| Title: |
Bradycardia in Athletes: Prevalence, Mechanisms, and Risks |
| Authors: |
D’Ambrosio, Paolo; De Paepe, Jarne; Spencer, Luke W.; Ohanian, Monique; Janssens, Kristel; Mitchell, Amy M.; Flannery, M. Darragh; Bekhuis, Youri; Pauwels, Rik; Delpire, Boris; Dausin, Christophe; Rowe, Stephanie J.; Van Puyvelde, Tim; Young, Paul E.; Soka, Magdalena J.; Johnson, Renee; Yu, Chenglong; Morris, Gwilym M.; Robyns, Tomas; Lacaze, Paul; Giannoulatou, Eleni; Kistler, Peter M.; Kalman, Jonathan M.; Heidbuchel, Hein; Willems, Rik; Claessen, Guido; Fatkin, Diane; La Gerche, André; Van Soest, Sofie; Herbots, Lieven; Bogaert, Jan; Hespel, Peter; Dymarkowski, Steven; Dresselaers, Tom; Miljoen, Hielko; Favere, Kasper; Paelinck, Bernard; Vermeulen, Dorien; Witvrouwen, Isabel; Hansen, Dominique; Op’t Eijnde, Bert; Thijs, Daisy; Vanvoorden, Peter; Lefebvre, Kristof; Rosseel, Thomas; Paratz, Elizabeth; Brosnan, Maria J.; Prior, David L. |
| Source: |
Circulation ; volume 153, issue 9, page 616-630 ; ISSN 0009-7322 1524-4539 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
BACKGROUND: Sinus bradycardia is a well-recognized physiological adaptation in endurance athletes, primarily attributed to sinus node remodeling or increased vagal modulation. Although genetic influences on resting heart rate (HR) have been observed, the genetic contribution to athletic bradycardia has not been elucidated. METHODS: We phenotyped current and former elite endurance athletes in the Pro@Heart cohort study using multimodal cardiac imaging, cardiopulmonary exercise testing, and Holter monitoring. Genetic susceptibility to bradycardia was assessed using a validated HR-associated polygenic risk score (HR-PRS), in which lower scores are associated with a lower HR, and compared with healthy nonathletic controls. Clinical and genetic features of bradycardic endurance athletes with minimum HR ≤40 bpm on a Holter monitor (bradycardic athletes [BAs]) were compared with non-BAs). A healthy cohort of nonathletes from the ASPREE study (Aspirin in Reducing Events in the Elderly) were used for genetic comparisons. RESULTS: Among 465 endurance athletes (median age, 23 [18–49] years, 75% men), 175 (38%) had a minimum HR on a Holter monitor ≤40 bpm, of whom 7 (2% of total) had a HR ≤30bpm. Pauses ≥2 s were observed in 115 (25%) athletes, of whom 12 (3% of total) had pauses ≥3 s. Mobitz I second-degree atrioventricular block was observed in 15 (3% of total) athletes. BAs were younger and fitter and exhibited greater athletic cardiac remodeling than non-BAs. Mean HR-PRS was significantly lower in all athletes compared with ASPREE nonathletes ( P |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/circulationaha.125.076170 |
| DOI: |
10.1161/CIRCULATIONAHA.125.076170 |
| Availability: |
https://doi.org/10.1161/circulationaha.125.076170; https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.076170 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.9DD0FE43 |
| Database: |
BASE |