Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atheroscle...Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis,even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.Methods: We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127 000-km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography(CTCA).Results: The runner was asymptomatic, had a low ESC-SCORE2(3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein(a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.Conclusions: This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.展开更多
文摘Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis,even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.Methods: We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127 000-km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography(CTCA).Results: The runner was asymptomatic, had a low ESC-SCORE2(3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein(a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.Conclusions: This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.
