Comprehensive assessment of cardiovascular structure and function and disease risk in middle-aged ultra-endurance athletes

Abstract Background and aims Recent studies suggest that long-term endurance training may be damaging to the heart, thus increasing cardiovascular disease (CVD) risk. However, studies utilizing cardiac imaging are conflicting and lack measures of central and peripheral vascular structure and function, which are also independently predictive of CVD events. Methods We performed a comprehensive assessment of cardiovascular structure and function in long-term (≥10 years) ultra-endurance athletes (ATH, 14M/11F, 50±1 y) and physically active controls (CON, 9M/9F, 49±2 y). Results As expected, left ventricular mass and end-diastolic volume (echocardiography) were greater in ATH vs CON, whereas there was no difference in cardiac function at rest. Coronary artery calcium scores (computed tomography) were not statistically different between groups. There was no evidence of myocardial fibrosis (contrast magnetic resonance imaging) in any subject. Aortic stiffness (carotid-femoral pulse wave velocity) was lower in ATH vs CON (6.2±0.2 vs 6.9±0.2 m/s, p 0.05). Conclusions Our data indicate that middle-aged ultra-endurance ATH do not have marked signs of widespread cardiovascular dysfunction or elevated CHD risk compared to CON meeting physical activity guidelines.