176 Ventricular arrhythmia and cardiac fibrosis in endurance experienced athletes (the ventoux study)

作者：Wasim Javed, Ioannis Botis, Ze Ming Goh, Mubien Shabi, Ben Brown, Raluca Tomoaia, Eylem Levelt, Lee Graham, John Gierula, John P. Greenwood, Sven Plein, Peter Swoboda · 年份：2024 · DOI：10.1136/heartjnl-2024-bcs.173 · 研究领域：Cardiovascular Effects of Exercise、Cardiac Imaging and Diagnostics

Introduction Myocardial fibrosis on cardiac magnetic resonance (CMR) has increasingly been detected in lifelong endurance athletes, particularly those who are male. In non-ischaemic cardiomyopathy, the presence of myocardial fibrosis on CMR is known to be associated with arrhythmia and adverse outcome. However, the significance of myocardial fibrosis in asymptomatic athletes is unknown. We aimed to prospectively investigate whether focal myocardial fibrosis on CMR in asymptomatic veteran endurance athletes is associated with incident ventricular arrhythmia by comparing the incidence of ventricular arrhythmia detected on implantable loop recorder (ILR) in those with and without myocardial fibrosis on CMR. Methods 106 healthy, asymptomatic, male amateur competitive cyclists and triathletes aged >50 years old were prospectively recruited. They all trained >10 hours per week for >15 years and regularly competed. All athletes underwent baseline assessment, resting 12-lead ECG and comprehensive CMR to detect myocardial fibrosis which included quantitative stress-perfusion, quantitative late gadolinium enhancement (LGE) and parametric tissue characterisation including native T1, ECV and T2 mapping. Each athlete subsequently underwent maximal effort exercise testing to quantify fitness levels before receiving an ILR to detect the presence of arrhythmia. Athletes were followed up for 2 years for the presence of ventricular arrhythmia (ventricular tachycardia (VT)/ non-sust...