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Differences in coronary vasodilatory capacity and atherosclerosis in endurance athletes using coronary CTA and computational fluid dynamics (CFD): Comparison with a sedentary lifestyle.
Eur J Radiol. 2020 Sep; 130:109168.EJ

Abstract

BACKGROUND

The aim was to assess the effect of endurance exercise on coronary vasodilatory capacity and atherosclerosis by coronary computed tomography angiography (CTA) and computational fluid dynamic (CFD) modelling.

METHODS

100 subjects (age 56.2y±11, 29 females) who underwent coronary CTA were included into this retrospectively matched cohort study. Endurance athletes (≥1 h per unit and ≥3 times per week training) were compared to controls with a sedentary lifestyle, and within subgroups with and without sublingual nitroglycerin preparation. CTA image analysis included coronary stenosis severity (CADRADS), total (segment involvement score = SIS) and mixed plaque burden (G-score), high-risk plaque criteria, the coronary artery calcium score (CACS) and CFD analysis including Fractional Flow Reserve (FFRCT), myocardial mass (M), total vessel lumen volume (V) and volume-to-mass (V/M) ratio.

RESULTS

The prevalence of atherosclerosis by CTA was 65.4 % and >50 % coronary stenosis was found in 17.3 % of athletes. Coronary stenosis severity (CADRADS), total and mixed non-calcified plaque burden (SIS and G-score) were lower in athletes (p = 0.003 and p < 0.001) but not CACS (p = 0.055) and less high-risk plaques were found (p < 0.001). The G-score was correlated with distal FFRCT (p = 0.025). V/M-ratio was different between athletes who received nitroglycerin compared with those who did not (V/M: 21.1 vs. 14.8; p < 0.001), but these differences were not observed in the control subjects.

CONCLUSION

Endurance training improves coronary vasodilatory capacity and reduces high-risk plaque and mixed non-calcifed plaque burden as assessed by coronary CTA angiography. Our study may advocate coronary CTA with FFRCT for evaluation of coronary artery disease in endurance athletes.

Authors+Show Affiliations

Department of Radiology, Innsbruck Medical University, Austria. Electronic address: Gudrun.Feuchtner@i-med.ac.at.Department of Radiology, Innsbruck Medical University, Austria.Department of Internal Medicine III- Cardiology, Innsbruck Medical University, Austria.Department of Internal Medicine III- Cardiology, Innsbruck Medical University, Austria.Department of Radiology, Innsbruck Medical University, Austria.Department of Cardiac Surgery, Innsbruck Medical University, Austria.Department of Cardiac Surgery, Innsbruck Medical University, Austria.Department of Internal Medicine III- Cardiology, Innsbruck Medical University, Austria.ISAG- Institute for Sport and Alpin- and Healthmedicine, Innsbruck, Austria.Stanford University, Dept. Bioengineering, Palo Alto, San Francisco, USA.Department of Radiology, Innsbruck Medical University, Austria.Department of Radiology, Innsbruck Medical University, Austria.University of British Columbia, Vancouver, Dept. Radiology BC Canada.Department of Internal Medicine III- Cardiology, Innsbruck Medical University, Austria.Department of Radiology, Innsbruck Medical University, Austria.Emory University Atlanta, Dept. Radiology, USA.Department of Internal Medicine III- Cardiology, Innsbruck Medical University, Austria.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32739779

