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he cardiac impact of both acute and cumulative exercise is greatest on the RV.

Greater reductions in RV function occurred in those athletes competing for a longer duration, suggesting that the heart has a finite capacity to maintain the increased work demands of exercise

cardiac injury is greatest in the least trained

Previous investigators have documented reductions in RV function in less trained subjects over the marathon distance

We enrolled elite and subelite athletes and found a significant association between fitness (VO2max) and the reduction in post-race RVEF

Even after many years of detraining, cardiac dilation may not completely regress in elite athletes

The focus on well-trained athletes may be of particular relevance, given that they perform exercise of highest intensity and duration most frequently, and, thus, may be at a greater risk of cumulative injury.

The lack of correlation between increases in troponin and changes in LV function seen in this study has been previously interpreted as evidence that post-exercise elevations in cardiac biomarkers are benign.

a significant correlation between changes in RVEF and post-race biomarker levels and this relationship was even stronger in the athletes who completed the race of longest duration, the ultra-triathlon

The correlations with RVEF, but not LVEF, provide further evidence of the differential effects of intense exercise on RV and LV function

BNP release during intense exercise is associated with greater relative increases in RV systolic pressures, but not LV pressures

BNP may provide a measure of both acute RV load and the resultant fatigue which occurs when this load is sustained

It has been demonstrated that ventricular load increases with exercise intensity and is greater for the RV than the LV,29 thus potentially explaining why the RV is more susceptible to fatigue after prolonged exercise.

This study demonstrates, for the first time, an association between endurance exercise of increasing duration and structural, functional, and biochemical markers of cardiac dysfunction in highly trained athletes

Functional abnormalities were confined to the RV and were largely reversible 1 week following the event

there remained a significant minority of athletes in whom there was evidence of myocardial fibrosis in the interventricular septum

RV abnormalities may be acquired through cumulative bouts of intense exercise and provides direction for prospective investigations aimed at elucidating whether extreme exercise may promote arrhythmias in some athletes.

the acute injury and chronic remodelling of the myocardium both disproportionately affect the RV and it remains possible that the two are linked.

focal DGE was confined to the interventricular septum and commonly at the site of RV attachment

emerging evidence that intense endurance exercise may be associated with an excess in arrhythmic disorders, the mechanisms for which remain unexplained

RVEF (and not LVEF) was reduced in athletes with complex ventricular arrhythmias when compared with healthy athletes and non-athletes without arrhythmias

it is premature to conclude that these changes may represent a proarrhythmic substrate

This study demonstrates that testosterone treatment either before or after EAE disease induction partially restores deficits in synaptic transmission, preserves presynaptic and postsynaptic integrity, and prevents hippocampal pathology.

treatment with a pregnancy estrogen, estriol, can prevent deficits in excitatory synaptic transmission in the hippocampus during EAE

testosterone is important to the maintenance of normal synaptic spine density in the hippocampus

estriol treatment was also capable of preserving levels of synaptic proteins that are known to orchestrate functional synaptic transmission within the hippocampus.

Estriol is a therapeutic candidate in MS because it has widespread effects on the immune system and the CNS

MS patients have significantly decreased relapse rates during the third trimester of pregnancy, when estriol levels are most elevated, and relapse rates rebound during the postpartum period coinciding with an abrupt decline in serum estriol levels

In nonpregnant MS patients, estriol treatment has been shown to significantly reduce gadolinium-enhancing lesion number and volumes measured by MRI