Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis
Background: The effects of high-volume exercise on coronary atherosclerosis remain controversial. Objectives: The authors aimed to evaluate the impact of endurance exercise on coronary atherosclerosis assessed by cardiac computed tomography (CT) in athletes and nonathletes, and analyze differences b...
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Elsevier
2025-06-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X25002042 |
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| author | Ahmed Abdelaziz, MD Ahmed Elshahat, MD Ahmed Farid Gadelmawla, MD Muhammad Desouky, MD Abdelrahman H. Hafez, MD Mohamed Abdelaziz, MD Noha Hammad, MD Dua Eldosoky, MD Kirtipal Bhatia, MD Annalisa Filtz, MD Daniel Lorenzatti, MD Toshiki Kuno, MD, PhD Salim S. Virani, MD, PhD Martha Gulati, MD, MS Michel D. Shapiro, DO, MCR Carl J. Lavie, MD Leandro Slipczuk, MD, PhD |
| author_facet | Ahmed Abdelaziz, MD Ahmed Elshahat, MD Ahmed Farid Gadelmawla, MD Muhammad Desouky, MD Abdelrahman H. Hafez, MD Mohamed Abdelaziz, MD Noha Hammad, MD Dua Eldosoky, MD Kirtipal Bhatia, MD Annalisa Filtz, MD Daniel Lorenzatti, MD Toshiki Kuno, MD, PhD Salim S. Virani, MD, PhD Martha Gulati, MD, MS Michel D. Shapiro, DO, MCR Carl J. Lavie, MD Leandro Slipczuk, MD, PhD |
| author_sort | Ahmed Abdelaziz, MD |
| collection | DOAJ |
| description | Background: The effects of high-volume exercise on coronary atherosclerosis remain controversial. Objectives: The authors aimed to evaluate the impact of endurance exercise on coronary atherosclerosis assessed by cardiac computed tomography (CT) in athletes and nonathletes, and analyze differences based on sex. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane Central for relevant studies from inception to September 2024, assessing the impact of different exercise volumes on subclinical coronary artery atherosclerosis assessed by coronary artery calcification (CAC) scoring or CT angiography (CCTA). The control group comprised nonathletes. The primary outcome was the difference in CAC scores between athletes and nonathletes and the secondary outcome was the differences in calcified plaque by CCTA. The analysis was stratified by sex and exercise volume assessed using metabolic equivalents of task (MET)-min/wk. Results: Nine observational studies including 61,150 participants were included in the analysis. Male athletes with an exercise volume of >3,000 MET-min/wk showed higher mean CAC scores than nonathlete males (mean difference = 31.62; 95% CI: 10.66-52.58; P < 0.001), while no difference in CAC was found for male athletes with 1,500 to 3,000 MET-min/wk (P = 0.93) or female athletes with an exercise volume of 1,500 MET-min/wk or greater (P = 0.39 and P = 0.07). Our secondary endpoint showed significant sex-specific differences on the association of exercise volume and calcified plaque number and volume by CCTA. Conclusions: Males with high-volume exercise training (>3,000 MET-min/wk) exhibited a higher burden of calcified plaque by CAC score than male nonathletes, while no such difference was observed in female athletes. |
| format | Article |
| id | doaj-art-4cacd7f8ac8d4ea7a8f2f76b08b1a2fa |
| institution | OA Journals |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-4cacd7f8ac8d4ea7a8f2f76b08b1a2fa2025-08-20T01:51:48ZengElsevierJACC: Advances2772-963X2025-06-014610178610.1016/j.jacadv.2025.101786Sex Differences in the Impact of Exercise Volume on Subclinical Coronary AtherosclerosisAhmed Abdelaziz, MD0Ahmed Elshahat, MD1Ahmed Farid Gadelmawla, MD2Muhammad Desouky, MD3Abdelrahman H. Hafez, MD4Mohamed Abdelaziz, MD5Noha Hammad, MD6Dua Eldosoky, MD7Kirtipal Bhatia, MD8Annalisa Filtz, MD9Daniel Lorenzatti, MD10Toshiki Kuno, MD, PhD11Salim S. Virani, MD, PhD12Martha Gulati, MD, MS13Michel D. Shapiro, DO, MCR14Carl J. Lavie, MD15Leandro Slipczuk, MD, PhD16Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Al-Azhar University, Cairo, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Al-Azhar University, Cairo, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Menoufia University, Menoufia, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; The Brooklyn Hospital Center, Brooklyn, New York, USAMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Al-Azhar