Shuaib M Abdullah1, Kyler W Barkley1, Paul S Bhella1, Jeffrey L Hastings1, Susan Matulevicius1, Naoki Fujimoto1, Shigeki Shibata1, Graeme Carrick-Ranson1, M Dean Palmer1, Nainesh Gandhi1, Laura F DeFina1, Benjamin D Levine2. 1. From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas. 2. From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas. BenjaminLevine@TexasHealth.org.
Abstract
BACKGROUND: Recent reports have suggested that long-term, intensive physical training may be associated with adverse cardiovascular effects, including the development of myocardial fibrosis. However, the dose-response association of different levels of lifelong physical activity on myocardial fibrosis has not been evaluated. METHODS AND RESULTS: Seniors free of major chronic illnesses were recruited from predefined populations based on the consistent documentation of stable physical activity over >25 years and were classified into 4 groups by the number of sessions/week of aerobic activities ≥30 minutes: sedentary (group 1), <2 sessions; casual (group 2), 2 to 3 sessions; committed (group 3), 4 to 5 sessions; and Masters athletes (group 4), 6 to 7 sessions plus regular competitions. All subjects underwent cardiopulmonary exercise testing and cardiac magnetic resonance imaging, including late gadolinium enhancement assessment of fibrosis. Ninety-two subjects (mean age 69 years, 27% women) were enrolled. No significant differences in age or sex were seen between groups. Median peak oxygen uptake was 25, 26, 32, and 40 mL/kg/min for groups 1, 2, 3, and 4, respectively. Cardiac magnetic resonance imaging demonstrated increasing left ventricular end-diastolic volumes, end-systolic volumes, stroke volumes, and masses with increasing doses of lifelong physical activity. One subject in group 2 had late gadolinium enhancement in a noncoronary distribution, and no subjects in groups 3 and 4 had evidence of late gadolinium enhancement. CONCLUSIONS: A lifelong history of consistent physical activity, regardless of dose ranging from sedentary to competitive marathon running, was not associated with the development of focal myocardial fibrosis.
BACKGROUND: Recent reports have suggested that long-term, intensive physical training may be associated with adverse cardiovascular effects, including the development of myocardial fibrosis. However, the dose-response association of different levels of lifelong physical activity on myocardial fibrosis has not been evaluated. METHODS AND RESULTS: Seniors free of major chronic illnesses were recruited from predefined populations based on the consistent documentation of stable physical activity over >25 years and were classified into 4 groups by the number of sessions/week of aerobic activities ≥30 minutes: sedentary (group 1), <2 sessions; casual (group 2), 2 to 3 sessions; committed (group 3), 4 to 5 sessions; and Masters athletes (group 4), 6 to 7 sessions plus regular competitions. All subjects underwent cardiopulmonary exercise testing and cardiac magnetic resonance imaging, including late gadolinium enhancement assessment of fibrosis. Ninety-two subjects (mean age 69 years, 27% women) were enrolled. No significant differences in age or sex were seen between groups. Median peak oxygen uptake was 25, 26, 32, and 40 mL/kg/min for groups 1, 2, 3, and 4, respectively. Cardiac magnetic resonance imaging demonstrated increasing left ventricular end-diastolic volumes, end-systolic volumes, stroke volumes, and masses with increasing doses of lifelong physical activity. One subject in group 2 had late gadolinium enhancement in a noncoronary distribution, and no subjects in groups 3 and 4 had evidence of late gadolinium enhancement. CONCLUSIONS: A lifelong history of consistent physical activity, regardless of dose ranging from sedentary to competitive marathon running, was not associated with the development of focal myocardial fibrosis.
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