Detraining in Olympic athletes reduced LVEDVi by 6 mL/m² and LVMi by 4 g/m² (p<0.001), with stable LVEF, indicating early reverse cardiac remodeling.
Does short-term detraining induce reverse cardiac remodeling in Olympic athletes?
Short-term detraining in Olympic athletes induces rapid reverse cardiac remodeling, characterized by significant reductions in ventricular volumes and myocardial mass, highlighting the dynamic plasticity of the athlete's heart.
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Abstract Introduction Intensive regular physical exercise induces the so-called athlete’s heart, characterized by enlarged cardiac chambers, increased myocardial mass, and improved relaxation capacity. While these physiological adaptations are well-documented, their reversibility following detraining remains underexplored. Short-term detraining provides an opportunity to assess the early reverse remodeling of the athlete’s heart, distinguishing physiological adaptation from pathological remodeling. The post-Olympic resting period serves as a unique setting to study these effects in a controlled, real-world scenario. Aims This study evaluates cardiac remodeling by comparing peak fitness and early detraining phases using cardiac magnetic resonance (CMR). Methods This prospective study included Olympic-level swimmers and water polo players preparing for the Paris 2024 Olympics. Athletes underwent two CMR assessments: Peak fitness (1–3 weeks pre-Olympics) and early rest (2–5 weeks post-competition) to evaluate short-term detraining effects. Comprehensive assessments included medical and training history through a detailed questionnaire covering cardiovascular health and training regimen. CMR imaging involved native cine imaging for ventricular function assessment and T1/T2 mapping for myocardial tissue characterization, performed on a 1.5 T Siemens Magnetom Aera scanner. Statistical analysis included paired t-tests to compare CMR parameters between peak fitness and early rest. Data analysis and figure creation were conducted using RStudio. We performed paired t-tests to compare CMR parameters between visits and used an interaction analysis to evaluate sex-related differences in the reverse remodeling trajectory. Results Overall, 28 (9 males, 19 females, mean age 25±5 years) athletes completed at least two CMRs. The mean interval between visits was 34±17 days. They reported no more than 4 hours per week of exercise this resting period. Over time, we observed a reduction in LVEDVi (110±14 to 104±16 mL/m², p0.001), LVMi (65±10 to 61±11 g/m², p0.001), and RVEDVi (111±17 to 104±19 mL/m², p0.001), indicating early reverse remodeling consistent across athletes, while LVEF remained stable (p=0.58) across visits. T1 and T2 mapping values increased during detraining, reflecting subtle myocardial tissue changes, with T1 increasing from 942±26 to 951±22 ms (p=0.02). Overall, males had larger indexed ventricular volumes and LVMi than females, but both sexes showed similar magnitudes of remodeling during detraining. Conclusion This study highlights the dynamic plasticity of the athlete’s heart and the utility of CMR in monitoring physiological remodeling. By defining early reverse remodeling patterns, our findings contribute to differentiating physiological adaptation from pathological remodeling, a critical distinction in sports cardiology.CMR metrics in peak and at rest Case of a male swimmer
Szabo et al. (Sat,) reported a other. Detraining in Olympic athletes reduced LVEDVi by 6 mL/m² and LVMi by 4 g/m² (p<0.001), with stable LVEF, indicating early reverse cardiac remodeling.