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 |
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| 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 |
| 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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