Hausswirth C, Lehénaff D. Physiological demands of running during long distance runs and triathlons. Sports Med. 2001;31:679–89.

Article  CAS  PubMed  Google Scholar 

Douglas PS, O’Toole ML, Hiller WD, Hackney K, Reichek N. Cardiac fatigue after prolonged exercise. Circulation. 1987;76:1206–13.

Article  CAS  PubMed  Google Scholar 

Lord RN, Utomi V, Oxborough DL, Curry BA, Brown M, George KP. Left ventricular function and mechanics following prolonged endurance exercise: an update and meta-analysis with insights from novel techniques. Eur J Appl Physiol. 2018;118:1291–9.

Article  PubMed  PubMed Central  Google Scholar 

Whyte GP, George K, Sharma S, Lumley S, Gates P, Prasad K, McKENNA WJ. Cardiac fatigue following prolonged endurance exercise of differing distances. Med Sci Sports Exerc. 2000;32:1067–72.

Article  CAS  PubMed  Google Scholar 

La Gerche A, Claessen G, Dymarkowski S, Voigt J-U, De Buck F, Vanhees L, Droogne W, Van Cleemput J, Claus P, Heidbuchel H. Exercise-induced right ventricular dysfunction is associated with ventricular arrhythmias in endurance athletes. Eur Heart J. 2015;36:1998–2010.

Article  PubMed  Google Scholar 

Russell K, Eriksen M, Aaberge L, et al. A novel clinical method for quantification of regional left ventricular pressure–strain loop area: a non-invasive index of myocardial work. Eur Heart J. 2012;33:724–33.

Article  PubMed  PubMed Central  Google Scholar 

Tiller NB. Pulmonary and respiratory muscle function in response to marathon and ultra-marathon running: a review. Sports Med. 2019;49:1031–41.

Article  PubMed  PubMed Central  Google Scholar 

Bekos C, Zimmermann M, Unger L, et al. Exercise-induced bronchoconstriction, temperature regulation and the role of heat shock proteins in non-asthmatic recreational marathon and half-marathon runners. Sci Rep. 2019;9:4168.

Article  PubMed  PubMed Central  Google Scholar 

Johnson BD, Weisman IM, Zeballos RJ, Beck KC. Emerging concepts in the evaluation of ventilatory limitation during exercise: the exercise tidal flow-volume loop. Chest. 1999;116:488–503.

Article  CAS  PubMed  Google Scholar 

Zavorsky GS, Milne ENC, Lavorini F, Rienzi JP, Cutrufello PT, Kumar SS, Pistolesi M. Small changes in lung function in runners with marathon-induced interstitial lung edema. Physiol Rep. 2014;2: e12056.

Article  PubMed  PubMed Central  Google Scholar 

Boussana A, Galy O, Gallais DL, Hue O. The effect of an olympic distance triathlon on pulmonary diffusing capacity and its recovery 24 hours later. J Hum Kinet. 2021;80:83–92.

Article  PubMed  PubMed Central  Google Scholar 

Caillaud C, Serre-Cousine O, Anselme F, Capdevilla X, Prefaut C. Computerized tomography and pulmonary diffusing capacity in highly trained athletes after performing a triathlon. J Appl Physiol. 1995;79:1226–32.

Article  CAS  PubMed  Google Scholar 

Aoun J, Dgayli K, Abou Zeid C, Wong G, LaCamera P. Pulmonary edema during the Boston Marathon. Respir Med Case Rep. 2019;27: 100845.

PubMed  PubMed Central  Google Scholar 

Pinsky MR. Cardiopulmonary interactions: physiologic basis and clinical applications. Ann Am Thorac Soc. 2018;15:S45–8.

Article  PubMed  PubMed Central  Google Scholar 

Balmain BN, Tomlinson AR, MacNamara JP, Hynan LS, Wakeham DJ, Levine BD, Sarma S, Babb TG. Reducing pulmonary capillary wedge pressure during exercise exacerbates exertional dyspnea in patients with heart failure with preserved ejection fraction: implications for V˙/Q˙ mismatch. Chest. 2023;164:686–99.

