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June 12, 2026European Journal of Preventive CardiologyOpen Access

35 athletes (24%) met AoD criteria, with similar prevalence in males and females (24% vs 25%, P=0.99); athletes with AoD had more profound LV remodelling and higher VO2peak, but AoD was not explained by peak SBP or training load.

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Population

143 master's endurance athletes without heritable aortopathy, mean age 63±8 years, 17% female.

Design

Cross-sectional

Authors

SFS J FoulkesKJK JanssensAMA Mitchell

Discussion

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Overview

May warrant surveillance in masters athletes; leaves open whether endurance training drives aortic remodeling.

Key Points

  • This analysis aims to determine the prevalence of aortic dilation in masters endurance athletes and assess its relationship with cardiac physiology and training load.
  • Evaluated masters endurance athletes aged ≥50 years without heritable aortopathy using transthoracic echocardiography.
  • Assessed historical and current training load via a standardized questionnaire and quantified cardiac remodelling through cardiac magnetic resonance.
  • Calculated circumferential aortic wall stress at rest and peak exercise per La Place law, with comparison groups analyzed using ANCOVA.
  • 24% of the 143 evaluated athletes met aortic dilation criteria (24% males, 25% females, P=0.99).
  • Athletes with aortic dilation were older (68±6 years vs 62±7 years, P<0.001) and exhibited more profound left-ventricular remodelling.
  • Peak aortic wall stress was 15% higher in athletes with dilation, but values were well below critical failure limits (800-1200kPa).

Structured PICO

P
Population
143 master's endurance athletes (aged ≥50 years) without heritable aortopathy, mean age 63±8 years, 17% female.
O
Outcome
Prevalence of aortic dilation (AoD) and its relationship with physiologic markers of cardiac remodelling and training loadsurrogate

Aortic dilation is present in nearly a quarter of master's endurance athletes and is associated with more profound left-ventricular remodelling and higher VO2peak, suggesting it may be a compensatory vascular adaptation to lifelong exercise.

Cite This Study

Foulkes et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd1386550ea4541ffe97dhttps://doi.org/10.1093/eurjpc/zwag249.365
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review2025
  2. 2Left ventricular end-diastolic volume as a new indexation method in athletes with aortic dilatation: a cardiac MRI study2026
  3. 3Acute Effects of Aerobic Exercise on Aortic Wall Stress in Thoracic Aortic Disease2025
  4. 4Aortopathy: Limitations of Diameter-Based Decision Making: A Case Report2026
  5. 5Evaluation of the Maximum Velocity of Blood Flow in Descending Aorta in Athletes2026