Prevalence and pattern of focal and potential diffuse myocardial fibrosis in male and female marathon runners using contrast-enhanced cardiac magnetic resonance

• Published in: European radiology 2023-07, Vol.33 (7), p.4648-4656
• Main Authors: Ragab, Haissam, Lund, Gunnar K., Breitsprecher, Lynn, Sinn, Martin R., Muellerleile, Kai, Cavus, Ersin, Stehning, Christian, Tahir, Enver, Blankenberg, Stefan, Patten, Monica, Pressler, Axel, Adam, Gerhard, Avanesov, Maxim
• Format: Article
• Language: English
• Subjects: Cardiac; Cardiomyopathies - diagnostic imaging; Cardiomyopathies - epidemiology; Cardiomyopathies - pathology; Contrast Media; Diagnostic Radiology; Female; Females; Fibrosis; Gadolinium; Heart; Humans; Imaging; Internal Medicine; Interventional Radiology; Ischemia; Magnetic resonance; Magnetic Resonance Imaging, Cine; Magnetic Resonance Spectroscopy; Male; Males; Marathon Running; Marathons; Medicine; Medicine & Public Health; Myocardium; Myocardium - pathology; Neuroradiology; Physical training; Predictive Value of Tests; Prevalence; Radiology; Ultrasound
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-023-09416-3

Objectives This study analyzed the prevalence and pattern of focal and potential diffuse myocardial fibrosis detected by late gadolinium enhancement (LGE) and extracellular volume (ECV) imaging in male and female marathon runners using cardiac magnetic resonance (CMR). Methods Seventy-four marathon runners were studied including 55 males (44 ± 8 years) and 19 females (36 ± 7 years) and compared to 36 controls with similar age and sex using contrast-enhanced CMR, exercise testing, and blood samples. Results Contrast-enhanced CMR revealed focal myocardial fibrosis in 8 of 74 runners (11%). The majority of runners were male (7 of 8, 88%). LGE was typically non-ischemic in 7 of 8 runners (88%) and ischemic in one runner. ECV was higher in remote myocardium without LGE in male runners (25.5 ± 2.3%) compared to male controls (24.0 ± 3.0%, p