Key result
Professional footballers had greater carotid intima-media thickness than matched controls (0.55 vs. 0.51 mm, p < 0.05), suggesting IMT may reflect exercise-induced stress rather than just atheroma.
Why the study?
Does professional athletic training increase carotid intima-media thickness compared to matched controls?
Cross-Sectional (n=38)
Does professional athletic training increase carotid intima-media thickness compared to matched controls?
Absolute Event Rate: 0.55% vs 0.51%
p-value: p=< 0.05
Increased carotid IMT in athletes suggests that carotid thickening can occur as a physiological adaptation to exercise-induced wall stress, challenging its exclusive use as a marker of early atherosclerosis.
May warrant caution interpreting carotid IMT in athletes; challenges its specificity as atherosclerosis marker and leaves open athlete-specific norms.
BACKGROUND: It is widely believed that carotid artery intima-media thickening represents an early marker for the development of atheroma. However, carotid intima-media thickening might also be expected to occur in response to an increased tensile stress and decreased wall shear stress which may accompany physical exercise. DESIGN, METHODS, AND RESULTS: In order to test this hypothesis 24 athletes (professional footballers) were compared to 14 age and sex matched control subjects. Each subject underwent carotid and femoral ultrasonography and echocardiography. The athletes had a greater left ventricular mass index compared with the controls: 135 (127-143) vs. 104 (91-116) g/m2, p < 0.001. In addition, they had a greater carotid intima-media thickness (IMT): 0.55 (0.52-0.57) vs. 0.51 (0.48-0.54) mm, p < 0.05. However, carotid artery diameters, femoral IMT and femoral artery diameters were similar: 6.0 (5.9-6.2) vs. 5.8 (5.6-6.1) mm, 0.43 (0.42-0.45) vs. 0.43 (0.41-0.45) mm and 8.3 (8.0-8.6) vs. 8.4 (8.0-8.7) mm, respectively. CONCLUSIONS: The increased carotid IMT of the athletes may result from intermittent exposure to markedly elevated systemic arterial pressures during exercise, resulting in intermittent elevations in carotid wall tensile stress. The lack of a disparity between athletes and controls for femoral IMT may be explained by the intermittent elevation of femoral wall tensile stress being accompanied by increased femoral artery blood flow and wall shear stress, which would tend to reduce any wall thickening. This is an important observation, since it suggests that an increased carotid IMT cannot be relied on solely as a marker of early atherosclerosis.
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Mayet et al. (2002) conducted a cross-sectional in Carotid artery intima-media thickening (n=38). Professional football (physical exercise) vs. Age and sex matched controls was evaluated on Carotid intima-media thickness (IMT) (p=< 0.05). Professional footballers had greater carotid intima-media thickness than matched controls (0.55 vs. 0.51 mm, p < 0.05), suggesting IMT may reflect exercise-induced stress rather than just atheroma.
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