{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:43:43Z","timestamp":1792511023632,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Myocardial adaptations to exercise have been well documented among competitive athletes. To what degree cardiac remodeling occurs among recreational exercisers is unknown. We sought to evaluate the effect of recreational marathon training on myocardial structure and function comprehensively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Male runners (n=45; age, 48\u00b17 years; 64% with \u22651 cardiovascular risk factor) participated in a structured marathon-training program. Echocardiography, cardiopulmonary exercise testing, and laboratory evaluation were performed pre and post training to quantify changes in myocardial structure and function, cardiorespiratory fitness, and traditional cardiac risk parameters. Completion of an 18-week running program (25\u00b19 miles\/wk) led to increased cardiorespiratory fitness (peak oxygen consumption, 44.6\u00b15.2 versus 46.3\u00b15.4 mL\/kg per minute;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In this setting, there was a significant structural cardiac remodeling characterized by dilation of the left ventricle (end-diastolic volume, 156\u00b126 versus 172\u00b128 mL,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), right ventricle (end-diastolic area=27.0\u00b14.8 versus 28.6\u00b14.3 cm\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.02), and left atrium (end-diastolic volume, 65\u00b119 versus 72\u00b119;\n              <jats:italic>P<\/jats:italic>\n              =0.02). Functional adaptations included increases in both early (E\u2032=12.4\u00b12.5 versus 13.2\u00b12.0 cm\/s;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and late (A\u2032=11.5\u00b11.9 versus 12.2\u00b12.1 cm\/s;\n              <jats:italic>P<\/jats:italic>\n              =0.02) left ventricular diastolic velocities. Myocardial remodeling was accompanied by beneficial changes in cardiovascular risk factors, including body mass index (27.0\u00b12.7 versus 26.7\u00b12.6 kg\/m\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), total cholesterol (199\u00b133 versus 192\u00b129 mg\/dL;\n              <jats:italic>P<\/jats:italic>\n              =0.01), low-density lipoprotein (120\u00b129 versus 114\u00b126 mg\/dL;\n              <jats:italic>P<\/jats:italic>\n              =0.01), and triglycerides (100\u00b152 versus 85\u00b136 mg\/dL;\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Among middle-aged men, recreational marathon training is associated with biventricular dilation, enhanced left ventricular diastolic function, and favorable changes in nonmyocardial determinants of cardiovascular risk. Recreational marathon training may, therefore, serve as an effective strategy for decreasing incident cardiovascular disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.114.002487","type":"journal-article","created":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T05:57:21Z","timestamp":1423720641000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Myocardial Adaptations to Recreational Marathon Training Among Middle-Aged Men"],"prefix":"10.1161","volume":"8","author":[{"given":"Jodi L.","family":"Zilinski","sequence":"first","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda E.","family":"Contursi","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Isaacs","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Deluca","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Lewis","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory B.","family":"Weiner","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Adolph M.","family":"Hutter","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre A.","family":"d\u2019Hemecourt","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Troyanos","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Sophia","family":"Dyer","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron L.","family":"Baggish","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Performance Program, Division of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Boston (J.L.Z., M.E.C., S.K.I., J.R.D., G.D.L., R.B.W., A.M.H., A.L.B.); Sports Medicine Division, Boston Children\u2019s Hospital, Boston, MA (P.A.d\u2019H.); Boston Athletic Association, MA (P.A.d\u2019H., C.T., K.S.D., A.L.B.); and Department of Emergency Medicine, Boston Medical Center, Boston, MA (K.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.978031"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2011.11.017"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-1-199901050-00005"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.04.052"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199101313240504"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00618486"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01170.2007"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00395.2008"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00482.2003"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737040-00003"},{"key":"e_1_3_4_12_2","unstructured":"Lamppa R. 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