- Oral presentation
- Open Access
CMR findings in high endurance veteran athletes - a 247 subject study
© Maestrini et al. 2016
- Published: 27 January 2016
- Endurance Exercise
- Sustained Ventricular Tachycardia
- Muscle Scar
- Total Cell Volume
- Veteran Athlete
Athletes demonstrate major adaptative changes in their hearts with high level of exercise. However the long term consequences of endurance training were not completely understood. We aimed to to explore the effect of long term endurance exercise on cardiac morphology and function, and diffuse fibrosis, and assess the significance of any discovered changes (correlation with documented ventricular arrhythmias).
Veteran athletes (Vets) were >40, did competitive endurance exercise >10 years and had done multiple competitions. Controls were healthy volunteers (HV). Demographics, blood pressure, Bloods (hematocrit, renal function, lipids), rest ECG were collected. CMR at 1.5 T with T1 mapping (ShMOLLI and MOLLI) was performed using extracellular volume (ECV) quantification. The intracellular volume (1-ECV) and total cell volume (ICV × LVMass/1.05) were derived. Vets also had a 24-hour Holter. Scar was defined on LGE as "Overt" - in the compacted LV myocardium (ischaemic or non-ischemic pattern) and not limited to the RV insertion points or "minor" (RV scar, RV insertion point scar or papilliary muscle scar).
247 subjects were recruited: 158 Vet (71% male, mean ± SD age:55 ± 8 ys) and 89 HV (53% male, mean age 50 ± 13 ys). Vets (male and female) demonstrated increased LV volumes, mass and atria size, with no difference in ejection fraction.
Overt LGE was significantly associated with non sustained ventricular tachycardia (OR = 5.4, 95% CI 1.2-24.9, p = 0.030).
Veteran athletes have increased LV and atrial size and increased LV mass. The LVH in veterans has a lower ECV and T1 than health - suggesting hypertrophy (away from scar) is cellular rather than interstitial. Compared to age/sex matched controls, there is significant overt (11%), and minor (25%) scarring. Overt scar was highly associated with NSVT.
The impression therefore is that sustained athleticism causes scarring which is detrimental.
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