title: Biochemical evidence of myocardial fibrosis in veteran endurance athletes.
abstract: BACKGROUND
  Studies on exercise-induced left ventricular hypertrophy (LVH) in veteran athletes suggest the presence of abnormal diastolic filling and incomplete regression of LVH on cessation of exercise.
  
  
  OBJECTIVE
  Myocardial fibrosis occurs in exercise induced LVH in veteran athletes.
  
  
  OBJECTIVE
  To document non-invasively the presence of fibrosis in veteran athletes
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  City centre district general hospital.
  
  
  METHODS
  45 normotensive elite veteran athletes and 45 normal sedentary subjects.
  
  
  METHODS
  Echocardiographic assessment was made of LV mass, LV systolic and LV diastolic function. Plasma carboxyterminal propeptide of collagen type I (PICP), carboxyterminal telopeptide of collagen type I (CITP) and tissue inhibitor of matrix metalloproteinase type I (TIMP-1) were measured as markers of collagen synthesis, degradation and inhibition of degradation, respectively.
  
  
  RESULTS
  Veteran athletes had significant elevation in LV dimensions and calculated LV mass index (LVMI). Diastolic and systolic function was normal. Plasma PICP (259 vs 166 microg/l, p<0.001), CITP (5.4 vs 2.9 microg/l, p<0.001) and TIMP-1 (350 vs 253 ng/ml, p = 0.01) were elevated in the cohort of athletes. There was a further elevation of TIMP-1 in athletes with echocardiographic LVH, defined as an LVMI >130 g/m(2) (417 vs 266 ng/ml, p = 0.02).
  
  
  CONCLUSIONS
  There is biochemical evidence of disruption of the collagen equilibrium favouring fibrosis in veteran athletes with LVH. This may suggest that fibrosis occurs as part of the hypertrophic process in veteran athletes.
authors.affiliation: Department of Cardiology, Western Infirmary, Glasgow, UK. mitchell@mlindsay.fsbusiness.co.uk
authors.forename: M Mitchell
authors.initials: MM
authors.lastname: Lindsay
authors.forename: Francis G
authors.initials: FG
authors.lastname: Dunn
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D024042:Collagen Type I / Q000378:metabolism; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010807:Physical Endurance / Q000502:physiology*; D011446:Prospective Studies; D013177:Sports / Q000502:physiology*; D013599:Systole / Q000502:physiology; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism
chemical_list: D024042:Collagen Type I; D019715:Tissue Inhibitor of Metalloproteinase-1