Reverse Cardiac Remodeling Among Elite Athletes After Short and Long-term Detraining

Exercise has many well-documented effects in the prevention or treatment of disease, but recently some studies have raised awareness of the possible negative effects of too much exercise. In former elite endurance athletes, an increased risk of cardiac fibrosis and arrhythmias have been described. Whether exercise itself is the culprit remains to be explored.

The right cardiac ventricle can be overloaded during long-term intense exercise, due to increased volume load and possibly an increased afterload. In a subgroub of athletes the appearance with morphological and functional changes resembling an ARVC like phenotype. Furthermore, atrial fibrillation among male middle-aged athletes is up to 5 times more common compared to age-matched non-athletes. The working hypothesis of this study is that male athletes remodel more than females and that some of thise changes are already measureable early after end of elite sporting carreer.

In this prospective cohort study, of 50 elite athletes at retirement, after 3 months and thereafter yearly for five years, to determine the characteristics of remodeling of the heart focusing on the left atrial and right ventricle.

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Key information

Conditions

Athlete Heart Arrhythmias, Cardiac Cardiovascular Diseases Heart Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Bispebjerg-Frederiksberg Hospital

Copenhagen, 2000, Denmark

About this study

A prospective cohort study of reverse cardiac remodeling in recently retired elite athletes

Aim To explore the remodeling of the heart focusing on right ventricle and left atria as well as pulmonary circulation in elite athletes at rest and during exercise as well as the effect of short and long-term reverse remodeling after the end of a professional sporting career

Methods The investigators will initiate a 5-year longitudinal study of cardiac detraining in 50 former elite athletes.

Primary outcome Change in left atrial minimum size after three months retirement (mL)

Secondary outcome:

Change in left atrium (LA) function measured by strain and volume measures by echocardiography and magnetic resonance cor (MRc) after three months and the following years
Change in right and left ventricle size and function by echocardiography and magnetic resonance cor (MRc) after three months and the following years
Change in VO2max after three months and the following years
Change in diurnal ventricular and supraventricular ectopy and heart rate variability after three months and the following years
Change in blood pressure, BMI after three months and the following years
Change in plasma lipids and HbA1c after three months and the following years

The full list of examinations includes:

Baseline family history, medical and training history
Cardio-pulmonary exercise test
24-hour Holter monitoring
Biochemistry
Cardiac MR including contrast at rest and during exercise
Trans thoracic echocardiography

Project organization and partners Recruitment of participants is organized in cooperation with the danish national elite sports organization (Team Danmark), Divisionsforeningen (The association of professional football clubs), and Spillerforeningen (The union of professional football players).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

≥18 years at the time of screening
Former elite athlete from endurance sport discipline
End of elite sporting career >1 year ago

Exclusion criteria

Any known cardiac disease
Any condition (eg, psychiatric illness) or situation that, in the investigator's opinion, could impose the subject at significant risk, or interfere significantly with the subject's participation in the study.

Treatment and study plan

Primary outcomes

Left atrial minimum volume

Time frame: 5 years
Primary endpoint The primary aim is to assess the long-term effect on remodeling of left atrium size measured by 2D echocardiography
- Primary endpoint: Change in LA minimum volume (mL)

Sponsors and collaborators

Lead sponsor

Bispebjerg Hospital

Other

Collaborators

Rigshospitalet, Denmark

Registry information

Acronym: Remod

Important dates

Study start: 2022
Primary completion: 2024
Study completion: 2024
First posted: Sep 27, 2022
Registry last updated: Sep 5, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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