Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast Enhanced CMR Study
Background—It is under debate whether the cumulative effects of intensive endurance exercise induce chronic cardiac damage, mainly involving the right heart. The aim of the study was to examine the cardiac structure and function in long-term elite master endurance athletes with special focus on the right ventricle by contrast enhanced cardiovascular magnetic resonance imaging (CMR).
Methods and Results—Thirty-three healthy caucasian competitive elite male master endurance athletes (age range: 30 - 60 years) with a training history of 29 ± 8 years, and 33 caucasian control subjects pair-matched for age, height and weight underwent cardiopulmonary exercise testing, echocardiography including tissue-Doppler imaging and speckle tracking, and CMR. Indexed LVM and RVM (LVM/BSA: 96 ± 13 and 62 ± 10 g/m2; P<.001; RVM/BSA: 36 ± 7 and 24 ± 5 g/m2; P<.001) and indexed LVEDV and RVEDV (LVEDV/BSA 104 ± 13 and 69 ± 18 ml/m2; P<.001; RVEDV/BSA 110 ± 22 and 66 ± 16 ml/m2; P<.001) were significantly increased in athletes (A) compared to control subjects (C). RVEF did not differ between A and C (52 ± 8 and 54 ± 6 %; P=.26). Pathological late enhancement was detected in one athlete. No correlations were found for LV and RV volumes and EF with NT pro-BNP, and high sensitive Troponin was negative in all subjects.
Conclusions—Based on our results, a chronic RV damage in elite endurance master athletes with lifelong high training volumes seems to be unlikely. Thus, the hypothesis of an exercise-induced ARVC has to be questioned.
- right ventricle
- cardiac magnetic resonance imaging
- myocardial injury
- arrhythmogenic right ventricular dysplasia/cardiomyopathy
- Received December 17, 2015.
- Revision received January 25, 2016.
- Accepted March 7, 2016.