Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Sport Sciences, CARDIAC MAGNETIC RESONANCE, LATE GADOLINIUM ENHANCEMENT, T1 MAPPING, EXTRACELLULAR VOLUME FRACTION, AGING, ARTERY WEDGE PRESSURE, MAGNETIC-RESONANCE, MYOCARDIAL FIBROSIS, EXTRACELLULAR VOLUME, NATIVE T1, EXERCISE, MARATHON, PREVALENCE, HEART, ECV, Aged, Athletes, Bicycling, Contrast Media, Exercise, Female, Fibrosis, Heart Ventricles, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Organometallic Compounds, Oxygen Consumption, Physical Endurance, Running, Stroke Volume, Swimming, Ventricular Remodeling, 1106 Human Movement and Sports Sciences, 1116 Medical Physiology, 1117 Public Health and Health Services, 3202 Clinical sciences, 3208 Medical physiology, 4207 Sports science and exercise

Abstract:

INTRODUCTION: Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and T1 mapping techniques enable the quantification of focal and diffuse myocardial LGE, respectively. Studies have shown evidence of fibrosis in middle-age athletes, but not relative to physically active (PA) adults who perform recommended physical activity levels. Therefore, we examined cardiac remodeling and presence of left ventricular (LV) LGE and T1 values in both recreational middle-age endurance athletes (EA) and PA adults. METHODS: Healthy EA and PA adults (45-65 yr) completed a standardized 3-T CMR protocol with ventricular volumetry, LV LGE, and T1 mapping. RESULTS: Seventy-two EA and 20 PA participants (mean age, 53 ± 5 vs 56 ± 4 yr; P < 0.01; V˙O2peak = 50 ± 7 vs 37 ± 9 mL·kg·min, P < 0.0001) were examined, with CMR data available in 89/92 participants. Focal LV LGE was observed in 30% of participants (n = 27/89): 33% of EA (n = 23/69; 33%) and 20% of PA (n = 4/20; 20%). LGE was present at the right ventricular hinge point (n = 21/89; 23.5%) or identified as ischemic (n = 2/89; 2%) or nonischemic (n = 4/89; 4%). Focal LV LGE was observed similarly in both EA and PA (P = 0.25). EA had larger LV chamber sizes and T1 native values (1169 ± 35 vs 1190 ± 26, P = 0.02) compared with PA, with similar LV ejection fraction. Global extracellular volume (ECV) was similar in both EA and PA (22.6% ± 3.5% vs 21.5% ± 2.6%, P = 0.26), with no relationship between global ECV and LV mass (r = -0.16, P = 0.19). CONCLUSIONS: Focal LGE at the right ventricular hinge point was detected at the same frequency in both groups, was unrelated to demographic or clinical indices, and was found without evidence of global ECV expansion in EA, suggesting a physiologic remodeling response. The long-term clinical implications of hinge-point LGE require clarification using prospective, long-term follow-up studies.