Evidence map›Paper›PMID 40710785›Full record

ReviewJournal of cardiovascular development and disease2025

Divergent Cardiac Adaptations in Endurance Sport: Atrial Fibrillation Markers in Marathon Versus Ultramarathon Athletes.

Zbigniew Waśkiewicz, Eduard Bezuglov, Oleg Talibov, Robert Gajda, Zhassyn Mukhambetov, Daulet Azerbaev, Sergei Bondarev

Abstract readReview
In one paragraph

Review in Journal of cardiovascular development and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Zbigniew WaśkiewiczInstitute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland.ORCID 0000-0003-4885-6417
Eduard BezuglovDepartment of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, 119991 Moscow, Russia.ORCID 0000-0003-3828-0506
Oleg TalibovDepartment of Internal Medicine, Clinical Pharmacology and Emergency Medicine, Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia.ORCID 0000-0001-6381-2450
Robert GajdaCenter for Sports Cardiology, Gajda-Med Medical Center, 06-100 Pułtusk, Poland.
Zhassyn MukhambetovDepartment of Sport Education and Coaching, Academy of Physical Education and Mass Sport, 010000 Astana, Kazakhstan.ORCID 0000-0001-7435-9022
Daulet AzerbaevDepartment of Sport Education and Coaching, Academy of Physical Education and Mass Sport, 010000 Astana, Kazakhstan.
Sergei BondarevDepartment of Cardiac, Thoracic, and Vascular Sciences, University of Padova, 35122 Padova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Endurance training induces significant cardiac remodeling, with evidence suggesting that prolonged high-intensity exercise may increase the risk of atrial fibrillation (AF). However, physiological responses differ by event type. This review compares AF-related markers in marathon and ultramarathon runners, focusing on structural adaptations, inflammatory and endothelial biomarkers, and the incidence of arrhythmias. A systematic analysis of 29 studies revealed consistent left atrial (LA) enlargement in marathon runners linked to elevated AF risk and fibrosis markers such as Galectin-3 and PIIINP. In contrast, ultramarathon runners exhibited right atrial (RA) dilation and increased systemic inflammation, as indicated by elevated high-sensitivity C-reactive protein (hs-CRP) and soluble E-selectin levels. AF incidence in marathoners ranged from 0.43 per 100 person-years to 4.4%, while direct AF incidence data remain unavailable for ultramarathon populations, highlighting a critical evidence gap. These findings suggest distinct remodeling patterns and pathophysiological profiles between endurance disciplines, with implications for athlete screening and cardiovascular risk stratification.

Indexed as

atrial fibrillationcardiac remodelingendurance athletesmarathonultramarathon

Identifiers

PMID40710785
PMCPMC12295922

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.