This NYT article reviews some recent research on the effects of high volume running on scar tissue in the heart. It focuses on long-term, always active, non-smoking runners. There is scarring in heart tissues among most if not all of them. Even rats who are made to marathon-like running and high volume training, show scarring of the heart. Scared heart muscle is more likely to go into fibrillation because the contraction pulses across the heart become more fragile and lose their coordination. A scarred muscle does not have the flexibility and contraction force, so the coordination breaks down at mutiple sites. The good news is that this is reversed, in the rats, when they are no longer made to run excessively.
I have argued that metronomic training reduces the chaos in the heart. Scarring of heart muscle is an obvious way that would occur. A scarred heart cannot have the power law variation of heart beat intervals and is more likely to lock onto periodic contraction patterns---fibrillation.
This only looked at heart muscle. Other tissues of the heart may also be damaged, particularly the valves. There is often damage in other tissues as well, ankles, knees, hips, the foot, the upper respiratory system, the kidney (which has to clear the damaged proteins), and other organs that may be but in transitory state of ischemia.
We are not against running: easy forest running with cuts and variation of pace, or sprinting a variety of distances at varying pace, if fun and easy. It is the metronomic, forced pacing and long duration of long-distance running that is unnatural. And piling up the miles is not enjoying much of anything.