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Cited by 193Cardiovascular Effects of ExerciseCardiovascular and exercise physiologyCardiac Imaging and Diagnostics

Coronary artery size and dilating capacity in ultradistance runners

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Haskell, W L, Sims, C, Myll, J, Bortz, W M, St Goar, F G, Alderman, E L·1993·Circulation
DOI 10.1161/01.cir.87.4.1076
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Abstract

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.

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  • Endurance athletes have larger coronary arteries and a greater vasodilatory potential.

    “it is known that endurance athletes have larger coronary arteries and a greater vasodilatory potential”

    From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [28]

    The Abstract reports greater coronary-artery dilation after nitroglycerin in the ultradistance runners. It also reports no significant difference in artery size before nitroglycerin, so the unqualified claim that endurance athletes have larger coronary arteries is not supported by this study's measurements. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Beneficial vascular adaptations such as an improved coronary flow reserve may allow athletes to better deal with coronary stenoses and experience fewer symptoms and events than the general population with a similar plaque burden.

    “Therefore, beneficial vascular adaptations such as an improved coronary flow reserve 46, 47 may also allow athletes to better deal with coronary stenoses and experience fewer symptoms and events than the general population with a similar plaque burden.”

    From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [47]

    The Abstract reports greater coronary artery dilation after nitroglycerin in ultradistance runners than in inactive men, which supports the general idea of a vascular difference. But the study did not establish improved coronary flow reserve or test athletes with coronary stenoses against people with a similar plaque burden. The Implications section explicitly says that any clinical benefit from the greater dilating capacity remains to be determined (pp. 1076–1082). (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The plaque-to-vessel ratio in athletes could be lower and thus lead to less significant stenosis.

    “meaning that the plaque-to-vessel ratio in athletes could be lower and thus lead to less significant stenosis.27,28”

    From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [28]

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Research works printed but not linked: 17

  1. Haskell WL: Mechanisms by which physical activity may enhance the clinical status of cardiac patients, in Pollock MC, Schmidt DH (eds): Heart Disease and Rehabilitation, ed 2. New York, John Wiley & Sons, 1985, pp 276-296
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  4. Mann GV, Spoerry A, Gray M, Jarashow D: Atherosclerosis in the Masi. Am J Epidemiol 1972;95:26-37
  5. Devereux RB, Reichek N: Echocardiographic determination of left ventricular mass in man. Circulation 1977;55:613-678
  6. Savin WM, Haskell WL, Schroeder B, Stinson EB: Cardiorespira- tory responses of cardiac transplant patients to graded, symptom- limited exercise. Circulation 1980;62:55-60
  7. Heiss G, Tanni I, Davis C: Lipoprotein-cholesterol distributions in selected North American populations: The Lipid Research Clinics Program Prevalence Study. Circulation 1980;61:302-315
  8. Liebow AA: Situations which lead to changes in vascular patterns, in Handbook ofPhysiology: Circulation. Washington, DC, American Physiological Society, 1963, Sect 2, Vol 2, Chap 37, pp 1251-1276
  9. Kamiya A, Togawa T: Adaptative regulation of wall shear stress to flow change in the canine carotid artery. Am J Physiol 1980;239: H14-H21
  10. Norris JN, Crawford MD: Coronary heart disease and physical activity of work: Evidence of a national necropsy survey. Br Med J 1958;5111:1485-1496
  11. Roberts CS, Robert WC: Cross-sectional area of the proximal portions of the three major epicardial coronary arteries in 98 necropsy patients with different coronary events relationship to heart weight, age and sex. Circulation 1980;62:953-959
  12. Dodge JT, Brown BG, Bolson EL, Dodge HT: Lumen diameter of normal human coronary arteries: Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation 1992;86:232-246
  13. Leung W-H, Stadium ML, Alderman EL: Determinants of nor- mal coronary artery dimensions in humans. Circulation 1991;84: 2294-2306
  14. Brown BG, Bolson E, Petersen RB, Pierce CD, Dodge HT: The mechanisms of nitroglycerin action: Stenosis vasodilatation as a major component of the drug response. Circulation 1981;64: 1089-1096
  15. Vita JA, Treasure CB, Nabel EG, McLenachan JM, Fish RD, Yeung AC, Vekshtein VI, Selwyn AP, Ganz P: Coronary vasomo- tor response to acetylcholine relates to risk factors for coronary artery disease. Circulation 1990;81:491-497
  16. Yasue H, Matsuyama K, Matsuyama K, Okumura K, Morikami Y, Ogawa H: Responses of angiographically normal human coronary arteries to intracoronary injection of acetylcholine by age and segment: Possible role of early atherosclerosis. Circulation 1990;81: 482-490
  17. Martin WH, Montgomery J, Snell PG, Corbett JR, Sokolov JJ, Buckey JC, Maloney DA, Blomqvist CG: Cardiovascular adapta- tions to intense swim training in sedentary middle-aged men and women. Circulation 1987;75:323-330

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Authors
Haskell, W. L., Sims, C., Myll, J., Bortz, W. M., St Goar, F. G., & Alderman, E. L.
Affiliations
  • Stanford Medicine (US)
  • Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA 94304-1583.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1993-04
Volume
87
Issue
4
Pages
1076-1082
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.87.4.1076
OpenAlex
W2116816843
Cited by
193
References
34
Citations by year
2025: 4 · 2024: 8 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 9 · 2019: 2 · 2018: 7 · 2017: 7 · 2016: 2 · 2015: 10 · 2014: 6 · 2013: 6 · 2012: 7
FWCI
7.58
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl028292-10)
  • National Heart, Lung, and Blood Institute (T32HL007034, HL-28292, HL 07034)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords
coronary artery size, endurance training, epicardial coronary arteries, nitroglycerin response, left ventricular mass, cardiorespiratory fitness, adiposity, serum lipoproteins, resting heart rate, coronary artery disease
MeSH terms
Adult, Aged, Coronary Vessels, Cross-Sectional Studies, Echocardiography, Nitroglycerin, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Physical Endurance, Regression Analysis, Running, Vasodilation, Exercise, Ventricular Function, Left, Coronary Angiography

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