{
  "abstract": "Background: The autonomic nervous and endocrine systems are involved in the physiological adaptation to exercise, and in experimental settings both the sympathovagal balance and the adrenal function are associated with athletic performance. In this real-life field study, the association between non-invasive markers of cardiac autonomic modulation, urinary adrenal hormone levels, and marathon finishing time in middle-aged Caucasian male athletes was investigated.\n\nMethods: A prospective study was conducted in male marathon runners aged ≥30 years. Continuous single-lead electrocardiographic (ECG) recordings were obtained using a wearable chest device from the day before the marathon until after its completion. Urinary adrenal hormone levels were measured before and after the race. Univariate linear regression analyses were performed to correlate general characteristics, nocturnal heart rate variability (HRV) parameters, and hormonal parameters with marathon finishing time. A multivariable model was then applied including age, body mass index (BMI), and training hours.\n\nResults: 104 athletes were enrolled in the study and 73 (median age 48 years, interquartile range = 16) had adequate data quality for the final analysis. Several HRV parameters correlated with better performance at univariate analysis; lower minimum nocturnal heart rate and vagal predominance, expressed as higher 2 Like Variations (2LV) values remained independently associated with shorter finishing time. Among hormonal variables, the post-/pre-race ratio of urinary normetanephrine hourly output and cortisol/cortisone ratio remained significant at multivariable analysis. Only BMI, but not age and training history, remained significant in a model integrating HRV and hormones.\n\nConclusions: Under real-world marathon conditions, specific HRV indices and endocrine markers showed promising value as indicators of physiological readiness with endurance exercise in male master athletes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy",
    "Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy",
    "Department of Sports Medicine, Semmelweis University, Budapest, Hungary",
    "Department of Medicine DIMED, University of Padova, Padua, Italy",
    "Laboratory Medicine Unit, University Hospital of Padova, Padua, Italy",
    "Unit of Endocrinology, University-Hospital of Padova, Padua, Italy",
    "Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil",
    "Department of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023–2027, University of Milan, Milan, Italy",
    "Ospedale Riabilitativo di Alta Specializzazione (ORAS), Motta di Livenza, Italy"
  ],
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  "author_total": 23,
  "authors": [
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        0
      ],
      "name": "Amedeo De Antoni"
    },
    {
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        1
      ],
      "name": "Lucia Silvia Giobbi"
    },
    {
      "affs": [
        0
      ],
      "name": "Sergei Bondarev"
    },
    {
      "affs": [
        0
      ],
      "name": "Martina Calligione"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Francesca Graziano"
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    {
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        0
      ],
      "name": "Simone Ungaro"
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    {
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        0
      ],
      "name": "Matteo Pizzolato"
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    {
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        0
      ],
      "name": "Alessandro Gianni"
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    {
      "affs": [
        0
      ],
      "name": "Giulia Pivetta"
    },
    {
      "affs": [
        0
      ],
      "name": "Lorenzo Da Rin De Monego"
    },
    {
      "affs": [
        0
      ],
      "name": "Girolamo Architetto"
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    {
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        4
      ],
      "name": "Giorgia Antonelli"
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        4
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      "name": "Giovanna Tretti"
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        5
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      "name": "Filippo Ceccato"
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      "name": "Angelica Carandina"
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      "name": "Ludovico Furlan"
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    {
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      "name": "Greta Salafia"
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    {
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        1
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      "name": "Francesca Magna"
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    {
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        6
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      "name": "Thais Marques da Silva"
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    {
      "affs": [
        3,
        4
      ],
      "name": "Martina Montagnana"
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    {
      "affs": [
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        7
      ],
      "name": "Nicola Montano"
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    {
      "affs": [
        0,
        8
      ],
      "name": "Alessandro Zorzi"
    },
    {
      "affs": [
        1,
        7
      ],
      "name": "Eleonora Tobaldini"
    }
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  "doi": "10.3389/fcvm.2026.1932814",
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  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
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  "title": "Associations of cardiac autonomic modulation and urinary adrenal hormones with marathon finishing time in middle-aged male athletes",
  "title_text": "Associations of cardiac autonomic modulation and urinary adrenal hormones with marathon finishing time in middle-aged male athletes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:45Z",
  "url": "https://research.draconitic.com/paper/ch7mg67td4fzt",
  "venue": "Frontiers in Cardiovascular Medicine",
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