Arrhythmias and structural remodeling in lifelong and retired master endurance athletes
Background: A greater prevalence of arrhythmias has been described in endurance athletes, but it remains unclear whether this risk persists after detraining. We aimed to evaluate the prevalence of arrhythmias and their relationship with cardiac remodeling in lifelong and retired master endurance ath...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-12-01
|
| Series: | Journal of Sport and Health Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095254625000213 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839619730744279040 |
|---|---|
| author | Paolo D’Ambrosio Jarne De Paepe Kristel Janssens Amy M. Mitchell Stephanie J. Rowe Luke W. Spencer Tim Van Puyvelde Jan Bogaert Olivier Ghekiere Rik Pauwels Lieven Herbots Tomas Robyns Peter M. Kistler Jonathan M. Kalman Hein Heidbuchel Rik Willems Guido Claessen André La Gerche |
| author_facet | Paolo D’Ambrosio Jarne De Paepe Kristel Janssens Amy M. Mitchell Stephanie J. Rowe Luke W. Spencer Tim Van Puyvelde Jan Bogaert Olivier Ghekiere Rik Pauwels Lieven Herbots Tomas Robyns Peter M. Kistler Jonathan M. Kalman Hein Heidbuchel Rik Willems Guido Claessen André La Gerche |
| author_sort | Paolo D’Ambrosio |
| collection | DOAJ |
| description | Background: A greater prevalence of arrhythmias has been described in endurance athletes, but it remains unclear whether this risk persists after detraining. We aimed to evaluate the prevalence of arrhythmias and their relationship with cardiac remodeling in lifelong and retired master endurance athletes compared to non-athletic controls. Methods: We performed a cross-sectional analysis of observational studies that used echocardiography and cardiac magnetic resonance to detail cardiac structure and function, and Holter monitors to identify atrial and ventricular arrhythmias in 185 endurance athletes and 81 non-athletic controls aged ≥40 years. Athletes were categorized as active lifelong (n = 144) or retired (n = 41) based on hours per week of high-intensity endurance exercise within 5 years of enrollment and validated by percentage of predicted maximal oxygen consumption (VO2max). Athletes with overt cardiomyopathies, channelopathies, pre-excitation, and/or myocardial infarction were excluded. Results: Lifelong athletes (median age = 55 years (interquartile range (IQR): 46–62), 79% male) were significantly fitter than retired athletes (median age = 66 years (IQR: 58–71), 95% male) and controls (median age = 53 years (IQR: 48–60), 96% male), respectively (predicted VO2max: 131% ± 18% vs. 99% ± 14% vs. 98% ± 15%, p < 0.001). Compared to controls, athletes in our cohort had a higher prevalence of atrial fibrillation ((AF): 32% vs. 0%, p < 0.001) and non-sustained ventricular tachycardia ((NSVT): 9% vs. 1%, p = 0.007). There was no difference in prevalence of any arrhythmia between lifelong and retired athletes. Lifelong athletes had larger ventricular volumes than retired athletes, who had ventricular volumes similar to controls (left ventricular end-diastolic volume indexed to body surface area (LVEDVi): 101 ± 20 mL/m2 vs. 86 ± 16 mL/m2 vs. 94 ± 18 mL/m2, p < 0.001; right ventricular end-diastolic volume indexed to body surface area (RVEDVi): 117 ± 23 mL/m2 vs. 101 ± 19 mL/m2 vs. 100 ± 19 mL/m2, p < 0.001). Athletes had more scar (40% vs. 18%, p = 0.002) and larger left atria (median volume = 45 mL/m2 (IQR: 38–52) vs. 31 mL/m2 (IQR: 25–38), p < 0.001) than controls, with no difference in atrial volumes and non-ischaemic scar between the athlete groups. Conclusion: Master endurance athletes have a higher prevalence of AF and NSVT than non-athletic controls. Whereas ventricular remodeling tends to reverse with detraining, the propensity to arrhythmias persists regardless of whether they are actively exercising or retired. |
| format | Article |
| id | doaj-art-dac26a94c1c9475cb1511c66830614c7 |
| institution | Matheson Library |
| issn | 2095-2546 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Sport and Health Science |
