Biochemical evidence of myocardial fibrosis in veteran endurance athletes

Background: Studies on exercise-induced left ventricular hypertrophy (LVH) in veteran athletes suggest the presence of abnormal diastolic filling and incomplete regression of LVH on cessation of exercise. Hypothesis: Myocardial fibrosis occurs in exercise induced LVH in veteran athletes. Aim: To document non-invasively the presence of fibrosis in veteran athletes Design: Prospective case–control study. Setting: City centre district general hospital. Participants: 45 normotensive elite veteran athletes and 45 normal sedentary subjects. Interventions: Echocardiographic assessment was made of LV mass, LV systolic and LV diastolic function. Plasma carboxyterminal propeptide of collagen type I (PICP), carboxyterminal telopeptide of collagen type I (CITP) and tissue inhibitor of matrix metalloproteinase type I (TIMP-1) were measured as markers of collagen synthesis, degradation and inhibition of degradation, respectively. Results: Veteran athletes had significant elevation in LV dimensions and calculated LV mass index (LVMI). Diastolic and systolic function was normal. Plasma PICP (259 vs 166 μg/l, p