Exercise-induced silent myocardial ischemia in master athletes

Leslie I. Katzel, Jerome L. Fleg, M. Janette Busby-Whitehead, John D. Sorkin, Lewis C. Becker, Edward G. Lakatta, Andrew P. Goldberg

Research output: Contribution to journalArticlepeer-review


High-physical activity levels are associated with reduced risk of symptomatic coronary artery disease (CAD). However, there are a number of reports of exercise-related sudden death and myocardial infarction in aerobically trained athletes. This study compared the prevalence of exercise- induced silent myocardial ischemia on maximum graded exercise tests with tomographic thallium scintigraphy in 70 master male athletes (63 ± 6 years, mean ± SD) (maximum aerobic capacity, VO2max >40 ml/kg/min) and in 85 healthy untrained men (61 ± 7 years) with no history of CAD. The prevalence of silent ischemia (exercise-induced ST-segment depression on electrocardiogram and perfusion abnormalities on thallium scintigraphy) was similar in athletes and untrained men; 16% of the athletes (11 of 70) had silent ischemia compared with 21% of the untrained men (chi-square = 0.81, p = 0.36). No athletes had hyperlipidemia, systemic hypertension, or diabetes mellitus. However, the apolipoprotein E4 allele was present in 9 of the 11 athletes with silent ischemia compared with 2 of 32 athletes with normal exercise tests (chi-square = 24, p = 0.0001). These results suggest that older male athletes with the apolipoprotein E4 allele are at increased risk for the development of exercise-induced silent ischemia.

Original languageEnglish (US)
Pages (from-to)261-265
Number of pages5
JournalAmerican Journal of Cardiology
Issue number3
StatePublished - Feb 1 1998
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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