title: Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast-Enhanced Cardiovascular Magnetic Resonance Study.
abstract: It is under debate whether the cumulative effects of intensive endurance exercise induce chronic cardiac damage, mainly involving the right heart. The aim of this study was to examine the cardiac structure and function in long-term elite master endurance athletes with special focus on the right ventricle by contrast-enhanced cardiovascular magnetic resonance.
  
  
  
  Thirty-three healthy white competitive elite male master endurance athletes (age range, 30-60 years) with a training history of 29±8 years, and 33 white control subjects pair-matched for age, height, and weight underwent cardiopulmonary exercise testing, echocardiography including tissue-Doppler imaging and speckle tracking, and cardiovascular magnetic resonance. Indexed left ventricular mass and right ventricular mass (left ventricular mass/body surface area, 96±13 and 62±10 g/m(2); P<0.001; right ventricular mass/body surface area, 36±7 and 24±5 g/m(2); P<0.001) and indexed left ventricular end-diastolic volume and right ventricular end-diastolic volume (left ventricular end-diastolic volume/body surface area, 104±13 and 69±18 mL/m(2); P<0.001; right ventricular end-diastolic volume/body surface area, 110±22 and 66±16 mL/m(2); P<0.001) were significantly increased in athletes in comparison with control subjects. Right ventricular ejection fraction did not differ between athletes and control subjects (52±8 and 54±6%; P=0.26). Pathological late enhancement was detected in 1 athlete. No correlations were found for left ventricular and right ventricular volumes and ejection fraction with N-terminal pro-brain natriuretic peptide, and high-sensitive troponin was negative in all subjects.
  
  
  
  Based on our results, chronic right ventricular damage in elite endurance master athletes with lifelong high training volumes seems to be unlikely. Thus, the hypothesis of an exercise-induced arrhythmogenic right ventricular cardiomyopathy has to be questioned.
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.). philipp.bohm@gmx.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Bohm
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Günther
authors.initials: G
authors.lastname: Schneider
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Lutz
authors.initials: L
authors.lastname: Linneweber
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Axel
authors.initials: A
authors.lastname: Rentzsch
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Nadine
authors.initials: N
authors.lastname: Krämer
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Wilfried
authors.initials: W
authors.lastname: Kindermann
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Tim
authors.initials: T
authors.lastname: Meyer
authors.affiliation: From Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany (P.B., L.L., N.K., W.K., T.M., J.S.); Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany (G.S.); and Clinic of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany (A.R., H.A.-K.).
authors.forename: Jürgen
authors.initials: J
authors.lastname: Scharhag
mesh_terms: D000328:Adult; D056352:Athletes; D003287:Contrast Media; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
chemical_list: D003287:Contrast Media
keywords: arrhythmogenic right ventricular cardiomyopathy; athletes; cardiac magnetic resonance imaging; myocardial injury; right ventricle