| spelling | doaj-art-dac26a94c1c9475cb1511c66830614c72025-07-23T05:24:01ZengElsevierJournal of Sport and Health Science2095-25462025-12-0114101043Arrhythmias and structural remodeling in lifelong and retired master endurance athletesPaolo D’Ambrosio0Jarne De Paepe1Kristel Janssens2Amy M. Mitchell3Stephanie J. Rowe4Luke W. Spencer5Tim Van Puyvelde6Jan Bogaert7Olivier Ghekiere8Rik Pauwels9Lieven Herbots10Tomas Robyns11Peter M. Kistler12Jonathan M. Kalman13Hein Heidbuchel14Rik Willems15Guido Claessen16André La Gerche17Department of Medicine, The University of Melbourne, Parkville, VIC 3010, Australia; Heart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, Australia; Department of Cardiology, The Royal Melbourne Hospital, Parkville, VIC 3010, Australia; Corresponding author.Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven 3000, BelgiumHeart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, Australia; The Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC 3065, AustraliaHeart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, AustraliaHeart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, Australia; Department of Cardiology, St. Vincent’s Hospital, Fitzroy, VIC 3065, AustraliaHeart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, AustraliaDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven 3000, BelgiumDepartment of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Radiology, University Hospitals Leuven, Leuven 3000, BelgiumDepartment of Radiology, Jessa Ziekenhuis, Hasselt 3500, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, UHasselt, Biomedical Research Institute, Diepenbeek, Hasselt 3500, BelgiumDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven 3000, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, UHasselt, Biomedical Research Institute, Diepenbeek, Hasselt 3500, BelgiumFaculty of Medicine and Life Sciences, Limburg Clinical Research Center, UHasselt, Biomedical Research Institute, Diepenbeek, Hasselt 3500, Belgium; Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt 3500, BelgiumDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven 3000, BelgiumDepartment of Medicine, The University of Melbourne, Parkville, VIC 3010, Australia; Department of Cardiology, The Alfred Hospital, Melbourne, VIC 3004, Australia; Department of Medicine, Monash University, Clayton, VIC 3168, Australia; Baker Heart and Diabetes Institute, Melbourne, VIC 3004, AustraliaDepartment of Medicine, The University of Melbourne, Parkville, VIC 3010, Australia; Department of Cardiology, The Royal Melbourne Hospital, Parkville, VIC 3010, Australia; Baker Heart and Diabetes Institute, Melbourne, VIC 3004, AustraliaDepartment of Cardiology, Antwerp University Hospital, Antwerp 2650, Belgium; Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR) Department, University of Antwerp, Antwerp 2610, BelgiumDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven 3000, BelgiumDepartment of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven 3000, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, UHasselt, Biomedical Research Institute, Diepenbeek, Hasselt 3500, Belgium; Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt 3500, BelgiumDepartment of Medicine, The University of Melbourne, Parkville, VIC 3010, Australia; Heart, Exercise & Research Trials (HEART) lab, St Vincent’s Institute, Fitzroy, VIC 3065, Australia; Department of Cardiology, St. Vincent’s Hospital, Fitzroy, VIC 3065, Australia; HEART Lab, Victor Chang Cardiovascular Research Institute, Darlinghurst, NSW 2010, AustraliaBackground: A greater prevalence of arrhythmias has been described in endurance athletes, but it remains unclear whether this risk persists after detraining. We aimed to evaluate the prevalence of arrhythmias and their relationship with cardiac remodeling in lifelong and retired master endurance athletes compared to non-athletic controls. Methods: We performed a cross-sectional analysis of observational studies that used echocardiography and cardiac magnetic resonance to detail cardiac structure and function, and Holter monitors to identify atrial and ventricular arrhythmias in 185 endurance athletes and 81 non-athletic controls aged ≥40 years. Athletes were categorized as active lifelong (n = 144) or retired (n = 41) based on hours per week of high-intensity endurance exercise within 5 years of enrollment and validated by percentage of predicted maximal oxygen consumption (VO2max). Athletes with