Fabian Sanchis-Gomar1, Marta López-Ramón2, Rafael Alis3, Nuria Garatachea4, Helios Pareja-Galeano5, Alejandro Santos-Lozano6, Pilar Catalán7, Veronica Sansoni8, Silvia Perego8, Giovanni Lombardi8, Herbert Löllgen9, Hector Bueno10, Enrique Serrano-Ostáriz11, Alejandro Lucia12. 1. Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain. Electronic address: fabian.sanchis@uv.es. 2. Cardiology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain. 3. Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; Servicio de Nefrología, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 4. Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain. 5. European University of Madrid, Madrid, Spain. 6. Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain; GIDFYS, European University Miguel de Cervantes, Valladolid, Spain. 7. Hospital Universitario Miguel Servet, Zaragoza, Spain. 8. Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy. 9. EFSMA and German Fed, Sports Medicine, Remscheid, Germany. 10. Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Madrid, Spain; Cardiology Department. Hospital Universitario 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain. 11. Faculty of Medicine, Physical Education and Sports Section, University of Zaragoza, Zaragoza, Spain. 12. Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University of Madrid, Madrid, Spain.
Abstract
BACKGROUND: The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. METHODS AND RESULTS: We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42 amateur-level ('sub-elite') cyclists or runners, aged 40-70years] and 18 aged-matched controls. A subset of 15 subjects (5 controls, 3 sub-elite and 7 elite athletes) also underwent cardiac magnetic resonance imaging (cMRI). Elite and sub-elite athletes had greater echocardiography-determined left ventricular myocardial mass indexed to body surface area than controls (113±22, 115.2±23.1 and 94.8±21g/m(2), respectively, p=0.008 for group effect), with similar results for left (50.5±4.4, 48.2±4.3 and 46.4±5.2mm, p=0.008) and right (38.6±3.8, 41.1±5.5 and 34.7±4.3mm, p<0.001) ventricular end-diastolic diameter, and cMRI-determined left atrial volume indexed to body surface area (62.7±8.1, 56.4±16.0 and 39.0±14.1ml/m(2), p=0.026). Two athletes showed a non-coronary pattern of small, fibrotic left ventricular patches detected by late gadolinium enhancement. No group effect was noted for biomarkers. CONCLUSIONS: Regardless of their competition level at a younger age, veteran endurance athletes showed an overall healthy, non-pathological pattern of cardiac remodeling. Nonetheless, the physiopathology of the ventricular fibrotic patches detected warrants further investigation.
BACKGROUND: The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. METHODS AND RESULTS: We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42 amateur-level ('sub-elite') cyclists or runners, aged 40-70years] and 18 aged-matched controls. A subset of 15 subjects (5 controls, 3 sub-elite and 7 elite athletes) also underwent cardiac magnetic resonance imaging (cMRI). Elite and sub-elite athletes had greater echocardiography-determined left ventricular myocardial mass indexed to body surface area than controls (113±22, 115.2±23.1 and 94.8±21g/m(2), respectively, p=0.008 for group effect), with similar results for left (50.5±4.4, 48.2±4.3 and 46.4±5.2mm, p=0.008) and right (38.6±3.8, 41.1±5.5 and 34.7±4.3mm, p<0.001) ventricular end-diastolic diameter, and cMRI-determined left atrial volume indexed to body surface area (62.7±8.1, 56.4±16.0 and 39.0±14.1ml/m(2), p=0.026). Two athletes showed a non-coronary pattern of small, fibrotic left ventricular patches detected by late gadolinium enhancement. No group effect was noted for biomarkers. CONCLUSIONS: Regardless of their competition level at a younger age, veteran endurance athletes showed an overall healthy, non-pathological pattern of cardiac remodeling. Nonetheless, the physiopathology of the ventricular fibrotic patches detected warrants further investigation.
Authors: Valeria Conti; Filippo Migliorini; Marco Pilone; María I Barriopedro; Juan José Ramos-Álvarez; Francisco Javer Calderon Montero; Nicola Maffulli Journal: Sci Rep Date: 2021-11-18 Impact factor: 4.379