Response by Bohm et al to Letter Regarding Article, “Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast-Enhanced Cardiovascular Magnetic Resonance Study”
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We agree with Heidbuchel and colleagues that our findings do not clearly refute the concept of exercise-induced right ventricular (RV) damage because no prospective longitudinal study has been performed so far. However, our finding of marked RV remodeling without functional RV impairment or scarring challenges the notion of an exercise-induced arrhythmogenic right ventricular cardiomyopathy.
First, we studied an exclusive cohort of world-class master endurance athletes with a training history of 29±8 years. Such athletes are not as easily available as ambitious recreational athletes, who would not demonstrate an extensive cardiac remodeling as our studied athletes. Our athletes demonstrated clear structural exercise-induced cardiac remodeling with a mild RV chamber size predominance of about 6% (left ventricular end-diastolic volume/right ventricular end-diastolic volume ratio <1, mean left ventricular end-diastolic volume 203±26 mL, and right ventricular end-diastolic volume 215±43 mL; control subjects: mean left ventricular end-diastolic volume 139±42 mL …