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Cycling history and competitiveness (score:10\u201370; higher=greater drive) were assessed by questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to controls, cyclists showed \u2018athlete\u2019s heart\u2019 characteristics, including bi-ventricular enlargement and increased left ventricular (LV) mass (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Focal non-ischemic myocardial LGE occurred in 19\/58 (33%) of male cyclists, predominantly at the RVIP (RVIP LGE, 79%), and inferolateral wall (non-RVIP LGE, 21%). No female cyclists showed LGE. Male cyclists with non-RVIP LGE had higher myocardial mass (90\u2009\u00b1\u20095 vs. 79\u2009\u00b1\u20098\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), reduced RV ejection fraction (RVEF, 47\u2009\u00b1\u20094% vs. 55\u2009\u00b1\u20095%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031), and elevated high-sensitivity troponin T (8.8\u2009\u00b1\u20091.7 vs. 5.1\u2009\u00b1\u20092.0 pg\/ml,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) compared to those without LGE. Compared to RVIP LGE cyclists, they also had greater LV mass (90\u2009\u00b1\u20095 vs. 74\u2009\u00b1\u200910\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), higher LV end-diastolic volume (133\u2009\u00b1\u200916 vs. 108\u2009\u00b1\u200912 ml\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) and lower RVEF (47\u2009\u00b1\u20094% vs. 57\u2009\u00b1\u20095%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Cyclists with RVIP LGE had comparable myocardial mass as those without LGE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.082). LGE presence was not associated with maximal oxygen uptake, exercise systolic blood pressure, cycling history, or competitiveness (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly one-third of cyclists had focal non-ischemic myocardial LGE, predominantly at the RVIP. Adverse remodeling and reduced function were confined to cyclists with non-RVIP LGE, suggesting a distinct, pathological phenotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10554-026-03693-x","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:37:58Z","timestamp":1776073078000},"page":"1469-1481","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac remodeling and myocardial late gadolinium enhancement in competitive amateur cyclists: insights from cardiac MRI"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3689-952X","authenticated-orcid":false,"given":"Felix","family":"Albrecht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3862-1702","authenticated-orcid":false,"given":"Tilo","family":"Thottakara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Schaerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-9233","authenticated-orcid":false,"given":"Goetz H.","family":"Welsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-7389","authenticated-orcid":false,"given":"Julia","family":"M\u00fcnch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Pressler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4728-8171","authenticated-orcid":false,"given":"Scott B.","family":"Reeder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-1731","authenticated-orcid":false,"given":"Monica","family":"Patten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4877-9204","authenticated-orcid":false,"given":"Gunnar K.","family":"Lund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4285-3090","authenticated-orcid":false,"given":"Jitka","family":"Starekova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"3693_CR1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.125.018470","volume":"18","author":"W Javed","year":"2025","unstructured":"Javed W, Botis I, Goh ZM et al (2025) Ventricular Arrhythmia and Cardiac Fibrosis in Endurance Experienced Athletes (VENTOUX). 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Approval was granted by the Ethics Committee of University Medical Center Hamburg-Eppendorf, Germany (Protocol code PV4764-3108-BO-ff, date of approval 2014\/07\/29).","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images.","order":4,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}}]}}