Circulation, Vol 87, 1076-1082, Copyright © 1993 by American Heart Association
WL Haskell, C Sims, J Myll, WM Bortz, FG St Goar and EL Alderman
BACKGROUND. Increases in coronary artery size and dilating capacity have
been observed in some animals after endurance training, and at autopsy,
active men appear to have enlarged epicardial coronary arteries. This
cross-sectional study was designed to test the hypothesis that highly
trained endurance runners have larger epicardial coronary arteries and
greater dilating capacity than inactive men. METHODS AND RESULTS. The
subjects, ages 39-66 years, included 11 male volunteers who had
participated in ultradistance running during the past 2 years and 11
physically inactive men who had been referred for arteriography but had no
visible coronary artery disease. The internal diameter of the proximal
segments of each major epicardial coronary artery was measured before and
after nitroglycerin administration using a computer-based quantitative
arteriographic analysis system. Measurements also included maximal oxygen
uptake, plasma lipoprotein concentrations, body composition, and cardiac
mass by echocardiography. Before nitroglycerin, the sum of the
cross-sectional areas for the proximal right, left anterior descending, and
circumflex arteries was not different for the runners and the inactive men:
22.7 +/- 4.79 versus 21.0 +/- 7.97 mm2 (p = 0.57), respectively. However,
the increase in the sum of the cross-sectional area for the proximal right,
left anterior descending, and circumflex arteries in response to
nitroglycerin was greater for the runners (13.20 +/- 4.76 versus 6.00 +/-
3.02 mm2; p = 0.002). Left ventricular mass index (152 +/- 21 versus 116
+/- 41 g/m2; p < 0.05) but not left ventricular mass (284 +/- 40 versus
246 +/- 91 g; p = 0.22) was significantly greater for the runners. Among
the runners, dilating capacity was positively correlated with aerobic
capacity and negatively related to adiposity, resting heart rate, and
plasma lipoprotein concentrations. CONCLUSIONS. Highly trained, middle-aged
endurance runners demonstrated a significantly greater dilating capacity of
their epicardial coronary arteries in response to nitroglycerin compared
with inactive men. The causes of this greater dilating capacity and its
clinical significance need to be determined.
ARTICLES
Coronary artery size and dilating capacity in ultradistance runners
Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA 94304-1583.
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