Myocardial fibrosis in endurance athletes: mechanisms and association with adverse cardiovascular events

Myocardial fibrosis is found in many endurance athletes. It may be mediated by exercise induced hypertension (EIH) and lead to cardiac arrhythmia and risk. Study 1 is a public engagement project enabling athletes to measure their own blood pressure after exercise.

Athletes with home recordings of EIH will undergo cardiovascular magnetic resonance, cardiopulmonary exercise test and 24-hour tape (N=200).

In this study we will investigate the prevalence of myocardial fibrosis in endurance athletes of all ages, genders and ethnicities and report its association with EIH and arrhythmia.

In Study 2 participants from Study 1 will be combined with existing cohorts of asymptomatic endurance athletes to create a cohort of 880 athletes with median follow up 7-years.

Individual anonymised scans will be analysed in a central core lab and athletes followed up for major adverse cardiovascular events (MACE) using hospitalisation episode statistics (HES) data. The research will establish whether athletic myocardial fibrosis is associated with increased cardiac risk.

It will also confirm if EIH is associated with myocardial fibrosis and subsequent risk across a diverse range of athletes. If positive, we hope our results will empower athletes to screen themselves for EIH.