University, Cairo, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Al-Azhar University, Cairo, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Port-Said University, Port-Said, EgyptMedical Research Group of Egypt (MRGE), Negida Academy, Arlington, Massachusetts, USA; Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, EgyptDivision of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, New York, USADivision of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, New York, USADivision of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, New York, USACardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USAAga Khan University, Karachi, PakistanThe Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA; Baim Institute for Clinical Research, Boston, Massachusetts, USACenter for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USADepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, Louisiana, USADivision of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, New York, USA; Address for correspondence: Dr Leandro Slipczuk, Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, 111 E 210th Street, Bronx, New York 10467, USA.Background: The effects of high-volume exercise on coronary atherosclerosis remain controversial. Objectives: The authors aimed to evaluate the impact of endurance exercise on coronary atherosclerosis assessed by cardiac computed tomography (CT) in athletes and nonathletes, and analyze differences based on sex. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane Central for relevant studies from inception to September 2024, assessing the impact of different exercise volumes on subclinical coronary artery atherosclerosis assessed by coronary artery calcification (CAC) scoring or CT angiography (CCTA). The control group comprised nonathletes. The primary outcome was the difference in CAC scores between athletes and nonathletes and the secondary outcome was the differences in calcified plaque by CCTA. The analysis was stratified by sex and exercise volume assessed using metabolic equivalents of task (MET)-min/wk. Results: Nine observational studies including 61,150 participants were included in the analysis. Male athletes with an exercise volume of >3,000 MET-min/wk showed higher mean CAC scores than nonathlete males (mean difference = 31.62; 95% CI: 10.66-52.58; P < 0.001), while no difference in CAC was found for male athletes with 1,500 to 3,000 MET-min/wk (P = 0.93) or female athletes with an exercise volume of 1,500 MET-min/wk or greater (P = 0.39 and P = 0.07). Our secondary endpoint showed significant sex-specific differences on the association of exercise volume and calcified plaque number and volume by CCTA. Conclusions: Males with high-volume exercise training (>3,000 MET-min/wk) exhibited a higher burden of calcified plaque by CAC score than male nonathletes, while no such difference was observed in female athletes.http://www.sciencedirect.com/science/article/pii/S2772963X25002042athletesCACcardiovascular riskscoronary artery calciumexercisesex differences |
| spellingShingle | Ahmed Abdelaziz, MD Ahmed Elshahat, MD Ahmed Farid Gadelmawla, MD Muhammad Desouky, MD Abdelrahman H. Hafez, MD Mohamed Abdelaziz, MD Noha Hammad, MD Dua Eldosoky, MD Kirtipal Bhatia, MD Annalisa Filtz, MD Daniel Lorenzatti, MD Toshiki Kuno, MD, PhD Salim S. Virani, MD, PhD Martha Gulati, MD, MS Michel D. Shapiro, DO, MCR Carl J. Lavie, MD Leandro Slipczuk, MD, PhD Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis JACC: Advances athletes CAC cardiovascular risks coronary artery calcium exercise sex differences |
| title | Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis |
| title_full | Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis |
| title_fullStr | Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis |
| title_full_unstemmed | Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis |
| title_short | Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis |
| title_sort | sex differences in the impact of exercise volume on subclinical coronary atherosclerosis |
| topic | athletes CAC cardiovascular risks coronary artery calcium exercise sex differences |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X25002042 |
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