ArticlePhysiological reports2026
Comparison of P wave indices between ultramarathon athletes and general population.
Article in Physiological reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Role of Exercise in Modulating the Brain-Heart Axis in Cardiovascular Diseases.International journal of molecular sciences · 2026Review
- Comparison of P wave indices between ultramarathon athletes and general population.Physiological reports · 2026Article
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Authors and funding
7 authors.
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Abstract
High-intensity endurance exercise is linked to increased atrial fibrillation (AF) risk. P wave indices are established AF risk markers, but their role in ultramarathon athletes is unexplored. This study aimed to compare P wave indices between ultramarathon athletes and healthy controls. This cross-sectional study enrolled 74 ultramarathon athletes and 38 age- and sex-matched healthy volunteers (2:1 ratio). Athletes had completed ≥1 race of ≥100 km or ≥60 km in the past year. Participants with AF, atrial flutter, cardiovascular diseases, or structural heart abnormalities were excluded. Resting 12-lead ECGs evaluated P wave indices: maximum P wave duration, P wave dispersion, P wave terminal force in lead V1 (PTFV1), and P wave amplitude in lead II (PWAII). The cohort's mean age was 44.8 ± 8.2 years, 70% male. Ultramarathon athletes had significantly higher maximum P wave duration (114.24 ± 7.95 ms vs. 105.76 ± 7.15 ms, p < 0.001), P wave dispersion (18.77 ± 5.75 ms vs. 7.87 ± 2.51 ms, p < 0.001), PTFV1 (5795.66 ± 3212.27 μV·ms vs. 2399.17 ± 1140.19 μV·ms, p < 0.001) and PWAII (0.16 ± 0.05 mV vs. 0.12 ± 0.04 mV). Abnormal P wave duration (>120 ms) and PTFV1 (≥4000 μV·ms) were significantly more prevalent in ultramarathon athletes (25.7% vs. 5.3%, p = 0.010; 63.5% vs. 5.3%, p < 0.001). Similar findings were observed across genders. Ultramarathon runners demonstrate significant atrial electrical remodeling, as evidenced by abnormal P wave indices, may have potential relevance to arrhythmia risk. Further longitudinal studies are warranted to assess clinical outcomes.
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