Impact of repeated prolonged exercise bouts on cardiac function and biomarkers

Natalie Middleton, Robert Shave, Keith George, Gregory Whyte, Richard Simpson, Geraint Florida-James, David Gaze

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


PURPOSE: The present study examined the impact of repeated bouts of prolonged (< 60 min) exercise on left ventricular function and cardiac biomarkers. METHODS: Ten athletes completed a 15.3-mile hill run on three consecutive days and were assessed before, immediately after, 1 h after, and 20 h after each bout. Six of the athletes completed a fourth bout. Left ventricular (LV) function was examined echocardiographically using two-dimensional M-mode, Doppler, and flow propagation velocity (Vp). Venous blood samples were analyzed for cardiac biomarkers including cardiac troponin T (cTnT). RESULTS: Ejection fraction (EF) significantly decreased (P = 0.027) after the third exercise bout compared with baseline (mean ± SD: 56.3 ± 4.4 vs 51.3 ± 5.9%), accompanied by a nonsignificant decrease in systolic blood pressure/end systolic volume (SBP/ESV) ratio. A sustained depression in systolic function 20 h after bout 3 also persisted in the subset who completed a fourth bout, yet this did not reach clinical levels. Significant (P < 0.01) reductions in early to late diastolic filling (E:A) ratio pre-to post-bout 1 (mean ± SD: 1.9 ± 0.5 vs 1.4 ± 0.3) and pre- to post-bout 3(2.0 ± 0.5 vs 1.3 ± 0.4) normalized after each 20-h recovery period. A similar pattern of change was observed in Vp. Cardiac troponin T was elevated in four individuals 1 h after bout 1 (range: 0.013-0.125 μg·L) but was undetectable thereafter except in one athlete. CONCLUSION: Repeated bouts of prolonged exercise induce short-term reductions in diastolic filling and a cumulative decrease in systolic function, yet these alterations seem to have minimal clinical or functional impact. Elevated cTnT after the initial bout, but not thereafter, may represent an adaptive response to prolonged exercise.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalMedicine and Science in Sports and Exercise
Issue number1
StatePublished - Jan 2007
Externally publishedYes


  • B-type natriuretic peptide
  • Cardiac troponin T
  • Echocardiography
  • Repetitive exercise

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


Dive into the research topics of 'Impact of repeated prolonged exercise bouts on cardiac function and biomarkers'. Together they form a unique fingerprint.

Cite this