title: Lifelong Physical Activity Regardless of Dose Is Not Associated With Myocardial Fibrosis.
abstract: BACKGROUND
  Recent reports have suggested that long-term, intensive physical training may be associated with adverse cardiovascular effects, including the development of myocardial fibrosis. However, the dose-response association of different levels of lifelong physical activity on myocardial fibrosis has not been evaluated.
  
  
  RESULTS
  Seniors free of major chronic illnesses were recruited from predefined populations based on the consistent documentation of stable physical activity over >25 years and were classified into 4 groups by the number of sessions/week of aerobic activities ≥30 minutes: sedentary (group 1), <2 sessions; casual (group 2), 2 to 3 sessions; committed (group 3), 4 to 5 sessions; and Masters athletes (group 4), 6 to 7 sessions plus regular competitions. All subjects underwent cardiopulmonary exercise testing and cardiac magnetic resonance imaging, including late gadolinium enhancement assessment of fibrosis. Ninety-two subjects (mean age 69 years, 27% women) were enrolled. No significant differences in age or sex were seen between groups. Median peak oxygen uptake was 25, 26, 32, and 40 mL/kg/min for groups 1, 2, 3, and 4, respectively. Cardiac magnetic resonance imaging demonstrated increasing left ventricular end-diastolic volumes, end-systolic volumes, stroke volumes, and masses with increasing doses of lifelong physical activity. One subject in group 2 had late gadolinium enhancement in a noncoronary distribution, and no subjects in groups 3 and 4 had evidence of late gadolinium enhancement.
  
  
  CONCLUSIONS
  A lifelong history of consistent physical activity, regardless of dose ranging from sedentary to competitive marathon running, was not associated with the development of focal myocardial fibrosis.
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Shuaib M
authors.initials: SM
authors.lastname: Abdullah
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Kyler W
authors.initials: KW
authors.lastname: Barkley
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Bhella
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Hastings
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Susan
authors.initials: S
authors.lastname: Matulevicius
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Shibata
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Graeme
authors.initials: G
authors.lastname: Carrick-Ranson
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: M Dean
authors.initials: MD
authors.lastname: Palmer
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Nainesh
authors.initials: N
authors.lastname: Gandhi
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas.
authors.forename: Laura F
authors.initials: LF
authors.lastname: DeFina
authors.affiliation: From the Department of Internal Medicine, University of Texas-Southwestern Medical Center, Dallas (S.M.A., K.W.B., P.S.B., J.L.H., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.); North Texas Veteran's Affair's Medical Center, Dallas (S.M.A., J.L.H.); The Cooper Institute, Dallas, TX (L.F.D.); Division of Cardiology, John Peter Smith Health Network (P.S.B.) and The Institute for Exercise and Environmental Medicine (S.M.A., K.W.B., P.S.B., S.M., N.F., S.S., G.C.-R., M.D.P., N.G., B.D.L.), Texas Health Presbyterian Hospital, Dallas. BenjaminLevine@TexasHealth.org.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Levine
mesh_terms: D000367:Age Factors; D000368:Aged; D059267:Cardiomegaly, Exercise-Induced; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000072599:Cardiorespiratory Fitness; D003287:Contrast Media / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005355:Fibrosis; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009206:Myocardium / Q000473:pathology*; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D020257:Ventricular Remodeling
chemical_list: D003287:Contrast Media
keywords: athlete’s heart; exercise; magnetic resonance imaging; myocardial fibrosis