Kaddoura Rasha, Al-Tamimi Hassan
Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Heart Views. 2025 Jan-Mar;26(1):34-42. doi: 10.4103/heartviews.heartviews_13_23. Epub 2025 Jul 16.
Regular physical exercise is undoubtedly associated with cardiovascular health benefit, increased longevity, and improved endurance performance. Competitive endurance athletes exceed the recommended exercise dose, which lead to pathologic cardiac remodeling such as myocardial fibrosis. This review examines the impact of myocardial fibrosis on atrial and ventricular structures and functions in endurance athletes. A systematic literature search identified eight trials that enrolled 470 athletes. The prevalence of myocardial fibrosis ranged from 13% to 48%, which was commonly of a focal nonischemic pattern. The included studies did not find consistent results on the impact of myocardial fibrosis on ventricular function and volume parameters. Moreover, the prognostic implications of myocardial fibrosis on patient clinical outcomes, such as arrhythmias and mortality, were not reported as there was no long-term follow-up. There is a clear unmet need to encourage larger studies on myocardial fibrosis phenotypes to shed more light on the underlying mechanism, clinical consequences, and prognosis.
定期进行体育锻炼无疑与心血管健康益处、延长寿命和提高耐力表现相关。竞技耐力运动员超过了推荐的运动剂量，这会导致病理性心脏重塑，如心肌纤维化。本综述探讨了心肌纤维化对耐力运动员心房和心室结构及功能的影响。一项系统的文献检索确定了八项试验，共纳入470名运动员。心肌纤维化的患病率在13%至48%之间，通常为局灶性非缺血性模式。纳入的研究在心肌纤维化对心室功能和容积参数的影响方面未发现一致的结果。此外，由于没有长期随访，未报告心肌纤维化对患者临床结局（如心律失常和死亡率）的预后影响。显然，迫切需要鼓励开展关于心肌纤维化表型的更大规模研究，以更清楚地了解其潜在机制、临床后果和预后。
