Exercise is good for the heart but, on the other hand, the older the individual the greater the likelihood that it may induce sudden cardiac death! Thus older marathon runners are at some risk.
A German group has studied MRI scans with late gadolinium enhancement to try to identify those at risk in advance. They performed MRI scans of the myocardium with late gadolinium enhancement in 108 asymptomatic healthy male subjects aged 50 to 72 with a minimum of five completed marathon races during a consecutive three-year period. They also enrolled a control group matched for age and risk factors and excluded subjects with known cardiovascular disease or diabetes mellitus. All subjects in the study underwent gadolinium-enhanced MRI scans, and those with late enhancement underwent additional adenosine stress perfusion imaging.
The investigators found an unexpectedly high number of the non professional athletes (some 12%) had late enhancement MRI scans suggesting myocardial disease, including ischemia, myocardial fibrosis, and scarring.
The authors concluded that late gadolinium enhancement may have important prognostic implications for older athletes.