No evidence of adverse cardiac remodeling in former elite endurance athletes

Sanchís-Gomar, Fabián; López-Ramón, Marta; Alis, Rafael; Garatachea, Nuria; Pareja‐Galeano, Helios; Santos‐Lozano, Alejandro; Catalán, Pilar; Sansoni, Veronica; Perego, Silvia; Lombardi, Giovanni; Löllgen, Herbert; Bueno, Héctor; Serrano-Ostáriz, Enrique; Lucía, Alejandro

doi:10.1016/j.ijcard.2016.07.197

Cited by 18 publications

(13 citation statements)

References 40 publications

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“…Importantly, this analysis shows that in children and adolescents, the factors mediating cardiac biomarkers after exercise as well as their kinetics, are comparable with the observed in previous studies in adults and differ from the observed after MI and AMI (74,75). It has been suggested that this reflects a reversible cellular process triggered by a normal physiological response to exercise (9,45,58,62). Likewise, the increase of cTn might reflect an increased rate and force of cardiac contraction during exercise that causes transient membrane damage and enables cystolic cTn to pass into circulation (69).…”

Section: Discussionsupporting

confidence: 83%

Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

Cirer-Sastre

Legaz-Arrese

Corbi

et al. 2019

Pediatric Exercise Science

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Purpose:The authors evaluated the impact of acute exercise and 24-hour recovery on serum concentration of cardiac troponins T and I (cTnT and cTnI) and N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) in healthy children and adolescents. The authors also determined the proportion of participants exceeding the upper reference limits and acute myocardial infarction cutoff for each assay.Method:Web of Science, SPORTDiscus, MEDLINE, ScienceDirect, and Scopus databases were systematically searched up to November 2017. Studies were screened and quality-assessed; the data was systematically extracted and analyzed.Results:From 751 studies initially identified, 14 met the inclusion criteria for data extraction. All 3 biomarkers were increased significantly after exercise. A decrease from postexercise to 24 hours was noted in cTnT and cTnI, although this decrease was only statistically significant for cTnT. The upper reference limit was exceeded by 76% of participants for cTnT, a 51% for cTnI, and a 13% for NT-proBNP. Furthermore, the cutoff value for acute myocardial infarction was exceeded by 39% for cTnT and a 11% for cTnI. Postexercise peak values of cTnT were associated with duration and intensity (Q(3) = 28.3,P < .001) while NT-proBNP peak values were associated with duration (Q(2) = 11.9,P = .003).Conclusion:Exercise results in the appearance of elevated levels of cTnT, cTnI, and NT-proBNP in children and adolescents. Postexercise elevations of cTnT and NT-proBNP are associated with exercise duration and intensity.

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Section: Discussionsupporting

confidence: 83%

Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

Cirer-Sastre

Legaz-Arrese

Corbi

et al. 2019

Pediatric Exercise Science

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“…LGE in Athletes and Sedentary Controls Fourteen ( 14) studies (4,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) matching the prespecified inclusion criteria were found and included in the updated review and meta-analysis (Table 1). A risk of bias assessment was performed using the Newcastle Ottawa Scale (Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies either included only male athletes and controls or reported sex-specific data. Forest plots could be constructed for male (4,21,22,(24)(25)(26)(27)(28)(29)31) and female (21,22,31) athletes. In total,…”

Section: Resultsmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Myocardial Fibrosis in Young and Veteran Athletes: Insights From a Meta-Analysis

Androulakis

Mouselimis

Tsarouchas

et al. 2021

Front. Cardiovasc. Med.

