Limits of Cardiovascular Adaptation During an Extreme Ultramarathon: Insights From Serial Multidimensional, Multiparametric CMR.

Extreme endurance athletic challenges provide unique opportunities to study the cardiovascular system's capacity for structural, functional, and hemodynamic adaptation. The authors present a case of a male subject who ran 2,469 km, with serial multiparametric cardiac magnetic resonance imaging used to demonstrate adaptive and maladaptive alterations in cardiac remodeling and myocardial tissue health. ( Level of Difficulty: Advanced. ).