{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:00Z","timestamp":1787018040657,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Amsterdam Movement Sciences","award":["P1A210AMC2018"],"award-info":[{"award-number":["P1A210AMC2018"]}]},{"name":"NOC*NSF"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Myocardial late gadolinium enhancement (LGE) using cardiac magnetic resonance imaging has been described in older endurance athletes, particularly at the ventricular hinge point. However, data on young, elite athletes are lacking. We therefore quantified the prevalence of hinge point LGE (HP-LGE) in young elite-level athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We investigated 309 (40% women; median age 25.1 [21.9\u201329.5] years) asymptomatic athletes included in the ELITE prospective cohort (Evaluation of Lifetime Participation in Intensive Top-level Sports and Exercise cohort), investigating cardiovascular screenings of elite (national-, international-, Olympic-, or Paralympic-) level athletes, including cardiac magnetic resonance imaging with short-axis cine imaging, LGE, and T1-mapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 124 (40%) athletes had HP-LGE, with a higher prevalence in men compared with women (47% versus 30%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004). When indexed for body surface area, athletes with HP-LGE had greater left ventricle end-systolic volumes (53\u00b111 mL\/m\u00b2 versus 51\u00b111 mL\/m\u00b2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.037), right ventricle end-systolic volumes (56\u00b112 mL\/m\u00b2 versus 53\u00b111 mL\/m\u00b2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.020), lower left ventricle ejection fraction (55.5\u00b15.0% versus 56.7\u00b14.6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.035), lower right ventricle ejection fraction (53.9\u00b15.0% versus 55.2\u00b14.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.021), and smaller estimated global left ventricle extracellular volumes (24.45\u00b12.52% versus 25.27\u00b12.59%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.015). In multivariable regression analyses, male sex was strongly associated with HP-LGE (odds ratio, 3.07 [95% CI, 1.32\u20137.32];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>HP-LGE is a common finding in asymptomatic, elite athletes and is strongly associated with sex. Lower left ventricle ejection fraction is moderately associated with HP-LGE. Our study\u2019s HP-LGE prevalence indicates that HP-LGE should be interpreted as a feature of the athlete\u2019s heart.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circimaging.124.017765","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:32:49Z","timestamp":1759941169000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac Ventricular Hinge Point LGE Is Highly Prevalent and Sex-Dependent in ELITE Athletes"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-4985","authenticated-orcid":true,"given":"Sjoerd M.","family":"Verwijs","sequence":"first","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0168-7783","authenticated-orcid":true,"given":"Juliette C.","family":"Van Hattum","sequence":"additional","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-2806","authenticated-orcid":true,"given":"Jo\u00eblle J.N.","family":"Daems","sequence":"additional","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-0765","authenticated-orcid":true,"given":"S. Matthijs","family":"Boekholdt","sequence":"additional","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."},{"name":"Atherosclerosis and Ischemic Syndromes (S.M.B., R.N.P., H.T.J.), Amsterdam Cardiovascular Sciences, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3940-4670","authenticated-orcid":true,"given":"R. Nils","family":"Planken","sequence":"additional","affiliation":[{"name":"Radiology and Nuclear Medicine (R.N.P., A.v.R., R.D.v.L., J.L.N.), Amsterdam UMC, location University of Amsterdam, the Netherlands."},{"name":"Atherosclerosis and Ischemic Syndromes (S.M.B., R.N.P., H.T.J.), Amsterdam Cardiovascular Sciences, the Netherlands."},{"name":"Pulmonary Hypertension and Thrombosis (R.N.P.), Amsterdam Cardiovascular Sciences, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Groenink","sequence":"additional","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."},{"name":"Heart Failure and Arrhythmias (M.G., Y.M.P., A.A.M.W.), Amsterdam Cardiovascular Sciences, the 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Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten H.","family":"Moen","sequence":"additional","affiliation":[{"name":"Netherlands Olympic Committee and Netherlands Sports Federation (NOC*NSF), High Performance Team, the Netherlands (M.H.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-9474","authenticated-orcid":true,"given":"Birgitta K.","family":"Velthuis","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Utrecht, the Netherlands (B.K.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-571X","authenticated-orcid":true,"given":"Yigal M.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Heart Center (S.M.V., J.C.V.H., J.J.N.D., S.M.B., M.G., Y.M.P., A.A.M.W., H.T.J.), Amsterdam UMC, location University of Amsterdam, the Netherlands."},{"name":"Heart Failure and Arrhythmias 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