Detection of cardiovascular disease in elite athletes using cardiac magnetic resonance imaging.

ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN(2013)

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摘要
Purpose: Sudden cardiac death [SCD] in competitive athletes is caused by a diverse set of cardiovascular diseases such as hypertrophic and dilated cardiomyopathy [HCM/DCM], myocarditis, coronary anomalies or even coronary artery disease. In order to identify potential risk factors responsible for SCD, elite athletes underwent cardiac magnetic resonance [CMR] imaging. Materials and Methods: 73 male [M] and 22 female [F] athletes (mean age 35.211.4 years) underwent CMR imaging. ECG-gated breath-hold cine SSFP sequences were used for the evaluation of wall motion abnormalities and myocardial hypertrophy as well as for quantitative analysis (left and right ventricular [LV, RV] end-diastolic and end-systolic volume [EDV, ESV], stroke volume [SV], ejection fraction [EF] and myocardial mass [MM]). Furthermore, left and right atrial sizes were assessed by planimetry and delayed enhancement imaging was performed 10 minutes after the application of contrast agent. Coronary arteries were depicted using free-breathing Flash-3D MR angiography. Results: The quantitative analyses showed eccentric hypertrophy of the left ventricle (remodeling index [MM/LV-EDV]: M 0.75, F 0.665), enlargement of the RV volumes (RV-EDV: M 122.619.0ml/m(2), F 99.97.2ml/m(2)) and an increased SV (LV-SV: M64.710.0ml/m(2), F 56.55.7ml/m(2); RV-SV; M66.710.4ml/m(2), F 54.27.1ml/m(2)). Abnormal findings were detected in 6 athletes (6.3%) including one benign variant of coronary anomaly and abnormal late gadolinium enhancement in 2 cases. None of the athletes showed wall motion abnormalities or signs of myocardial ischemia. Conclusion: CMR imaging of endurance athletes revealed abnormal findings in more than 5% of the athletes. However, the prognostic significance remains unclear. Thus, cardiac MRI cannot be recommended as a routine examination in the care of athletes.
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关键词
heart,cardiac,MR functional imaging,MR angiography,ischemia/infarction,normal variants
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