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Heart and Vessels

, Volume 28, Issue 5, pp 626–631 | Cite as

Comparison of morphological and functional adaptations of the heart in highly trained triathletes and long-distance runners using cardiac magnetic resonance imaging

  • Erik Franzen
  • Stefanie Mangold
  • Gunnar Erz
  • Claus D. Claussen
  • Andreas M. Niess
  • Ulrich Kramer
  • Christof Burgstahler
Original Article

Abstract

“Athlete’s heart” is characterized by an increase in ventricular chamber sizes and myocardial mass (MM), and is mainly observed in endurance athletes. At present, it remains unclear whether cardiac adaptations in long-distance runners differ from those in triathletes. Twenty male triathletes (mean age 38.7 ± 6.2 years) and 20 male marathon runners (mean age 44.1 ± 7.9) underwent cardiac magnetic resonance imaging to calculate left and right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and MM. Late-enhancement (LE) imaging was used to exclude structural alterations or myocardial scarring. EDV, ESV, SV, and EF for the left and right ventricles, as well as MM, did not differ between long-distance runners and triathletes, although the weekly training volume was significantly higher in triathletes (17.05 vs 9.95 h/week, P < 0.0001). There was a significant correlation between weekly training volume and right and left EDV, right and left ESV as well as MM within the study group. Myocardial LE was absent in all athletes. Highly trained male long-distance runners and triathletes have comparable cardiac parameters. However, the extent of physical training seems to be associated with the degree of cardiac adaptation in endurance athletes. The absence of LE supports the idea that athlete’s heart is a nonpathological adaptation of the cardiovascular system.

Keywords

Athlete’s heart Cardiac magnetic resonance imaging Triathlete 

Notes

Acknowledgments

The authors would like to thank the participants for volunteering for the study. This study was supported by a Grant from the German Heart Research Foundation.

References

  1. 1.
    Perseghin G, De Cobelli F, Esposito A, Lattuada G, Terruzzi I, La Torre A, Belloni E, Canu T, Scifo P, Del Maschio A, Luzi L, Alberti G (2007) Effect of the sporting discipline on the right and left ventricular morphology and function of elite male track runners: a magnetic resonance imaging and phosphorus 31 spectroscopy study. Am Heart J 154:937–942PubMedCrossRefGoogle Scholar
  2. 2.
    Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE (2000) The athlete’s heart. A meta-analysis of cardiac structure and function. Circulation 101:336–344PubMedCrossRefGoogle Scholar
  3. 3.
    Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO (1996) Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 276:199–204PubMedCrossRefGoogle Scholar
  4. 4.
    Fagard R (2003) Athlete’s heart. Heart 89:1455–1461PubMedCrossRefGoogle Scholar
  5. 5.
    Miller S, Simonetti OP, Carr J, Kramer U, Finn JP (2002) MR Imaging of the heart with cine true fast imaging with steady-state precession: influence of spatial and temporal resolutions on left ventricular functional parameters. Radiology 223:263–269PubMedCrossRefGoogle Scholar
  6. 6.
    Prakken NH, Cramer MJ, Teske AJ, Arend M, Mali WP, Velthuis BK (2011) The effect of age in the cardiac MRI evaluation of the athlete’s heart. Int J Cardiol 149:68–73PubMedCrossRefGoogle Scholar
  7. 7.
    Zandrino F, Molinari G, Smeraldi A, Odaglia G, Masperone MA, Sardanelli F (2000) Magnetic resonance imaging of athlete’s heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries. Eur Radiol 10:319–325PubMedCrossRefGoogle Scholar
  8. 8.
    Pluim BM, Lamb HJ, Kayser HW, Leujes F, Beyerbacht HP, Zwinderman AH, van der Laarse LA, Vliegen HW, De Roos A, van der Wall EE (1998) Functional and metabolic evaluation of the athlete’s heart by magnetic resonance imaging and dobutamine stress magnetic resonance spectroscopy. Circulation 97:666–672PubMedCrossRefGoogle Scholar
  9. 9.
    Scharf M, Brem MH, Wilhelm M, Schoepf UJ, Uder M, Lell MM (2010) Cardiac magnetic resonance assessment of left and right ventricular morphologic and functional adaptations in professional soccer players. Am Heart J 159:911–918PubMedCrossRefGoogle Scholar
  10. 10.
    Scharhag J, Schneider G, Urhausen A, Rochette V, Kramann B, Kindermann W (2002) Athlete’s heart: right and left ventricular mass and function in male endurance athletes and untrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol 40:1856–1863PubMedCrossRefGoogle Scholar
  11. 11.
    Olimulder MA, Kraaier K, Galjee MA, Scholten MF, van Es J, Wagenaar LJ, van der Palen J, von Birgelen C (2012) Infarct tissue characteristics of patients with versus without early revascularization for acute myocardial infarction: a contrast-enhancement cardiovascular magnetic resonance imaging study. Heart Vessels 27:250–257PubMedCrossRefGoogle Scholar
  12. 12.
    Coats AJS, Shewan LG (2011) Statement on authorship and publishing ethics in the International Journal of Cardiology. Int J Cardiol 153:239–240PubMedGoogle Scholar
  13. 13.
    Kozakova M, Balkau B, Morizzo C, Bini G, Flyvbjerg A, Palombo C (2011) Physical activity, adiponectin, and cardiovascular structure and function. Heart Vessels. doi: 10.1007/s00380-011-0215-4 (online first)
  14. 14.
    Lauschke J, Maisch B (2009) Athlete’s heart or hypertrophic cardiomyopathy? Clin Res Cardiol 98:80–88PubMedCrossRefGoogle Scholar
  15. 15.
    Maron BJ (2009) Distinguishing hypertrophic cardiomyopathy from athlete’s heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening. Br J Sports Med 43:649–656PubMedCrossRefGoogle Scholar
  16. 16.
    Scharf M, Brem MH, Wilhelm M, Schoepf UJ, Uder M, Lell MM (2010) Atrial and ventricular functional and structural adaptations of the heart in elite triathletes assessed with cardiac MR imaging. Radiology 257:71–79PubMedCrossRefGoogle Scholar
  17. 17.
    Prakken NH, Velthuis BK, Teske AJ, Mosterd A, Mali WP, Cramer MJ (2010) Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex. Eur J Cardiovasc Prev Rehabil 17:198–203PubMedCrossRefGoogle Scholar
  18. 18.
    Benito B, Gay-Jordi G, Serrano-Mollar A, Guasch E, Shi Y, Tardif JC, Brugada J, Nattel S, Mont L (2011) Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 123:13–22PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2012

Authors and Affiliations

  • Erik Franzen
    • 1
  • Stefanie Mangold
    • 2
  • Gunnar Erz
    • 1
  • Claus D. Claussen
    • 2
  • Andreas M. Niess
    • 1
  • Ulrich Kramer
    • 2
  • Christof Burgstahler
    • 1
  1. 1.Department of Internal Medicine V, Sports MedicineUniversity of TuebingenTübingenGermany
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity of TuebingenTübingenGermany

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