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Myocardial fibrosis and its relationship with ventricular arrhythmias and reduced ventricular systolic function in young and veteran endurance athletes

Title: Myocardial fibrosis and its relationship with ventricular arrhythmias and reduced ventricular systolic function in young and veteran endurance athletes
Authors: De Paepe, Jarne; D’Ambrosio, Paolo; De Bosscher, Ruben; Bekhuis, Youri; Pauwels, Rik; Dausin, Christophe; Janssens, Kristel; Mitchell, Amy; Elliott, Adrian; Van De Heyning, Caroline M; Sanders, Prashanthan; Kistler, Peter M; Kalman, Jonathan M; Fatkin, Diane; Heidbuchel, Hein; Herbots, Lieven; Willems, Rik; Robyns, Tomas; Ghekiere, Olivier; Bogaert, Jan; La Gerche, André; Claessen, Guido; Van Soest, Sofie; Claus, Piet; Sinnaeve, Peter; Claeys, Mathias; Goetschalckx, Kaatje; Van Puyvelde, Tim; Vandenberk, Bert; Hespel, Peter; Dymarkowski, Steven; Dresselaers, Tom; Delpire, Boris; Miljoen, Hielko; Favere, Kasper; Paelinck, Bernard; Vermeulen, Dorien; Witvrouwen, Isabel; Hansen, Dominique; Eijnde, Bert Op't; Thijs, Daisy; Vanvoorden, Peter; Lefebvre, Kristof; Rowe, Stephanie; Spencer, Luke; Paratz, Elizabeth; Brosnan, Maria J; Prior, David L
Contributors: research foundation Flanders; National Health and Medical Research Council of Australia; Abbott Belgium; Boston Scientific Belgium; Royal Australian College of Physicians Research Entry Scholarship; National Health and Medical Research Council Postgraduate Scholarship; Heart Foundation PhD Scholarship; Australian Government Research Training Program Scholarship.
Source: European Journal of Preventive Cardiology ; ISSN 2047-4873 2047-4881
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Aims The prevalence of ventricular fibrosis and its association with ventricular arrhythmias (VAs) and reduced ventricular systolic function in endurance athletes remains unclear. Methods and results We evaluated 296 young [median age 19 (17–22)] and 138 middle-aged [56 (50–60)] male endurance athletes, alongside 66 middle-aged non-athletic controls [54 (49–60)], all without known cardiac disease. Cardiac magnetic resonance imaging assessed myocardial fibrosis and biventricular function. Twenty-four-hour Holter monitoring was used to quantify VAs. Non-hinge-point fibrosis was more prevalent in middle-aged athletes compared with young athletes (20 vs. 3%, P < 0.001) and middle-aged controls (20 vs. 9%, P=0.045), while hinge-point fibrosis did not differ. Reduced left ventricular ejection fraction and/or right ventricular ejection fraction was more frequent in middle-aged athletes than controls (23 vs. 8%, P=0.009), but similar to young athletes (23 vs. 22%, P=0.906). Middle-aged athletes had a higher prevalence of non-sustained ventricular tachycardia (8 vs. 2%, P=0.006), >100 premature ventricular complexes/24 h (13 vs. 5%, P = 0.004), multifocal ventricular ectopy (11 vs. 4%, P = 0.003), and complex ventricular ectopy (25 vs. 10%, P < 0.001) compared with young athletes, with no significant differences compared with controls. Non-hinge-point fibrosis increased the odds of a higher burden of unifocal and multifocal ventricular ectopy, but not of reduced systolic function. Conclusion Middle-aged athletes more frequently exhibit myocardial fibrosis than young athletes and middle-aged non-athletes. Non-hinge-point fibrosis is present in up to one-fifth of middle-aged athletes and predictive of a higher burden of both unifocal and multifocal ventricular ectopy. Reduced systolic function is more prevalent in athletes and not predicted by fibrosis.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurjpc/zwaf715
DOI: 10.1093/eurjpc/zwaf715/66004064/zwaf715.pdf
Availability: https://doi.org/10.1093/eurjpc/zwaf715; https://academic.oup.com/eurjpc/advance-article-pdf/doi/10.1093/eurjpc/zwaf715/66004064/zwaf715.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.77B5BD8D
Database: BASE