Cardiorespiratory Implications of Extreme Endurance Exercise: Balancing Health Benefits and Risks

Background: Regular physical activity decreases the risk of cardiovascular disease, type II diabetes, obesity, certain cancers, and all-cause mortality. However, mounting evidence suggests that extreme exercise behaviors may be detrimental to human health. Ultra-marathon running imposes unique cardiorespiratory demands that may lead to transient or chronic adverse effects. Methods: This review collates several decades of literature on the physiology and pathophysiology of ultra-marathon running with emphasis on cardiorespiratory implications. Prevalence and clinical significance of post-race decreases in lung function, diffusing capacity, respiratory muscle fatigue, pulmonary edema, biomarkers of cardiac injury, left/right ventricular dysfunction, and chronic myocardial remodeling are systematically examined. Results: Post-race pulmonary function decreases include reduced forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO), likely due to pulmonary interstitial edema. Respiratory muscle fatigue occurs in response to the high ventilatory demands of prolonged running. Biomarkers of cardiac injury including cardiac troponins and natriuretic peptides are elevated post-race, with transient right ventricular dysfunction reported. The clinical significance of these findings and their relationship to long-term cardiac health remains debated. Conclusion: While extreme endurance exercise may lead to transient cardiorespiratory perturbations, the chronic structural and functional adaptations in ultra-marathon runners suggest a high degree of physiological resilience. These findings inform risk stratification for ultra-marathon participants and best practices for medical personnel overseeing these events.

کلیدواژه ها:

Ultra-marathon ، Cardiorespiratory function ، Cardiac biomarkers ، Pulmonary function ، Exercise-induced cardiac remodeling ، Risk stratification