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Background: Cardiac magnetic resonance (CMR) combined with late gadolinium enhancement (LGE) has revealed a non-negligible increased incidence of myocardial fibrosis (MF) in athletes compared to healthy sedentary controls.Objective: The aim of this systematic research and meta-analysis is to investigate and present our perspective regarding CMR indices in athletes compared to sedentary controls, including T1 values, myocardial extracellular volume (ECV) and positive LGE indicative of non-specific fibrosis, also to discuss the differences between young and veteran athletes.Methods: The protocol included searching, up to October 2021, of MEDLINE, EMBASE, SPORTDiscus, Web of Science and Cochrane databases for original studies assessing fibrosis via CMR in athletes. A mean age of 40 years differentiated studies' athletic populations to veteran and young.Results: The research yielded 14 studies including in total 1,312 individuals. There was a statistically significant difference in LGE fibrosis between the 118/759 athletes and 16/553 controls (Z = 5.2, P < 0.001, I2 = 0%, PI = 0.45). Notably, LGE fibrosis differed significantly between 546 (14.6%) veteran and 140 (25.7%) young athletes (P = 0.002). At 1.5T, T1 values differed between 117 athletes and 48 controls (P < 0.0001). A statistically significant difference was also shown at 3T (110 athletes vs. 41 controls, P = 0.0004), as well as when pooling both 1.5T and 3T populations (P < 0.00001). Mean ECV showed no statistically significant difference between these groups.Conclusions: Based on currently available data, we reported that overall LGE based non-specific fibrosis and T1 values differ between athletes and sedentary controls, in contrast to ECV values. Age of athletes seems to have impact on the incidence of MF. Future prospective studies should focus on the investigation of the underlying pathophysiological mechanisms.

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“…Our results support the conclusion that long-term IE leads to right ventricular fibrosis. Despite numerous studies reporting that intensive endurance exercise would result in MF both in human 3) 16) and animal models, 1) 17) a bulk of the studies 6) 18) showed no MF in intensive endurance athletes. Thus, the relationship between long-term IE and the development of MF are still unknown.…”

Section: Discussionmentioning

confidence: 96%

“…Long-term intense exercise (IE) induced myocardial fibrosis (MF) has been characterized in both animal 1) 2) and human studies. 3) 4) However, not all human studies demonstrated this phenomenon, 5) 6) making the relationship between long-term intense endurance exercise and the development of MF unclear. Furthermore, studies observed MF with different patterns and location in lifelong endurance athletes.…”

Section: Introductionmentioning

confidence: 99%

Exercise induced Right Ventricular Fibrosis is Associated with Myocardial Damage and Inflammation

et al. 2018

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Background and ObjectivesIntense exercise (IE) induced myocardial fibrosis (MF) showed contradictory findings in human studies, making the relationship between IE and the development of MF unclear. This study aims to demonstrate exercise induced MF is associated with cardiac damage, and inflammation is essential to the development of exercise induced MF.MethodsSprague-Dawley rats were submitted to daily 60-minutes treadmill exercise sessions at vigorous or moderate intensity, with 8-, 12-, and 16-week durations; time-matched sedentary rats served as controls. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum cardiac troponin I (cTnI) concentration. After completion of the exercise protocol rats were euthanized. Biventricular morphology, ultrastructure, and collagen deposition were then examined. Protein expression of interleukin (IL)-1β and monocyte chemotactic protein (MCP)-1 was evaluated in both ventricles.ResultsAfter IE, right but not left ventricle (LV) MF occurred. Serum cTnI levels increased and right ventricular damage was observed at the ultrastructure level in rats that were subjected to long-term IE. Leukocyte infiltration into the right ventricle (RV) rather than LV was observed after long-term IE. Long-term IE also increased protein expression of pro-inflammation factors including IL-1β and MCP-1 in the RV.ConclusionsRight ventricular damage induced by long-term IE is pathological and the following inflammatory response is essential to the development of exercise induced MF.

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No evidence of adverse cardiac remodeling in former elite endurance athletes

Cited by 18 publications

References 40 publications

Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Myocardial Fibrosis in Young and Veteran Athletes: Insights From a Meta-Analysis

Exercise induced Right Ventricular Fibrosis is Associated with Myocardial Damage and Inflammation

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