Cardiovascular Imaging Considerations for Masters-Aged Athletes

Abstract

Masters athletes (MAs), defined as individuals >= 35 years of age who are engaged in competitive or high-volume recreational sports or exercise training, comprise a growing group regularly cared for in sports cardiology. The cardiovascular care of MAs can be challenging because many of the classical tenets in sports cardiology and exercise physiology were derived from young, competitive athletes and therefore do not fully generalize to the care of MAs. Appropriate implementation of multimodality cardiovascular imaging is essential to guide the risk stratification and clinical management of MAs. In this state-of-the-art review, physiological and pathologic considerations unique to MAs are highlighted. The strengths and limitations of specific cardiovascular imaging modalities are reviewed along with guidance on their appropriate use in the care of MAs. The purpose of this document is to represent the first primary reference on best practice considerations for the use of multimodality cardiovascular imaging in the care of MAs. (JACC Cardiovasc Imaging. 2026;19:538-550) (c) 2026 by the American College of Cardiology Foundation.