| Title |
Myocardial Fibrosis in Competitive Triathletes Detected by Contrast-Enhanced CMR Correlates With Exercise-Induced Hypertension and Competition History
|
|---|---|
| Published in |
JACC: Cardiovascular Imaging, December 2017
|
| DOI | 10.1016/j.jcmg.2017.09.016 |
| Pubmed ID | |
| Authors |
Enver Tahir, Jitka Starekova, Kai Muellerleile, Alexandra von Stritzky, Julia Münch, Maxim Avanesov, Julius M. Weinrich, Christian Stehning, Sebastian Bohnen, Ulf K. Radunski, Eric Freiwald, Stefan Blankenberg, Gerhard Adam, Axel Pressler, Monica Patten, Gunnar K. Lund |
| Abstract |
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. 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. 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. LGE CMR revealed focal nonischemic myocardial fibrosis in 9 of 54 (17%) male triathletes (LGE+) but in none of the female triathletes (p < 0.05). LGE+ triathletes had higher peak exercise systolic blood pressure (213 ± 24 mm Hg) than LGE- triathletes (194 ± 26 mm Hg; p < 0.05). Furthermore, left ventricular mass index was higher in LGE+ triathletes (93 ± 7 g/m2) than in LGE- triathletes (84 ± 11 g/m2; 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 < 0.05). LGE+ 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 < 0.0001), resulting in high sensitivity (89%) and specificity (79%). Multivariate analysis identified peak exercise systolic blood pressure (p < 0.05) and the swimming race distance (p < 0.01) as independent predictors of LGE presence. 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. |
X Demographics
The data shown below were collected from the profiles of 219 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 68 | 31% |
| Venezuela, Bolivarian Republic of | 15 | 7% |
| Mexico | 10 | 5% |
| Argentina | 5 | 2% |
| France | 4 | 2% |
| Chile | 4 | 2% |
| Dominican Republic | 4 | 2% |
| Colombia | 3 | 1% |
| United States | 3 | 1% |
| Other | 17 | 8% |
| Unknown | 86 | 39% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 164 | 75% |
| Practitioners (doctors, other healthcare professionals) | 35 | 16% |
| Scientists | 13 | 6% |
| Science communicators (journalists, bloggers, editors) | 7 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 153 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 153 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 22 | 14% |
| Student > Ph. D. Student | 14 | 9% |
| Student > Master | 14 | 9% |
| Student > Bachelor | 14 | 9% |
| Student > Doctoral Student | 12 | 8% |
| Other | 32 | 21% |
| Unknown | 45 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 64 | 42% |
| Sports and Recreations | 10 | 7% |
| Nursing and Health Professions | 6 | 4% |
| Social Sciences | 3 | 2% |
| Biochemistry, Genetics and Molecular Biology | 3 | 2% |
| Other | 11 | 7% |
| Unknown | 56 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 158. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 September 2018.
All research outputs
#263,845
of 25,738,558 outputs
Outputs from JACC: Cardiovascular Imaging
#36
of 2,722 outputs
Outputs of similar age
#5,742
of 445,767 outputs
Outputs of similar age from JACC: Cardiovascular Imaging
#1
of 56 outputs
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