Brief Summary

Medial arterial calcification (MAC) is an under-recognized vascular condition that remains poorly characterized from an epidemiological perspective. In the general population, its estimated prevalence is approximately 2.5%, mainly based on ankle-brachial index measurements. In contrast, prevalence exceeds 10% in high-risk populations such as patients with diabetes, chronic kidney disease, or established cardiovascular disease, with wide variability depending on the diagnostic method used.

In these populations, MAC is associated with adverse clinical outcomes, including critical limb ischemia, major amputation, and increased cardiovascular mortality, sometimes exceeding the prognostic impact of atherosclerosis. However, data on MAC in healthy individuals are currently lacking, and its clinical significance in this population remains unknown.

Endurance athletes represent a unique population exposed to prolonged and intense hemodynamic stress. Previous studies have reported increased coronary artery calcification in athletes with very high levels of physical activity, and differences according to sporting discipline. Incidental findings of MAC have also been observed in endurance athletes, raising the question of a potential association with training volume and vascular adaptations to long-term exercise.

The objective of this study is to assess the prevalence of medial arterial calcification in endurance athletes using ultrasound imaging, and to explore its relationship with training characteristics and cardiovascular risk markers.

Conditions

• Calcifications, Vascular

Primary Outcome Measures

• Presence or absence of medial arterial calcification detected by ultrasound in the lower limb arteries (At enrollment (single assessment on the day of inclusion))
  Qualitative variable: number of subjects with medial arterial calcification. Measurement method: lower limb arterial duplex ultrasound (common and superficial femoral arteries, popliteal arteries, anterior tibial arteries, posterior tibial arteries), using a severity score ranging from 0 to 4 per side, i.e. 0 to 8 in total (0: completely normal vessel; 1: calcifications extending over \< 1 cm; 2: calcifications over 1-2 cm; 3: calcifications over 2-3 cm; 4: calcifications over \> 3 cm). A score of 0 indicates absence of medial arterial calcification, whereas a score of ≥ 1 indicates presence of medial arterial calcification.

Study Officials

• Stéphane Doutreleau, Doctor (Principal Investigator) — University Hospital, Grenoble
• Christophe Seinturier, Doctor (Study Director) — University Hospital, Grenoble