Background: Physical activity has a cardinal role in preventing and treating cardiovascular diseases. Understanding thechanges that occur to the cardiac muscle in athletes is still doubtful whether it is only an adaptation to exercise or a concealed pathological condition. Most of these changes are well documented in apparently healthy heart and characterized by cardiac enlargement with Brady-arrhythmias specially individuals participating in long distance runners with exercise capacity without signs of cardiovascular disease. Methods: The study searched the subclinical myocardial necrosis by comparingtwo groups of young marathon runners, both groups were chosen from Al Gizera youth center in January 2018. First group included adults above the age of 18 years and ran for 12 km. and the second was under 18 years and ran for about 8 km. Both groups were volunteered for this study. They are monitored carefully with blood pressure, heart rate and respiratory rate and their blood samples were collected pre- and post-race immediately for assessment of cardiac markers NTproBNP, Galectin-3 and cTnI. Results: All cardiac？markers were elevated post exercise compared to that achieved in？pre-exercise regardless age of athletes. Also, pre-exercise adult results were higher in galectin-3 and cTnI but not in proBNP while there is no difference in the acute response in both groups. These results revealed micro cardiac necrosis due to long run exercise with possible bad prognosis. Conclusions: It is important to develop risk assessment and prediction methods for screening the young athletes and consider the term athletic heart as a subclinical disorder rather than physiological adaptation.
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