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Myocardial Fibrosis in Competitive Triathletes Detected by Contrast-Enhanced CMR Correlates With Exercise-Induced Hypertension and Competition History

Overview of attention for article published in JACC Cardiovascular Imaging, December 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#5 of 907)
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
2 news outlets
twitter
210 tweeters

Readers on

mendeley
10 Mendeley
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1 CiteULike
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Title
Myocardial Fibrosis in Competitive Triathletes Detected by Contrast-Enhanced CMR Correlates With Exercise-Induced Hypertension and Competition History
Published in
JACC Cardiovascular Imaging, December 2017
DOI 10.1016/j.jcmg.2017.09.016
Pubmed ID
Authors

Tahir, Enver, Starekova, Jitka, Muellerleile, Kai, von Stritzky, Alexandra, Münch, Julia, Avanesov, Maxim, Weinrich, Julius M., Stehning, Christian, Bohnen, Sebastian, Radunski, Ulf K., Freiwald, Eric, Blankenberg, Stefan, Adam, Gerhard, Pressler, Axel, Patten, Monica, Lund, Gunnar K., Enver Tahir, Jitka Starekova, Kai Muellerleile, Alexandra von Stritzky, Julia Münch, Maxim Avanesov, Julius M. Weinrich, Christian Stehning, Sebastian Bohnen, Ulf K. Radunski, Eric Freiwald, Stefan Blankenberg, Gerhard Adam, Axel Pressler, Monica Patten, Gunnar K. Lund

Abstract

This study analyzed the presence of myocardial fibrosis detected by late gadolinium-enhancement (LGE) cardiac magnetic resonance (CMR) in correlation with the performance of competitive triathletes objectified by an exercise test and individual competition history. Myocardial fibrosis detected by LGE CMR has been reported to occur in 0% to 50% of asymptomatic athletes. However, the cause and mechanisms of myocardial fibrosis are unclear. Eighty-three asymptomatic triathletes undergoing >10 training h per week (43 ± 10 years of age; 65% male) and 36 sedentary controls were studied by using LGE and extracellular volume (ECV) CMR. Parameters of physical fitness were measured by spiroergometry. Triathletes reported their lifetime competition results. LGE CMR revealed focal nonischemic myocardial fibrosis in 9 of 54 (17%) male triathletes (LGE+) but in none of the female triathletes (p < 0.05). LGE+ triathletes had higher peak exercise systolic blood pressure (213 ± 24 mm Hg) than LGE- triathletes (194 ± 26 mm Hg; p < 0.05). Furthermore, left ventricular mass index was higher in LGE+ triathletes (93 ± 7 g/m2) than in LGE- triathletes (84 ± 11 g/m2; p < 0.05). ECV in LGE- myocardium was higher in LGE+ triathletes (26.3 ± 1.8%) than in LGE- triathletes (24.4 ± 2.2%; p < 0.05). LGE+ triathletes completed longer cumulative distances in swimming and cycling races and participated more often in middle and Iron Man distances than LGE- triathletes. A cycling race distance of >1,880 km completed during competition had the highest accuracy to predict LGE, with an area under the curve value of 0.876 (p < 0.0001), resulting in high sensitivity (89%) and specificity (79%). Multivariate analysis identified peak exercise systolic blood pressure (p < 0.05) and the swimming race distance (p < 0.01) as independent predictors of LGE presence. Myocardial fibrosis in asymptomatic triathletes seems to be associated with exercise-induced hypertension and the race distances. There appears to be a safe upper limit, beyond which exercise may result in myocardial fibrosis.

Twitter Demographics

The data shown below were collected from the profiles of 210 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 10 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 10 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 4 40%
Student > Doctoral Student 3 30%
Student > Master 1 10%
Professor 1 10%
Other 1 10%
Other 0 0%
Readers by discipline Count As %
Medicine and Dentistry 7 70%
Unspecified 2 20%
Sports and Recreations 1 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 165. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 January 2018.
All research outputs
#52,684
of 8,940,608 outputs
Outputs from JACC Cardiovascular Imaging
#5
of 907 outputs
Outputs of similar age
#2,465
of 216,696 outputs
Outputs of similar age from JACC Cardiovascular Imaging
#1
of 45 outputs
Altmetric has tracked 8,940,608 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 907 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.9. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 216,696 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 45 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.