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Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study

Title: Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study
Authors: Pauwels, Rik; Dausin, Christophe; Ruiz-Carmona, Sergio; De Bosscher, Ruben; De Paepe, Jarne; Bekhuis, Youri; Delpire, Boris; Sinnaeve, Peter; Dymarkowski, Steven; Ghekiere, Olivier; Bruckers, Liesbeth; Kuznetsova, Tatiana; Van De Heyning, Caroline M.; Van Herck, Paul L.; Eijsvogels, Thijs M.H.; Herbots, Lieven; Robyns, Tomas; La Gerche, André; Heidbuchel, Hein; Willems, Rik; Claessen, Guido; Bogaert, Jan; Goetschalckx, Kaatje; Claus, Piet; Fatkin, Diane; Van Soest, Sofie; Janssens, Kristel; Claeys, Mathias; Hespel, Peter; Dresselaers, Tom; Miljoen, Hielko; Favere, Kasper; Paelinck, Bernard; Vermeulen, Dorien; Witvrouwen, Isabel; Hansen, Dominique; Op’t Eijnde, Bert; Thijs, Daisy; Vanvoorden, Peter; Lefebvre, Kristof; D’Ambrosio, Paolo; Rowe, Stephanie; Mitchell, Amy M.; Spencer, Luke; Duchenne, Jürgen
Contributors: Fund for Scientific Research Flanders; E-Dekker grant; FIT-HEART consortium grant
Source: Circulation ; volume 153, issue 14, page 1009-1022 ; ISSN 0009-7322 1524-4539
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2026
Description: BACKGROUND: Middle-aged and older endurance athletes have increased prevalence of coronary artery disease (CAD) on coronary computed tomography angiography compared with healthy controls, despite similarly low cardiovascular risk. Previous studies relied on self-reported data to quantify training load (TL), which poorly correlates with objective wearable-derived TL and may bias outcomes. The effect of objective TL on CAD risk remains unknown. METHODS: In this observational, cross-sectional analysis of the Master@Heart study, 222 men (median age, 54 [49–59] years) were included: 77 lifelong athletes, 98 late-onset athletes, and 47 controls. TL was assessed using objective wearable-derived training duration and intensity (12 consecutive months), as well as self-reported training measures. Coronary computed tomography angiography–derived CAD prevalence was compared across TL quartiles (Q) using a global unadjusted chi-square test and logistic regression, adjusted for cardiovascular risk factors and years of endurance exercise, to estimate odds ratios between Q4 and Q1. In addition, adjusted logistic regression models were fitted with continuous TL, using smoothing splines to capture potential nonlinear associations. RESULTS: Across quartiles of objective Edwards training impulse (training duration × heart rate–weighted intensity), unadjusted global differences were observed for ≥1 plaque ( P 0 ( P =0.002), and CAC>100 ( P =0.012). Q4 participants had significantly higher adjusted odds of ≥1 plaque (odds ratio, 5.85; 95% CI, 2.33–14.71), CAC>0 (odds ratio, 5.03; 95% CI, 2.04–12.35), and CAC>100 (odds ratio, 3.50; 95% CI, 1.22–10.00) versus Q1. Similar associations were found for objective training duration, whereas no clear associations were observed for relative time spent in high-intensity zones. In continuous analyses, Edwards training impulse and objective training duration showed significant positive associations with ≥1 plaque and CAC>100 ( P ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1161/circulationaha.125.077117
DOI: 10.1161/CIRCULATIONAHA.125.077117
Availability: https://doi.org/10.1161/circulationaha.125.077117; https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.077117
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.ED52AB03
Database: BASE