Endurance Athletes May Face Increased Cardiac Risks Due to Heart Scarring

Recent research has suggested a concerning link between the presence of scar tissue in the hearts of endurance athletes and an elevated risk of life-threatening heart rhythms. This study, published in the journal Circulation: Cardiovascular Imaging, focused on male athletes over the age of 50, revealing potential implications for their health as they age.

Ventricular tachycardia, a serious type of abnormal heart rhythm originating from the lower chambers of the heart, poses a significant danger, potentially leading to sudden cardiac death. Sudden cardiac arrest is known to be a leading cause of death among athletes, particularly older men. The study explored how myocardial fibrosis, characterized by thickening or scarring of heart muscle tissue, could affect otherwise healthy endurance athletes.

The research team aimed to understand the relationship between heart scarring and dangerous heart rhythms in highly trained athletes, particularly as they age. They conducted a study dubbed VENTOUX, named after a famous mountain in the Tour de France. The study involved 106 male cyclists and triathletes, all over 50 years old, who had trained for a minimum of 10 hours per week for at least 15 years and exhibited no prior symptoms of heart disease.

Participants underwent cardiovascular magnetic resonance imaging (CMR) to obtain high-quality images of their hearts. Each athlete also had a continuous ECG monitor implanted to track their heartbeats over two years. The results revealed that:

• Nearly half of the participants (47.2%) exhibited signs of scarring in the left ventricle.
• Approximately 3% experienced a sustained rapid heart rate from the lower chambers, while 19% had shorter episodes of increased heart rates.

Researchers promptly contacted any athlete who displayed potentially harmful rhythms, encouraging them to seek immediate medical evaluation. The findings were unexpected, as the strong correlation between heart scarring and dangerous rhythms had not been previously documented in healthy performance athletes.

The study's lead emphasized the importance of awareness among athletes regarding symptoms such as chest pain, dizziness, or palpitations during physical activity. Additionally, he highlighted the need for all individuals involved in sports to be trained in CPR and the use of automated external defibrillators.

While the incidence of sudden cardiac death during sports varies across studies, the occurrence of abnormal heart rhythms in this research was significantly higher than that found in the general population. However, it's important to note that the study had limitations, including a small, select group of participants. Consequently, the findings may not be applicable to women, non-athletes, or athletes from different backgrounds.

Future research is expected to explore the implications for female athletes and expand the understanding of cardiac health in this demographic.