overt cardiomyopathies, channelopathies, pre-excitation, and/or myocardial infarction were excluded. Results: Lifelong athletes (median age = 55 years (interquartile range (IQR): 46–62), 79% male) were significantly fitter than retired athletes (median age = 66 years (IQR: 58–71), 95% male) and controls (median age = 53 years (IQR: 48–60), 96% male), respectively (predicted VO2max: 131% ± 18% vs. 99% ± 14% vs. 98% ± 15%, p < 0.001). Compared to controls, athletes in our cohort had a higher prevalence of atrial fibrillation ((AF): 32% vs. 0%, p < 0.001) and non-sustained ventricular tachycardia ((NSVT): 9% vs. 1%, p = 0.007). There was no difference in prevalence of any arrhythmia between lifelong and retired athletes. Lifelong athletes had larger ventricular volumes than retired athletes, who had ventricular volumes similar to controls (left ventricular end-diastolic volume indexed to body surface area (LVEDVi): 101 ± 20 mL/m2 vs. 86 ± 16 mL/m2 vs. 94 ± 18 mL/m2, p < 0.001; right ventricular end-diastolic volume indexed to body surface area (RVEDVi): 117 ± 23 mL/m2 vs. 101 ± 19 mL/m2 vs. 100 ± 19 mL/m2, p < 0.001). Athletes had more scar (40% vs. 18%, p = 0.002) and larger left atria (median volume = 45 mL/m2 (IQR: 38–52) vs. 31 mL/m2 (IQR: 25–38), p < 0.001) than controls, with no difference in atrial volumes and non-ischaemic scar between the athlete groups. Conclusion: Master endurance athletes have a higher prevalence of AF and NSVT than non-athletic controls. Whereas ventricular remodeling tends to reverse with detraining, the propensity to arrhythmias persists regardless of whether they are actively exercising or retired.http://www.sciencedirect.com/science/article/pii/S2095254625000213AthletesArrhythmiasAtrial fibrillationNon-sustained ventricular tachycardiaDetraining |
| spellingShingle | Paolo D’Ambrosio Jarne De Paepe Kristel Janssens Amy M. Mitchell Stephanie J. Rowe Luke W. Spencer Tim Van Puyvelde Jan Bogaert Olivier Ghekiere Rik Pauwels Lieven Herbots Tomas Robyns Peter M. Kistler Jonathan M. Kalman Hein Heidbuchel Rik Willems Guido Claessen André La Gerche Arrhythmias and structural remodeling in lifelong and retired master endurance athletes Journal of Sport and Health Science Athletes Arrhythmias Atrial fibrillation Non-sustained ventricular tachycardia Detraining |
| title | Arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| title_full | Arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| title_fullStr | Arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| title_full_unstemmed | Arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| title_short | Arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| title_sort | arrhythmias and structural remodeling in lifelong and retired master endurance athletes |
| topic | Athletes Arrhythmias Atrial fibrillation Non-sustained ventricular tachycardia Detraining |
| url | http://www.sciencedirect.com/science/article/pii/S2095254625000213 |
| work_keys_str_mv | AT paolodambrosio arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT jarnedepaepe arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT kristeljanssens arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT amymmitchell arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT stephaniejrowe arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT lukewspencer arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT timvanpuyvelde arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT janbogaert arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT olivierghekiere arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT rikpauwels arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT lievenherbots arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT tomasrobyns arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT petermkistler arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT jonathanmkalman arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT heinheidbuchel arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT rikwillems arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT guidoclaessen arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes AT andrelagerche arrhythmiasandstructuralremodelinginlifelongandretiredmasterenduranceathletes |