UNDERSTANDING MYOCARDIAL FIBROSIS IN ATHLETES: MECHANISMS AND TARGETED THERAPEUTIC APPROACHES

Abstract

Background: Myocardial fibrosis, characterized by the excessive deposition of extracellular matrix and disordered collagen arrangement within myocardial tissue, is a critical pathological process underlying many cardiovascular diseases such as hypertension and cardiomyopathy. Increasingly prevalent, myocardial fibrosis poses significant health risks, not only to the general population but notably to athletes engaged in high-intensity sports, where the cardiac demand and stress are substantially elevated. Objective: This review aims to elucidate the underlying pathological mechanisms of myocardial fibrosis with a specific focus on the renin-angiotensin-aldosterone system (RAAS), inflammatory responses, oxidative stress, and transforming growth factor-beta 1 (TGF-β1). Additionally, it highlights the advances in targeted therapeutic strategies that could be particularly beneficial in managing athlete-specific cardiovascular risks associated with myocardial fibrosis. Methods: We examine the role of systemic factors such as RAAS, inflammation, and oxidative stress in promoting fibrotic changes within the myocardium and discuss the latest research on targeted treatments that address these underlying mechanisms. The potential of these therapies to mitigate the progression of myocardial fibrosis offers promising prospects for enhancing cardiovascular health and performance in athletes. Results: The disordered collagen deposition central to myocardial fibrosis significantly impairs cardiac function, a concern that is magnified in athletes due to their high cardiovascular loads. Current research indicates that targeted therapies can effectively modulate these pathological processes, offering potential for both prevention and reversal of fibrosis. Conclusion: Understanding and addressing myocardial fibrosis in athletes is crucial for optimizing heart health and maintaining peak performance. With ongoing advances in targeted therapies, sports medicine practitioners are better equipped to manage this condition, potentially extending athletes’ careers and improving their quality of life. Future research should focus on tailoring these therapeutic approaches to meet the unique needs of the athletic population, ensuring that treatments are both effective and conducive to high-level physical activity.