Letter by Schmermund Regarding Article, “Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes With a Low Atherosclerotic Risk Profile”
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To the Editor:
Is it possible that excessively increased coronary blood flow and cardiac workload can lead to increased coronary atherosclerosis and myocardial fibrosis? Merghani et al1 have published intriguing findings in middle-aged and older athletes, in comparison with healthy persons without excessive athletic activities. Apart from the thorough examinations, including coronary computed tomography angiography and cardiac magnetic resonance imaging, the article is notable in that only persons without known cardiovascular risk factors were included. Whereas most subjects, both athletes and nonathletes, had normal coronary arteries and left ventricular myocardial structure, some athletes appeared to have unexpected amounts of primarily calcified (rather than noncalcified or mixed) coronary atherosclerosis. The …