Fanatical sports not only make your muscles stronger, but also cause subtle changes in the heart itself. ACS researcher Joelle Daems and colleagues have discovered that top athletes have a different 'tissue structure' in their hearts compared to people who do not exercise. This change can be seen with a special MRI technique, and occurs in both male and female athletes. It was previously thought that this might only happen in men, but it now appears that this is also the case in women. This knowledge can help to distinguish healthy sports adjustments from incipient heart disease, and thus hopefully recognize and prevent serious heart problems in athletes earlier.
Elite Athletes
For his study, Daems included athletes from the Evaluation of Lifetime Participation in Intense Top-level Sports and Exercise (ELITE) cohort. ‘Within the ELITE cohort, we are collecting cardiac screening data from elite athletes and following them over time, even after they retire from competitive sports’, explains Joelle Daems, Phd candidate. The elite athletes are over sixteen years of age, compete at national, international, Paralympic, and/or Olympic levels in the Netherlands, and exercise more than ten hours per week.
Special MRI technique
The change in tissue structure can be seen with Cardiac Magnetic Resonance (CMR) imaging, a non-invasive standard to assess cardiac volumes and function, as well as for myocardial tissue characterization and fibrosis. CMR T1 mapping is an imaging technique to assess tissue structure. In athletes, this imaging technique could help in differentiating early-onset cardiomyopathy (EICR) from exercise-induced cardiac remodeling.
Changes in both men and women
Using CMR T1 mapping, Daems shows changes in cardiac tissue in both male and female athletes. It is important to emphasize that these changes happen separately from the known adjustments to sports, such as having a larger heart or a thicker heart muscle. Daems further clarifies: ‘These results show that intensive sports really affect the cells in your heart.’ It was previously thought that this might only happen in men, but it now appears that this is also the case in women: the greatest change being observed in female athletes compared to healthy controls. The next step is to further investigate how these findings can help in distinguishing physiological changes due to exercise from cardiac diseases and how the hearts of men and women respond when subjected to frequent and intense exercise.
who wish to explore this further—whether through fundamental research, animal models, or new studies in young athletes.
Long-term effects
These findings also raise other questions: Are these tissue changes permanent, or do they disappear when someone stops exercising? And what does this mean for athletes’ heart health in the long term? Since data is collected from athletes, even after they retire, the goal is to study the long-term effects of high-level athletic performance on heart health. ‘We welcome collaboration with fellow researchers who wish to explore this further—whether through fundamental research, animal models, or new studies in young athletes’, says Daems.
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