ArticleCirculation2024
Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy.
Article in Circulation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 39 citations in OpenAlex.
- Predictive Effect of Echocardiographic Assessment of Myocardial Efficiency on Martial Arts Performance.Journal of sports science & medicine · 2026Observational
- Masters Athletes With Abnormal Cardiovascular Findings: A Clinical Consensus Statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.Journal of the American College of Cardiology · 2026Article
- Differentiating Cardiac (Mal)adaptation in 2 Athletes With Bicuspid Aortic Valves.JACC. Case reports · 2026Article
- Differentiating an Athlete's Heart and Cardiomyopathy: Role of Advanced Cardiac Imaging.JACC. Case reports · 2026Article
- Severe Left Ventricular Dilation With Preserved Contractile Reserve in an Adolescent Elite Athlete.JACC. Case reports · 2026Article
- Echocardiography and Sports Cardiology: Expanding Horizons From Elite Athletes to Advanced Cardiovascular Disease.Reviews in cardiovascular medicine · 2026Article
- Unravelling the grey zone: submaximal-to-peak stress echocardiography enhances diagnostic accuracy in differentiating early dilated cardiomyopathy from physiological adaptation.Echo research and practice · 2026Article
- Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.European heart journal · 2026Article
- Left Ventricular Ejection Fraction in Heart Failure-A Parameter to Be Discontinued?Journal of clinical medicine · 2026Review
- Cardiovascular Imaging Considerations for Masters-Aged Athletes.JACC. Cardiovascular imaging · 2026Review
- Longitudinal Insights Into Pediatric Hypertension, Cardiac Consequences, and Physical Activity.Current hypertension reports · 2026Review
- Galangin 3-methyl ether alleviates mouse hypertrophic cardiomyopathy via targeting HDAC2 and subsequently inactivating the PI3K-AKT signaling pathway.Acta pharmacologica Sinica · 2026Article
- The metabolic signature of excessive endurance exercise-A prospective study in Tour de France cyclists.iScience · 2026Article
- Muscle, Neuromuscular, and Cardiac Damage in Trail Running: A Systematic Review.Muscles (Basel, Switzerland) · 2026Review
- Marathon-associated sudden cardiac death: a mini review of risk perception, pathophysiological mechanisms, and prevention strategies.Frontiers in cardiovascular medicine · 2026Review
- Titin-related familial dilated cardiomyopathy: factors associated with disease onset.European heart journal · 2025Observational
- A concise guide of contemporary cardiovascular imaging practices to differentiate athlete's heart in the gray zone.Heart failure reviews · 2025Review
- Clinical and Cardiovascular Magnetic Resonance Characteristics of Veteran Male Endurance Athletes With Atrial Fibrillation: VENTOUX-AF.Journal of the American Heart Association · 2025Article
- Cardiac fibrosis: from mechanisms and models to medicines.Trends in pharmacological sciences · 2025Review
- Cardiovascular magnetic resonance to differentiate veteran athlete's heart with cavity dilatation and mild dilated cardiomyopathy.European heart journal. Cardiovascular Imaging · 2025Article
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Authors and funding
30 authors at 11 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExercise-induced cardiac remodeling can be profound, resulting in clinical overlap with dilated cardiomyopathy, yet the significance of reduced ejection fraction (EF) in athletes is unclear. The aim is to assess the prevalence, clinical consequences, and genetic predisposition of reduced EF in athletes.
methodsYoung endurance athletes were recruited from elite training programs and underwent comprehensive cardiac phenotyping and genetic testing. Those with reduced EF using cardiac magnetic resonance imaging (defined as left ventricular EF <50%, or right ventricular EF <45%, or both) were compared with athletes with normal EF. A validated polygenic risk score for indexed left ventricular end-systolic volume (LVESVi-PRS), previously associated with dilated cardiomyopathy, was assessed. Clinical events were recorded over a mean of 4.4 years.
resultsOf the 281 elite endurance athletes (22±8 years, 79.7% male) undergoing comprehensive assessment, 44 of 281 (15.7%) had reduced left ventricular EF (N=12; 4.3%), right ventricular EF (N=14; 5.0%), or both (N=18; 6.4%). Reduced EF was associated with a higher burden of ventricular premature beats (13.6% versus 3.8% with >100 ventricular premature beats/24 h;
conclusionsReduced EF occurs in approximately 1 in 6 elite endurance athletes and is related to genetic predisposition in addition to exercise training. Genetic and imaging markers may help identify endurance athletes in whom scrutiny about long-term clinical outcomes may be appropriate. REGISTRATION: URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374976&isReview=true; Unique identifier: ACTRN12618000716268.
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