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Reversal of Runner's Bradycardia with Training Overstress

Dressendorfer, Rudolph H. PhD; Hauser, Andrew M. MD; Timmis, Gerald C. MD

Clinical Journal of Sport Medicine:
Clinical Investigations

Objective: To elicit a criterion elevation (>10%) in resting heart rate (HR) with training overstress, and subsequently test the hypothesis that such “reversed bradycardia” (RB) negatively affects running performance.

Design: Prospective before-and-after intervention with a comparison group.

Setting: General community.

Participants: 21 healthy male marathon runners.

Intervention: Voluntary doubling of training miles on 14 consecutive days.

Main Outcome Measures: Left ventricular (LV) function by echocardiography, HR, and plasma epinephrine (PE) at rest and during submaximal exercise, and 15 km road run performance.

Results: Two days after the training overstress, 12 runners met the criterion (RB group), showing an average elevation in resting HR of 16% (range: 11 to 23%). The RB group also exhibited hyperkinetic LV shortening (p < 0.05), elevated exercise HR (p < 0.001), increased PE at rest and during exercise (p < 0.05), and reduced 15 km performance (p < 0.05). The other nine runners who maintained a stable resting HR during the intervention showed no significant outcome changes.

Conclusions: In addition to muscular overuse, heightened sympathetic drive likely contributed to the observed reversal of bradycardia. The development of this stress-related cardiac perturbation was associated with a decrement in running performance, confirming the hypothesis.

Author Information

Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, U.S.A.

Received January 21, 2000; accepted August 9, 2000.

Address correspondence to Rudolph H. Dressendorfer, PhD, 6025 Colwell Rd., Penryn, CA 95663, U.S.A. E-mail:

© 2000 Lippincott Williams & Wilkins, Inc.