Myocardial Fibrosis and Coronary Calcifications Caused by Endurance Exercise? Insights from Former Professional Cyclists

  1. Maceira, Alicia 1
  2. Valenzuela, Pedro L. 2
  3. Santos-Lozano, Alejandro 23
  4. García-González, María P. 1
  5. Ortega, Laura Higueras 1
  6. Díaz-Gonzalez, Leonel 45
  7. Boraita, Araceli 6
  8. Barranco-Gil, David 27
  9. Lucia, Alejandro 27
  1. 1 Ascires Grupo Biomédico, Valencia, SPAIN
  2. 2 Instituto de Investigación Sanitaria Hospital 12 de Octubre
    info

    Instituto de Investigación Sanitaria Hospital 12 de Octubre

    Madrid, España

  3. 3 Universidad Miguel de Cervantes
    info

    Universidad Miguel de Cervantes

    Santiago de Chile, Chile

    ROR https://ror.org/05ap1zt54

  4. 4 Cardiology Department, CEMTRO Clinic, Madrid, SPAIN
  5. 5 Hospital Universitario La Paz
    info

    Hospital Universitario La Paz

    Madrid, España

    ROR https://ror.org/01s1q0w69

  6. 6 Department of Cardiology, Sports Medicine Center, Spanish Agency for Health Protection in Sports, Madrid, SPAIN
  7. 7 Universidad Europea de Madrid
    info

    Universidad Europea de Madrid

    Madrid, España

    ROR https://ror.org/04dp46240

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Revista:
Medicine & Science in Sports & Exercise

ISSN: 1530-0315,  0195-9131

Año de publicación: 2022

Volumen: Publish Ahead of Print

Tipo: Artículo

DOI: 10.1249/MSS.0000000000003043 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Medicine & Science in Sports & Exercise

Objetivos de desarrollo sostenible

Resumen

Purpose To compare the prevalence of myocardial fibrosis and coronary calcification in individuals who have performed very high levels of strenuous endurance exercise (SEE) (former male professional cyclists) and sex/age-matched controls.Methods We used a cross-sectional (case-control) observational design, where cases were former finishers of ≥1 Grand Tour (Tour de France, Giro d’ Italia or Vuelta a España) and controls were untrained individuals free of cardiovascular risk. All participants underwent cardiac magnetic resonance and cardiac computer tomography in the same center during years 2020-2021 to detect myocardial fibrosis (late gadolinium enhancement) and to quantify coronary calcium, respectively.Results 23 cases (age 46 ± 6 years) and 59 controls (47 ± 7 years) were studied. Fibrotic patches were evidenced only in the left ventricle (LV), with a higher prevalence in cases (23% vs. 2% in controls, P = 0.006). However, fibrotic tissue was non-ischemic and of low extension (0.6 ± 0.4% of LV mass), and no significant differences were found between cases and controls for native T1 or T2 values. No between-group differences were found for coronary calcium indicators, including Agatston or density scores. Sub-analyses revealed no differences attending to whether cases were still performing regular SEE (n = 8) or not (n = 15) after professional retirement.Conclusions Although former professional cyclists seemed to show a greater prevalence of myocardial fibrosis, the extension of fibrotic tissue was minimal and no alterations were found in coronary calcification indicators. While keeping in mind the low sample size of the cases’ group, our results do not support evidence for major cardiac maladaptations with long-term exposure to SEE, at least in middle-aged adults.