Tesla scanner (Siemens, Erlangen, Germany).
It was possible to analyse the diameters of analysed arteries in all of the studied cases and controls. There were no differences in the median diameter of CA and aortic arch vessels between endurance athletes and controls (Table I). There was only a non-significantly larger LM diameter in athletes (p = 0.08).
Based on the above results, we suggest that long-term high-intensity endurance training has no significant influence on the enlargement of CA at rest. This is in line with some other studies describing no significant difference in coronary artery diameters in ultra-endurance athletes in comparison to sedentary individuals based on angiography [3]. In contrast to other studies reporting the vascular system adaptation and remodelling in response to physical activity manifesting as enlarged arterial calibre [2], these differences may occur because in most of the studies diameters of coronary arteries were measured during intake of exogenous nitroglycerin or other vasodilators [3]. Also, the diameter may not be enlarged in all circumstances at rest; this may be due to compensatory increases in vasoconstrictor tone...


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