HMN 2025: How Scar tissue in athletes’ hearts is tied to larger threat of harmful cardiac rhythms

Scar tissue within the coronary heart was related to irregular coronary heart rhythms amongst wholesome, long-time male endurance athletes aged 50 or older, doubtlessly rising their threat of sudden cardiac dying, based on a small study printed in Circulation: Cardiovascular Imaging, an American Heart Association journal.

An irregular rhythm originating from a ventricular coronary heart chamber, referred to as ventricular tachycardia, is taken into account one of the crucial critical sorts of irregular coronary heart rhythm. It is extraordinarily harmful and may result in sudden cardiac dying. Sudden cardiac arrest is a number one reason behind dying in athletes, largely affecting older males.

Myocardial fibrosis—the scarring or thickening of coronary heart muscle tissue—has beforehand been linked to irregular heartbeats; nonetheless, the way it impacts in any other case wholesome endurance athletes stays unclear.

“Dangerous coronary heart rhythms throughout sport are fortunately uncommon,” mentioned senior study writer Peter Swoboda, M.B.B.S., Ph.D., an affiliate professor of cardiology on the University of Leeds within the U.Ok. “In sure extremely educated athletes—significantly as they become old—it’s attainable to establish scarred coronary heart tissue by way of magnetic resonance imaging. We needed to research whether or not harmful coronary heart rhythms in endurance athletes may be brought on by coronary heart scarring.

“Our important intention was to assist endurance athletes proceed to take part safely in sports activities, significantly as they become old,” he mentioned.

The study, referred to as VENTOUX, was named after a well-known mountain climb within the world-renowned Tour de France bike race. The researchers adopted 106 male cyclists/triathletes aged 50 or older, who had no signs of coronary heart illness. All had educated at the very least 10 hours every week for 15 years or extra.

The individuals underwent cardiovascular magnetic resonance (CMR) imaging, a specialised check that makes use of magnetic fields to provide detailed photographs of the guts. They additionally had an ECG recorder implanted underneath the pores and skin of their chest that recorded each heartbeat for 2 years.

During a mean follow-up of two years, researchers discovered:

• Almost half of the athletes (47.2%) confirmed indicators of scarring on the left ventricle of the guts; and
• About 3% of the athletes displayed a sustained, doubtlessly harmful quick coronary heart fee originating within the decrease chambers of the guts, whereas 19% skilled shorter bursts of fast heartbeats.

Any participant who developed a doubtlessly dangerous rhythm was contacted urgently to evaluate signs and suggested to hunt unbiased medical consideration.

“We didn’t count on the affiliation between scarring and harmful rhythms to be this robust,” Swoboda mentioned. “Similar findings have been reported in sufferers with coronary heart muscle illness. However, we didn’t count on this in wholesome, efficiency athletes.”

He urged any athlete who experiences chest ache, dizziness or palpitations throughout exercise to hunt therapy and likewise suggested, “It’s vital that everybody concerned in sports activities is aware of CPR and methods to use an automatic exterior defibrillator.”

Although the annual incidence of sudden cardiac dying throughout sports activities varies amongst research, the annual fee of irregular coronary heart rhythms detected on this study was significantly larger than charges among the many normal inhabitants.

The study has a number of limitations, resembling together with a small variety of very choose individuals. The findings could not apply to folks not represented within the study: ladies, non-athletes or non-European cyclists. In addition, the findings couldn’t differentiate whether or not the cardiac scarring itself was the reason for irregular coronary heart rhythms or if it was a marker for a separate underlying course of.

Future analysis will study ladies, the authors mentioned.