Myocardial Fibrosis in Competitive Triathletes Detected by Contrast-Enhanced CMR Correlates With Exercise-Induced Hypertension and Competition History

Autor: Julia Münch, Axel Pressler, Christian Stehning, Ulf K Radunski, Kai Muellerleile, Stefan Blankenberg, Gunnar K. Lund, Enver Tahir, Julius Matthias Weinrich, Sebastian Bohnen, Jitka Starekova, Monica Patten, Maxim Avanesov, Alexandra von Stritzky, Gerhard Adam, Eric Freiwald
Rok vydání: 2018
Předmět:
Adult
Male
Competitive Behavior
medicine.medical_specialty
Adolescent
Heart Diseases
Physical fitness
Contrast Media
Magnetic Resonance Imaging
Cine
030204 cardiovascular system & hematology
Risk Assessment
Asymptomatic
Running
030218 nuclear medicine & medical imaging
Young Adult
03 medical and health sciences
Meglumine
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Organometallic Compounds
Humans
Medicine
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
LV hypertrophy
Swimming
Aged
Peak exercise
business.industry
Myocardium
Area under the curve
Middle Aged
Fibrosis
Bicycling
Blood pressure
Athletes
Case-Control Studies
Hypertension
embryonic structures
Physical Endurance
Cardiology
Female
Myocardial fibrosis
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Cardiac magnetic resonance
Zdroj: JACC: Cardiovascular Imaging. 11:1260-1270
ISSN: 1936-878X
DOI: 10.1016/j.jcmg.2017.09.016
Popis: Objectives This study analyzed the presence of myocardial fibrosis detected by late gadolinium-enhancement (LGE) cardiac magnetic resonance (CMR) in correlation with the performance of competitive triathletes objectified by an exercise test and individual competition history. Background Myocardial fibrosis detected by LGE CMR has been reported to occur in 0% to 50% of asymptomatic athletes. However, the cause and mechanisms of myocardial fibrosis are unclear. Methods Eighty-three asymptomatic triathletes undergoing >10 training h per week (43 ± 10 years of age; 65% male) and 36 sedentary controls were studied by using LGE and extracellular volume (ECV) CMR. Parameters of physical fitness were measured by spiroergometry. Triathletes reported their lifetime competition results. Results LGE CMR revealed focal nonischemic myocardial fibrosis in 9 of 54 (17%) male triathletes (LGE + ) but in none of the female triathletes (p + triathletes had higher peak exercise systolic blood pressure (213 ± 24 mm Hg) than LGE − triathletes (194 ± 26 mm Hg; p + triathletes (93 ± 7 g/m 2 ) than in LGE − triathletes (84 ± 11 g/m 2 ; p 0.05). ECV in LGE − myocardium was higher in LGE + triathletes (26.3 ± 1.8%) than in LGE − triathletes (24.4 ± 2.2%; p + triathletes completed longer cumulative distances in swimming and cycling races and participated more often in middle and Iron Man distances than LGE − triathletes. A cycling race distance of >1,880 km completed during competition had the highest accuracy to predict LGE, with an area under the curve value of 0.876 (p Conclusions Myocardial fibrosis in asymptomatic triathletes seems to be associated with exercise-induced hypertension and the race distances. There appears to be a safe upper limit, beyond which exercise may result in myocardial fibrosis.
Databáze: OpenAIRE
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