Detection of Cardiovascular Disease in Elite Athletes Using Cardiac Magnetic Resonance Imaging

作者：Mangold S; Kramer U^*; Franzen E; Erz G; Bretschneider C; Seeger A; Claussen C D; Niess A M; Burgstahler C

来源：RoFo-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 2013, 185(12): 1167-1174.

DOI：10.1055/s-0033-1350130

• heart
• cardiac
• MR functional imaging
• MR angiography
• ischemia/infarction
• normal variants

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. %26lt;br%26gt;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. %26lt;br%26gt;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. %26lt;br%26gt;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.

• 出版日期2013-12