000170962 001__ 170962
000170962 005__ 20260430151736.0
000170962 0247_ $$2doi$$a10.1016/j.ijcard.2026.134502
000170962 0248_ $$2sideral$$a149034
000170962 037__ $$aART-2026-149034
000170962 041__ $$aeng
000170962 100__ $$0(orcid)0000-0001-8374-9081$$aGaratachea, Nuria$$uUniversidad de Zaragoza
000170962 245__ $$aCardiac magnetic resonance tissue characterization in endurance athletes with paroxysmal atrial fibrillation phenotype (PAFIYAMA)
000170962 260__ $$c2026
000170962 5060_ $$aAccess copy available to the general public$$fUnrestricted
000170962 5203_ $$aBackground
Endurance athletes have an increased risk of atrial fibrillation (AF), and focal late gadolinium enhancement (LGE) is frequently detected on cardiac magnetic resonance (CMR); however, whether myocardial fibrosis or diffuse myocardial abnormalities underlie AF-related functional phenotypes remains unclear. We previously described a paroxysmal AF phenotype in male endurance athletes (PAFIYAMA), characterized by reduced forward flow despite preserved global systolic function; nonetheless, the underlying myocardial substrate remains unknown.
Methods
In this observational cross-sectional study, 63 competitive male endurance athletes (PAFIYAMA n = 22; controls n = 41) underwent CMR with cine imaging, LGE, native T1, extracellular volume fraction (ECV), and T2 mapping. Training load was derived from the Lifetime Total Physical Activity Questionnaire. Group comparisons and multivariable models adjusted for age, body mass index, training load, and peak exercise blood pressure.
Results
Focal LGE was present in 15/63 (24%) athletes and did not differ between PAFIYAMA and controls. Among LGE-positive athletes, enhancement was predominantly hinge-point/insertional (8/15, 53.3%) or limited septal intramyocardial (6/15, 40.0%), with one subepicardial lateral case (1/15, 6.7%). Athletes with LGE had larger indexed biventricular volumes but similar native T1, ECV, and T2. Compared with controls, PAFIYAMA athletes showed lower biventricular stroke volume indices and lower left ventricle mass, with a slightly lower LVEF that remained within the normal range, and no differences in LGE prevalence or mapping indices.
Conclusions
In endurance athletes with the PAFIYAMA phenotype, CMR tissue characterization does not support focal LGE or diffuse mapping abnormalities as the substrate of the functional phenotype; interpretation of LGE in athletes should integrate pattern and clinical context.
000170962 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FSE/LMP24-18
000170962 540__ $$9info:eu-repo/semantics/embargoedAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000170962 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000170962 700__ $$aEchevarría-Polo, Marcos$$uUniversidad de Zaragoza
000170962 700__ $$0(orcid)0000-0001-6025-5070$$aHernández-Vicente, Adrián$$uUniversidad de Zaragoza
000170962 700__ $$aD'Ascenzi, Flavio
000170962 700__ $$aFabregat-Andrés, Óscar
000170962 700__ $$aGrazioli, Gonzalo
000170962 700__ $$ade la Guía-Galipienso, Fernando
000170962 700__ $$aSanchis-Gomar, Fabian
000170962 7102_ $$11006$$2245$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Educación Física y Depor.
000170962 773__ $$g456 (2026), 134502 [4 pp.]$$pInt. j. cardiol.$$tINTERNATIONAL JOURNAL OF CARDIOLOGY$$x0167-5273
000170962 8564_ $$s568438$$uhttps://zaguan.unizar.es/record/170962/files/texto_completo.pdf$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2027-04-17
000170962 8564_ $$s1467245$$uhttps://zaguan.unizar.es/record/170962/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2027-04-17
000170962 909CO $$ooai:zaguan.unizar.es:170962$$particulos$$pdriver
000170962 951__ $$a2026-04-30-13:57:58
000170962 980__ $$aARTICLE