Comparison of pro-atrial natriuretic peptide and atrial remodeling in marathon versus non-marathon runners

Wilhelm, Matthias; Nuoffer, Jean-Marc; Schmid, Jean-Paul; Wilhelm, Ilca; Saner, Hugo (2012). Comparison of pro-atrial natriuretic peptide and atrial remodeling in marathon versus non-marathon runners. American journal of cardiology, 109(7), pp. 1060-5. New York, N.Y.: Elsevier 10.1016/j.amjcard.2011.11.039

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Long-term endurance sports are associated with atrial remodeling and an increased risk for atrial fibrillation (AF) and atrial flutter. Pro-atrial natriuretic peptide (pro-ANP) is a marker of atrial wall tension and elevated in patients with AF. The aim of this study was to test the hypothesis that atrial remodeling would be perpetuated by repetitive episodes of atrial stretching during strenuous competitions, reflected by elevated levels of pro-ANP. A cross-sectional study was performed on nonelite runners scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race. Four hundred ninety-two marathon and nonmarathon runners applied for participation, 70 were randomly selected, and 56 entered the final analysis. Subjects were stratified according to former marathon participations: a control group (nonmarathon runners, n = 22), group 1 (1 to 4 marathons, n = 16), and group 2 (≥5 marathons, n = 18). Results were adjusted for age, training years, and average weekly endurance training hours. The mean age was 42 ± 7 years. Compared to the control group, marathon runners in groups 1 and 2 had larger left atria (25 ± 6 vs 30 ± 6 vs 34 ± 7 ml/m(2), p = 0.002) and larger right atria (27 ± 7 vs 31 ± 8 vs 35 ± 5 ml/m(2), p = 0.024). Pro-ANP levels at baseline were higher in marathon runners (1.04 ± 0.38 vs 1.42 ± 0.74 vs 1.67 ± 0.69 nmol/L, p = 0.006). Pro-ANP increased significantly in all groups after the race. In multiple linear regression analysis, marathon participation was an independent predictor of left atrial (β = 0.427, p <0.001) and right atrial (β = 0.395, p = 0.006) remodeling. In conclusion, marathon running was associated with progressive left and right atrial remodeling, possibly induced by repetitive episodes of atrial stretching. The altered left and right atrial substrate may facilitate atrial arrhythmias.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
UniBE Contributor:	Wilhelm, Matthias, Nuoffer, Jean-Marc, Schmid-Walker, Jean-Paul, Saner, Hugo Ernst
ISSN:	0002-9149
Publisher:	Elsevier
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	04 Oct 2013 14:22
Last Modified:	02 Mar 2023 23:20
Publisher DOI:	10.1016/j.amjcard.2011.11.039
PubMed ID:	22221947
Web of Science ID:	000302111400023
Additional Information:	Wilhelm, Matthias;Nuoffer, Jean-Marc;Schmid, Jean-Paul;Wilhelm, Ilca;Saner, Hugo;Am J Cardiol. 2012 Apr 1;109(7):1060-5. doi: 10.1016/j.amjcard.2011.11.039. Epub 2012 Jan 3.
URI:	https://boris.unibe.ch/id/eprint/7628 (FactScience: 212927)