Exercise induced coronary inflammation in masters athletes

Abstract

Background: Chronic endurance exercise has been linked to increased prevalence of coronary artery disease (CAD) in male master athletes. Data are limited regarding the presence of exercise-induced coronary inflammation and its association with atherosclerosis in master endurance athletes. Human coronary inflammation can be detected non-invasively by imaging pericoronary adipose tissue (PCAT). We tested the hypothesis that chronic endurance exercise leads to increased prevalence of atherosclerosis via coronary inflammation. Methods: Computed tomography coronary angiogram CTCA scans from 2 cohorts of master athletes and age-matched controls, without known risk factors for CAD, were analysed post-hoc and the PCAT attenuation index was calculated around the proximal right coronary artery (FAIRCA). The athletes and the healthy controls also underwent an electrocardiogram, an echocardiogram, a cardiopulmonary exercise test (CPET), a 24-hour Holter tape and a Cardiac Magnetic Resonance (CMR) scan. Results: Scans from 243 masters endurance athletes (62% females) and 58 age and Framingham CAD risk score matched healthy controls were analysed. FAIRCA was significantly higher (less negative) in male masters athletes vs female masters athletes [-61.3 Hounsfield Units (HU) vs -62.8 HU, p=0.01], in male athletes vs male controls (-61.3 HU vs -68.6 HU, p<0.001) and in female athletes vs female controls (-62,8 HU vs -67.5 HU, p=0.005). In female masters athletes, peak oxygen consumption during CPET (peak VO2) statistically significantly predicted the FAIRCA, F(1,146) = 22.62, p<0.0001. There was no correlation between the FAIRCA and presence of atherosclerosis in male masters athletes. Conclusions: Masters athletes show increased markers of coronary inflammation. This effect appears to be greater in male masters athletes and is associated with a higher peak VO2 in female masters athletes. However, we did not identify a link between coronary inflammation and coronary atherosclerosis in this cohort. (Table Presented).