Article  PubMed  PubMed Central  Google Scholar 

Buckner K. Cardiac asthma. Immunol Allergy Clin North Am. 2013;33:35–44.

Article  PubMed  Google Scholar 

Magini A, Apostolo A, Salvioni E, Italiano G, Veglia F, Agostoni P. Alveolar–capillary membrane diffusion measurement by nitric oxide inhalation in heart failure. Eur J Prev Cardiol. 2015;22:206–12.

Article  PubMed  Google Scholar 

Fermoyle CC, Stewart GM, Borlaug BA, Johnson BD. Simultaneous measurement of lung diffusing capacity and pulmonary hemodynamics reveals exertional alveolar-capillary dysfunction in heart failure with preserved ejection fraction. J Am Heart Assoc. 2021;10: e019950.

Article  PubMed  PubMed Central  Google Scholar 

Maufrais C, Millet GP, Schuster I, Rupp T, Nottin S. Progressive and biphasic cardiac responses during extreme mountain ultramarathon. Am J Physiol-Heart Circul Physiol. 2016;310:H1340–8.

Article  Google Scholar 

Graham BL, Steenbruggen I, Miller MR, et al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med. 2019;200:e70–88.

Article  PubMed  PubMed Central  Google Scholar 

Parsons JP, Hallstrand TS, Mastronarde JG, et al. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med. 2013;187:1016–27.

Article  CAS  PubMed  Google Scholar 

O’donnell DE, Revill SM, Webb KA. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;164:770–7.

Article  PubMed  Google Scholar 

De La Villeon G, Gavotto A, Ledong N, et al. Double gas transfer factors (DLCO-DLNO) at rest in patients with congenital heart diseases correlates with their ventilatory response during maximal exercise. Int J Cardiol Congenital Heart Dis. 2022;8: 100346.

Article  Google Scholar 

Zavorsky GS, Hsia CCW, Hughes JMB, Borland CDR, Guénard H, van der Lee I, Steenbruggen I, Naeije R, Cao J, Dinh-Xuan AT. Standardisation and application of the single-breath determination of nitric oxide uptake in the lung. Eur Respir J. 2017;49:1600962.

Article  PubMed  Google Scholar 

Roughton FJW, Forster RE. Relative importance of diffusion and chemical reaction rates in determining rate of exchange of gases in the human lung, with special reference to true diffusing capacity of pulmonary membrane and volume of blood in the lung capillaries. J Appl Physiol. 1957;11:290–302.

Article  CAS  PubMed  Google Scholar 

Murias JM, Zavorsky GS. Short-term variability of nitric oxide diffusing capacity and its components. Respir Physiol Neurobiol. 2007;157:316–25.

Article  CAS  PubMed  Google Scholar 

Franklin BA, Thompson PD, Al-Zaiti SS, et al. Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective—an update: a scientific statement From the American Heart Association. Circulation. 2020. https://doi.org/10.1161/CIR0000000000000749.

Article  PubMed  PubMed Central  Google Scholar 

Hiemstra YL, van der Bijl P, el Mahdiui M, Bax JJ, Delgado V, Marsan NA. Myocardial work in nonobstructive hypertrophic cardiomyopathy: implications for outcome. J Am Soc Echocardiogr. 2020;33:1201–8.

Article  PubMed  Google Scholar 

Erevik CB, Kleiven Ø, Frøysa V, et al. Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue. Front Cardiovasc Med. 2023;9:1081664.

Article  PubMed  PubMed Central  Google Scholar 

Zavorsky GS, Zimmerman RD, Shendell DG, Goodfellow LT. Acute reduction in spirometry values after prolonged exercise among recreational runners. Respir Care. 2019;64:26–33.

Article  PubMed  Google Scholar 

Vernillo G, Rinaldo N, Giorgi A, Esposito F, Trabucchi P, Millet GP, Schena F. Changes in lung function during an extreme mountain ultramarathon. Scand J Med Sci Sports. 2015;25:e374–80.

Article  CAS  PubMed  Google Scholar 

Hughes JMB, Dinh-Xuan AT. The DLNO/DLCO ratio: physiological significance and clinical implications. Respir Physiol Neurobiol. 2017;241:17–22.

Article  CAS