{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:55:16Z","timestamp":1788285316357,"version":"build-2803163510"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n Importance<\/jats:title>\n The effects of long-term repetitive and strenuous exercise loads on the right ventricle and plasma troponin levels are unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the marathon-induced increase in troponin T and its association with right ventricular remodeling after 10 years of repetitive bouts of strenuous exercise.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a longitudinal, observational cohort study (the Prospective Follow-Up, Marathon, Long-Term, Inflammation, Cardiovascular System [Pro-MagIC] study) conducted from August to December 2019. Participants were male marathon runners recruited from a single center in Germany.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Repetitive strenuous exercise training and endurance competitions for 10 years.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Cardiac biomarkers and 3-dimensional echocardiography were assessed prerace, immediately, on days 1 and 3 postrace, and at 10-year follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 152 male runners (mean [SD] age, 43 [3] years) were included in this analysis. Right ventricular ejection fraction declined significantly from the prerace (median, 52.4%; IQR, 50.0%-55.1%) to immediate postrace (median, 47.6%; IQR, 44.7%-51.5%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) assessment and 1-day postrace (median, 50.7%; IQR, 48.4%-53.0%;\n P<\/jats:italic>\n \u2009=\u2009.001) but recovered at 3-day postrace (median, 51.3%; IQR, 50.4%-53.0%;\n P<\/jats:italic>\n \u2009=\u2009.18); it also recovered to the prerace level even at the 10-year follow-up (median, 51.9%; IQR, 49.6%-54.5%;\n P<\/jats:italic>\n \u2009=\u2009.15). Left ventricular ejection fraction decreased (median, 59.6%; IQR, 55.6%-64.5% to median, 57.6%; IQR, 54.1%-61.6%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), whereas lateral E\/e\u2032 ratio, as an index of left ventricular filling pressure, increased (median, 5.1; IQR, 4.3-6.1 to median, 5.4; IQR, 4.5-6.4;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) at the 10-year follow-up. No association of exercise-induced troponin T increase after the marathon with right and left ventricular ejection fraction changes at the 10-year follow-up was detected (Pearson\n r<\/jats:italic>\n \u2009=\u2009\u22120.10,\n P<\/jats:italic>\n \u2009=\u2009.35 and Pearson\n r<\/jats:italic>\n \u2009=\u2009\u22120.09,\n P<\/jats:italic>\n \u2009=\u2009.35, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Results showed that marathon-induced acute troponin T increase was not associated with right ventricular ejection fraction after 10 years of endurance training and competition. Left ventricular ejection fraction and left ventricular diastolic function changed significantly; however, the values remained within normal limits. These data suggest that repetitive strenuous exercise training and endurance competitions did not induce long-term deterioration of right ventricular function in most recreational male endurance athletes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2025.4456","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T16:00:27Z","timestamp":1765382427000},"page":"36","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Changes in Ventricular Function in Recreational Marathon Runners"],"prefix":"10.1001","volume":"11","author":[{"given":"Michael Johannes","family":"Schindler","sequence":"first","affiliation":[{"name":"University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland"},{"name":"Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, TUM University Hospital Klinikum rechts der Isar, Technical University of Munich, 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