Response by Merghani et al to Letters Regarding Article, “Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes With a Low Atherosclerotic Risk Profile”

We are grateful for interest shown in our article. Harrell and colleagues propose that myocardial bridging may be a potential explanation for the increased prevalence of coronary atherosclerosis in male masters athletes. We agree that this is an interesting concept. As expected, we observed an element of myocardial bridging in a small proportion of our athletes and control subjects but did not report this in our article. Although it is conceivable that myocardial bridging may cause atherosclerotic plaque proximal to the bridge, our observations do not substantiate this particular theory as a possible mechanism of atherosclerosis in masters athletes. Male masters athletes had a higher prevalence of atherosclerosis affecting ≥2 vessels compared with controls (23 [21.7%] versus 2 [3.7%]; P =0.0024) and a higher proportion of multiple plaques (25 [23.6%] versus 2 [3.7%]; P =0.0014).1 The diffuse pattern of atherosclerosis noted in some of the athletes is difficult to reconcile with a single …