Abstract 4193: Prevalence, Pattern and Prognostic Relevance of Myocardial Late Gadolinium Enhancement in Marathon Runners
Background: Frequent marathon running has been suggested to have a role in the development of subclinical myocardial damage, which may precipitate cardiac events. In this study we assessed the prevalence, myocardial pattern and prognostic relevance of myocardial damage as evidenced by cardiac magnetic resonance (CMR)-based myocardial late gadolinium enhancement (LGE) in male marathon runners.
Methods: Late inversion recovery fast low angle shot sequences after gadolinium contrast application were performed in 102 ostensibly healthy male runners aged 50 –72 years with ≥5 marathons during the past 3 years and also in 102 age-matched controls derived from a local preventive screening program. Predominantly subcardial regions of LGE “typical” of myocardial infarction were distinguished from an “atypical” predominantly mid-myocardial patchy pattern. Outcome after 21.3±2.8 months was obtained in all runners.
Results: The prevalence of LGE in the marathon cohort was higher than in controls (12% vs. 4%; p=0.077, McNemar’s test (exact)). Typical LGE was more frequently located in the left anterior descending (LAD) coronary artery territory than atypical LGE in marathon runners and controls (Fig. 1⇓, p=0.0027, Fisher’s exact test). Events occurred in 4 runners. Event-free-survival was worse in those with myocardial LGE compared to those without LGE (Fig. 2⇓, p<0.001, log-rank).
Discussion: Presumably healthy marathon runners have a high rate of myocardial LGE. A different distribution of LGE patterns may hint towards differences in their etiology. The presence and myocardial distribution of LGE is suggested to have diagnostic and prognostic relevance in marathon runners.