Assessment of hepatic fat content and prediction of myocardial fibrosis in athletes by using proton density fat fraction sequence

Purpose To explore the characteristics of the hepatic fat content in athletes, and predict late gadolinium enhancement (LGE) based on magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Material and methods From March 2020 to March 2021, 233 amateur athletes and 42 healthy sedentary controls were prospectively recruited. The liver fat content of four regions of interest (ROIs 1–4), the mean liver fat fraction (FF), cardiac function, and myocardium LGE were recorded, respectively. The values of ROIs 1–4 and FF were compared between athletes and controls. According to the liver fat content threshold for distinguishing athletes and controls, the cutoff total exercise time that induced a change in liver fat was obtained. The correlations among the liver fat content, cardiac function, and other parameters were analyzed. Moreover, the liver fat content was used to predict myocardium LGE by logistic regression. Results There were significant differences for the values of ROI 1, ROI 3, ROI 4, and FF between athletes and controls (all p < 0.05). The cutoff total exercise time for inducing a change in the liver fat content was 1680 h (area under the curve [AUC] = 0.593, specificity = 83.3, p < 0.05). Blood indexes, cardiac function, and basic clinical parameters were related to liver fat content (all p < 0.05). The prediction model for LGE had an AUC value of 0.829 for the receiver operator characteristic curve. Conclusion MRI-PDFF could assess liver fat content and predict cardiac fibrosis in athletes for risk stratification and follow-up.