Phidippides Cardiomyopathy: Extreme Endurance Training Finally Being Recongized In one study, approximately 12 per cent of apparently healthy marathon runners showed evidence for patchy myocardial scarring, and the coronary heart disease event rate during a two-year follow up was significantly higher in marathon runners than in runners not doing marathons .. [i]t had been known that elite-level athletes commonly develop abnormal electrocardiogram readings.Because endurance sports call for a sustained increase in cardiac output for several hours, the heart is put into a state of volume overload. It has been shown that approximately one-third of marathon runners experience dilation of the right atrium and ventricle, have elevations of cardiac troponin and natriuretic peptides, and in a smaller fraction later develop small patches of cardiac fibrosis that are the likely substrate for ventricular tachyarrhythmias and sudden death. Cardiac magnetic resonance imaging is emerging as the diagnostic test of choice for this condition.http://www.ncbi.nlm.nih.gov/pubmed/22222888
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