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Resilience against exercise-related coronary atherosclerosis: A case study in a master athlete participating in 500 marathons

2026Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg04:Educação de Qualidade
dc.contributor.authorKnechtle, Beat
dc.contributor.authorDuric, Sasa
dc.contributor.authorScheer, Volker
dc.contributor.authorNikolaidis, Pantelis T.
dc.contributor.authorChlíbková, Daniela
dc.contributor.authorLeite, Luciano Bernardes
dc.contributor.authorCuk, Ivan
dc.contributor.authorForte, Pedro
dc.contributor.authorWilhelm, Matthias
dc.contributor.authorWeiss, Katja
dc.contributor.authorRosemann, Thomas
dc.date.accessioned2026-06-19T09:10:50Z
dc.date.available2026-06-19T09:10:50Z
dc.date.issued2026
dc.description.abstractBackground 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 similar to 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.eng
dc.description.sponsorshipWe thank the runner for providing us all his specific data.
dc.identifier.citationKnechtle, Beat; Duric, Sasa; Scheer, Volker; Nikolaidis, Pantelis T.; Chlíbková, Daniela; Leite, Luciano Bernardes; Cuk, Ivan; Forte, Pedro; Wilhelm, Matthias; Weiss, Katja; Rosemann, Thomas (2026). Resilience against exercise-related coronary atherosclerosis: A case study in a master athlete participating in 500 marathons. Sports Medicine and Health Science. ISSN 2666-3376. 8:2, p. 1-9
dc.identifier.doi10.1016/j.smhs.2025.07.011
dc.identifier.issn2666-3376
dc.identifier.urihttp://hdl.handle.net/10198/36908
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.ispartofSports Medicine and Health Science
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectRunning
dc.subjectMiddle-aged ma
dc.subjectCardiovascular disease
dc.titleResilience against exercise-related coronary atherosclerosis: A case study in a master athlete participating in 500 marathonseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage9
oaire.citation.issue2
oaire.citation.startPage1
oaire.citation.titleSports Medicine and Health Science
oaire.citation.volume8
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameForte
person.givenNamePedro
person.identifier.ciencia-id351B-B16B-79C7
person.identifier.orcid0000-0003-0184-6780
relation.isAuthorOfPublication3ecc6d1b-07a4-40d7-81f4-df6fd7b3d5b0
relation.isAuthorOfPublication.latestForDiscovery3ecc6d1b-07a4-40d7-81f4-df6fd7b3d5b0

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