Heart failure & cardiomyopathiesCohort study
Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy
- Prospective cohort study
Authors' conclusion
Reduced EF occurs in approximately 1 in 6 elite endurance athletes and is related to genetic predisposition in addition to exercise training.
Study context
- Population
- Young elite endurance athletes (22±8 years, 79.7% male)
- Participants
- 281 athletes
- Exposure
- Athletes with reduced ejection fraction (EF) vs athletes with normal EF
- Reduced EFn = 44
- Outcome
- Prevalence of reduced EF (LV, RV or both) by CMR
Main finding
As reported in the abstract
Reduced EF prevalence
Reduced EF (any)
44 of 281 (15.7%)
Reduced LVEF only
N=12; 4.3%
Reduced RVEF only
N=14; 5.0%
Reduced LVEF and RVEF
N=18; 6.4%
Observational data: associations, not effects.
Further findings
>100 ventricular premature beats/24 h
P = 0.008
| Outcome | Reduced EF | Normal EF | P value |
|---|---|---|---|
| LV global longitudinal strain | −17% ± 2% | −19% ± 2% | P < 0.001 |
| LVESVi polygenic risk score | mean 0.57 ± 0.13 | mean 0.51 ± 0.14 | P = 0.009 |
- LVESVi polygenic risk score — Top vs bottom decile of LVESVi-PRS: 11-fold increase in likelihood of reduced EF
- P=0.034
LVESVi polygenic risk score
- Male sex and higher LVESVi-PRS the only significant predictors of reduced EF (multivariate, incl. age and fitness)
Safety
Clinical events during follow-up (mean 4.4 years)
- Deaths (1 trauma, 1 SCD with reduced RVEF and LVESVi-PRS >95%)
- Two
- No athletes developed symptomatic HF or arrhythmias
Original publication
Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy. Circulation. Published 18 December 2023. doi:10.1161/circulationaha.122.063777
Summarised from the published abstract; every number is checked against it