Citation

Feuchtner, Gudrun M., et al. "Differences in Coronary Vasodilatory Capacity and Atherosclerosis in Endurance Athletes Using Coronary CTA and Computational Fluid Dynamics (CFD): Comparison With a Sedentary Lifestyle." European Journal of Radiology, vol. 130, 2020, p. 109168.
Feuchtner GM, Langer C, Senoner T, et al. Differences in coronary vasodilatory capacity and atherosclerosis in endurance athletes using coronary CTA and computational fluid dynamics (CFD): Comparison with a sedentary lifestyle. Eur J Radiol. 2020;130:109168.
Feuchtner, G. M., Langer, C., Senoner, T., Barbieri, F., Beyer, C., Bonaros, N., Schachner, T., Friedrich, G., Baldauf, B., Taylor, C. A., Klauser, A., Rauch, S., Leipsic, J., Dichtl, W., Widmann, G., De Cecco, C. N., & Plank, F. (2020). Differences in coronary vasodilatory capacity and atherosclerosis in endurance athletes using coronary CTA and computational fluid dynamics (CFD): Comparison with a sedentary lifestyle. European Journal of Radiology, 130, 109168. https://doi.org/10.1016/j.ejrad.2020.109168
Feuchtner GM, et al. Differences in Coronary Vasodilatory Capacity and Atherosclerosis in Endurance Athletes Using Coronary CTA and Computational Fluid Dynamics (CFD): Comparison With a Sedentary Lifestyle. Eur J Radiol. 2020;130:109168. PubMed PMID: 32739779.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in coronary vasodilatory capacity and atherosclerosis in endurance athletes using coronary CTA and computational fluid dynamics (CFD): Comparison with a sedentary lifestyle. AU - Feuchtner,Gudrun M, AU - Langer,Christian, AU - Senoner,Thomas, AU - Barbieri,Fabian, AU - Beyer,Christoph, AU - Bonaros,Nikolaos, AU - Schachner,Thomas, AU - Friedrich,Guy, AU - Baldauf,Benito, AU - Taylor,Charles A, AU - Klauser,Andrea, AU - Rauch,Stefan, AU - Leipsic,Jonathon, AU - Dichtl,Wolfgang, AU - Widmann,Gerlig, AU - De Cecco,Carlo N, AU - Plank,Fabian, Y1 - 2020/07/11/ PY - 2020/04/14/received PY - 2020/06/04/revised PY - 2020/07/05/accepted PY - 2020/8/3/pubmed PY - 2021/2/18/medline PY - 2020/8/3/entrez KW - Computational fluid dynamic (CFD) modelling KW - Coronary computed tomography angiography (CTA) KW - Sport medicine SP - 109168 EP - 109168 JF - European journal of radiology JO - Eur J Radiol VL - 130 N2 - BACKGROUND: The aim was to assess the effect of endurance exercise on coronary vasodilatory capacity and atherosclerosis by coronary computed tomography angiography (CTA) and computational fluid dynamic (CFD) modelling. METHODS: 100 subjects (age 56.2y±11, 29 females) who underwent coronary CTA were included into this retrospectively matched cohort study. Endurance athletes (≥1 h per unit and ≥3 times per week training) were compared to controls with a sedentary lifestyle, and within subgroups with and without sublingual nitroglycerin preparation. CTA image analysis included coronary stenosis severity (CADRADS), total (segment involvement score = SIS) and mixed plaque burden (G-score), high-risk plaque criteria, the coronary artery calcium score (CACS) and CFD analysis including Fractional Flow Reserve (FFRCT), myocardial mass (M), total vessel lumen volume (V) and volume-to-mass (V/M) ratio. RESULTS: The prevalence of atherosclerosis by CTA was 65.4 % and >50 % coronary stenosis was found in 17.3 % of athletes. Coronary stenosis severity (CADRADS), total and mixed non-calcified plaque burden (SIS and G-score) were lower in athletes (p = 0.003 and p < 0.001) but not CACS (p = 0.055) and less high-risk plaques were found (p < 0.001). The G-score was correlated with distal FFRCT (p = 0.025). V/M-ratio was different between athletes who received nitroglycerin compared with those who did not (V/M: 21.1 vs. 14.8; p < 0.001), but these differences were not observed in the control subjects. CONCLUSION: Endurance training improves coronary vasodilatory capacity and reduces high-risk plaque and mixed non-calcifed plaque burden as assessed by coronary CTA angiography. Our study may advocate coronary CTA with FFRCT for evaluation of coronary artery disease in endurance athletes. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/32739779/Differences_in_coronary_vasodilatory_capacity_and_atherosclerosis_in_endurance_athletes_using_coronary_CTA_and_computational_fluid_dynamics__CFD_:_Comparison_with_a_sedentary_lifestyle_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(20)30357-0 DB - PRIME DP - Unbound Medicine ER -