T1 Mapping in Athletes

Cardiac adaptation to high-intensity exercise is well recognized and often termed the athlete’s heart. The characteristic features of athlete’s heart are increased left ventricular (LV) volume, increased LV wall thickness and mass, resting bradycardia, and ECG repolarization abnormalities. These changes are particularly associated with endurance training causing eccentric LV hypertrophy, whereas significant resistance training (eg, weight lifters) may lead to concentric LV hypertrophy. Although somewhat controversial, it is widely accepted that in the majority of athletes, these changes occur as a physiological response to exercise training; LV volumes and mass regress in subjects who stop training and decondition. However, there is an increasing number of reports in older veteran athletes that may suggest that some people who exercise intensely over many years develop myocardial fibrosis and have an increased risk of arrhythmias, particularly atrial fibrillation.