Cardiac remodeling in ambitious endurance-trained amateur athletes older than 50 years–an observational study

Abstract

Background Data on cardiac remodeling in veteran athletes are conflicting but of clinical importance. Methods Sixty-nine clinically stable and healthy individuals >50 years were identified (median 55 (IQR 52–64), 26% female). Echocardiographic features were identified in individuals, who have performed endurance sports at 70% of their maximum heart rate for at least 1 hour 3 times/ week over the previous 5 years. Results Median training time in all participants was 6 hours per week. Therefore, based on these 6 hours of weekly training, participants were grouped into 45 ambitious endurance-trained amateur athletes (EAA) and 24 recreationally active endurance-trained athletes (RAP) training ≥6 hours (6–10) and <6 hours (3.5–5), respectively. Left ventricular (LV) diameters were slightly larger in EAA than in RAP (27 mm/m2 (25–28) vs. 25 mm/m2 (24–27), p = 0.023) and EAA showed preserved diastolic function (p = 0.028) with lower E/E’ ratio (7 (6–9) vs. 9 (7–10), p = 0.039). Interventricular septal thickness and relative wall thickness ratio were similar. Global right ventricular and LV strain were similar, but left atrial (LA) reservoir strain was higher in EAA than in RAP (27% (22–34) vs. 20% (15–29), p = 0.002). Conclusions Endurance training in healthy athletes >50 years is not associated with chamber dilatation or LV hypertrophy. A weekly training duration of ≥6 hours seems beneficial to preserve diastolic function associated with an increased LA reservoir function.

Relationship between echocardiographic characteristics and cardiac biomarkers during long-distance trail running

“…Recently, it has been observed that a troponin exerciseinduced increase above the 99th percentile could be an early marker of mortality and cardiovascular events (27) notably in participants with hypertension (28). Nevertheless, these results remain to be discussed (7,26,29,30). To date, no study has reported a relationship between echocardiographic characteristics and cardiac biomarkers in long distance runners.…”

“…This increase of practice has also been observed among individuals older than 45 years old, currently representing around 50% of the participants in marathons and long-distance running races ( 3 ). Beneficial cardiovascular effects of moderate exercise are recognized ( 4 ), while cardiovascular effects of prolonged and intense exercise remains debated ( 5 – 7 ). Physical activity such as long-term endurance sport practice induces a cardiac remodeling named “athlete’s heart”( 8 – 10 ), mainly concerning the left ventricle (LV), but also right ventricle (RV) by inducing right ventricular remodeling ( 11 ), even if clinical significance is unclear ( 12 , 13 ).…”