TY - JOUR T1 - Pulmonary edema is frequently triggered by marathon running JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 1655 AU - Gerald Zavorsky AU - Eric Milne AU - Massimo Pistolesi AU - Federico Lavorini AU - Joseph Rienzi AU - Kaleen Lavin AU - Allison Straub Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/1655.abstract N2 - Despite the mounting evidence that pulmonary edema can be triggered by strenuous exercise, (Acta Physiol, 2007, 189: 305-17) it is still widely debated (J Appl Physiol, 2010, 109: 1276-80). The purpose of this study was therefore to determine if pulmonary edema is triggered by marathon running and, if so, to examine its incidence and severity. Twenty-seven runners completed the 2011 Steamtown Marathon, in Scranton, PA, United States, beginning at an elevation of 452 meters above sea level (8°C, 96% RH) and ending with a net elevation drop of 291 meters at the finish (21°C, 51% RH). All runners finished between 142 and 289 minutes. Posteroanterior (PA) and lateral (LA) radiographs were taken one day before the race (pre), and then at 19 (SD 8), 55 (13), and 98 (15) min post-marathon finish, the delay ensuring that any post-exercise increase in capillary blood volume would return to normal. Two experienced chest image readers (EM, MP) independently interpreted the images. They were blinded as to the times at which the radiographs were taken. The PA+LA radiographs were viewed together as a set at each time-point and were scored on eight different radiological characteristics. When summed together, the scores could range from 0 (no edema) to 32 (severe interstitial edema). Mean edema scores from all subjects increased from 1.5 units pre-exercise to 4.1, 3.7, and 2.8 units at 19, 55, and 98 minutes post-exercise, respectively (p < 0.01). Nine runners (33%) had an average increase in the edema score (average of the 19 min post-score minus the average of the pre-score) by 7.1 units (5-fold increase), which still remained high at 55 min post-exercise. In conclusion, pulmonary edema is triggered in 33% of marathon finishers. ER -