Do marathon runners face an “ominous” risk of myocardial fibrosis?

Excerpt

My attention was held by one statement in the conclusions drawn from an otherwise stimulating review of cardiovascular function in veteran marathon runners (Wilson et al. 2010). The authors spoke of an “ominously high prevalence of late gadolinium enhancement” in such athletes “(12%, indicative of myocardial fibrosis).” Late gadolinium enhancement (LGE) is certainly indicative of myocardial fibrosis (McCrohon et al. 2003), and if an unusual prevalence of this finding was to be substantiated, it might indeed indicate a need for caution when encouraging marathon running among older adults. However, specific and sophisticated laboratory data must always be weighed carefully against the evidence of overall health in larger populations, and available studies suggest that endurance athletes are not particularly vulnerable to heart attacks. Rather, this population is characterized by a below average prevalence of cardiac risk factors (Findlay et al. 1987), a longer than average life expectancy, and a below average risk of myocardial ischaemia (Sarna et al. 1993, 1997). …