Key result
One month of complete detraining reduces LV mass in athletes ~7%, mediated by decreased intracellular volume.
Why the study?
Athletic cardiac remodeling can be difficult to differentiate from pathological hypertrophy, and the mechanisms of regression during detraining are unclear.
Does complete detraining reduce left ventricular mass and alter intracellular/extracellular compartments in athletes?
Cohort (n=28)
Does complete detraining reduce left ventricular mass and alter intracellular/extracellular compartments in athletes?
Absolute Event Rate: 121% vs 130%
p-value: p=<0.0001
Regression of athletic left ventricular hypertrophy can be detected after just 1 month of complete detraining and is mediated by a decrease in the intracellular myocardial compartment.
Supports short-term detraining effects on athletic LVH; leaves open compartment dynamics and need for prospective outcome trials.
Background: Athletic cardiac remodeling can occasionally be difficult to differentiate from pathological hypertrophy. Detraining is a commonly used diagnostic test to identify physiological hypertrophy, which can be diagnosed if hypertrophy regresses. We aimed to establish whether athletic cardiac remodeling assessed by cardiovascular magnetic resonance is mediated by changes in intracellular or extracellular compartments and whether this occurs by 1 or 3 months of detraining. Methods: Twenty-eight athletes about to embark on a period of forced detraining due to incidental limb bone fracture underwent clinical assessment, ECG, and contrast-enhanced cardiovascular magnetic resonance within a week of their injury and then 1 month and 3 months later. Results: After 1 month of detraining, there was reduction in left ventricular (LV) mass (130±28 to 121±25 g; P <0.0001), increase in native T1 (1225±30 to 1239±30 ms; P =0.02), and extracellular volume fraction (24.5±2.3% to 26.0±2.6%; P =0.0007) with no further changes by 3 months. The decrease in LV mass was mediated by a decrease in intracellular compartment volume (94±22 to 85±19 mL; P <0.0001) with no significant change in the extracellular compartment volume. High LV mass index, low native T1, and low extracellular volume fraction at baseline were all predictive of regression in LV mass in the first month. Conclusions: Regression of athletic LV hypertrophy can be detected after just 1 month of complete detraining and is mediated by a decrease in the intracellular myocardial compartment with no change in the extracellular compartment. Further studies are needed in athletes with overt and pathological hypertrophy to establish whether native T1 and extracellular volume fraction may complement electrocardiography, echocardiography, cardiopulmonary exercise testing, and genetic testing in predicting the outcome of detraining.
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Swoboda et al. (2019) conducted a cohort in Athletic cardiac remodeling (n=28). Complete detraining vs. Baseline was evaluated on Left ventricular (LV) mass (p=<0.0001). Complete detraining for 1 month in athletes reduced left ventricular mass from 130 to 121 g (P<0.0001), mediated by a decrease in intracellular compartment volume.
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