Cardiac remodeling and myocardial late gadolinium enhancement in competitive amateur cyclists: insights from cardiac MRI

PURPOSE: To evaluate cardiac remodeling and right ventricular insertion point (RVIP) and non-RVIP late gadolinium enhancement (LGE) patterns, and their clinical and performance correlates, in cyclists using MRI. METHODS: In this prospective study, 66 competitive amateur cyclists (88% male; age 42 ± 13y) and 35 controls (74% males; age 40 ± 13y) underwent 3.0T contrast-enhanced cardiac MRI and cardiopulmonary exercise testing. Cycling history and competitiveness (score:10-70; higher=greater drive) were assessed by questionnaire. RESULTS: , p = 0.043) and lower RVEF (47 ± 4% vs. 57 ± 5%, p = 0.011). Cyclists with RVIP LGE had comparable myocardial mass as those without LGE (p = 0.082). LGE presence was not associated with maximal oxygen uptake, exercise systolic blood pressure, cycling history, or competitiveness (all p > 0.05). CONCLUSION: Nearly one-third of cyclists had focal non-ischemic myocardial LGE, predominantly at the RVIP. Adverse remodeling and reduced function were confined to cyclists with non-RVIP LGE, suggesting a distinct, pathological phenotype.