Left ventricular diastolic filling patterns in competitive triathletes with and without myocardial fibrosis by cardiac magnetic resonance time-volume analysis
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Left ventricular diastolic filling patterns in competitive triathletes with and without myocardial fibrosis by cardiac magnetic resonance time-volume analysis. / Chen, Hang; Jungesblut, Johanna; Saering, Dennis; Muellerleile, Kai; Beitzen-Heineke, Antonia; Harms, Phillip; Erley, Jennifer; Schoennagel, Bjoern; Schneider, Jan N; Cavus, Ersin; Fischer, Roland; Lund, Gunnar K; Adam, Gerhard; Tahir, Enver.
in: EUR J RADIOL, Jahrgang 158, 110615, 01.2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Left ventricular diastolic filling patterns in competitive triathletes with and without myocardial fibrosis by cardiac magnetic resonance time-volume analysis
AU - Chen, Hang
AU - Jungesblut, Johanna
AU - Saering, Dennis
AU - Muellerleile, Kai
AU - Beitzen-Heineke, Antonia
AU - Harms, Phillip
AU - Erley, Jennifer
AU - Schoennagel, Bjoern
AU - Schneider, Jan N
AU - Cavus, Ersin
AU - Fischer, Roland
AU - Lund, Gunnar K
AU - Adam, Gerhard
AU - Tahir, Enver
N1 - Copyright © 2022 Elsevier B.V. All rights reserved.
PY - 2023/1
Y1 - 2023/1
N2 - PURPOSE: To investigate the influence of myocardial fibrosis on left ventricular (LV) diastolic filling patterns in triathletes compared to sedentary controls by cardiac magnetic resonance (CMR) imaging.METHOD: 101 male triathletes (43 ± 11 years) and 28 controls (41 ± 10 years) were recruited and underwent 1.5 T CMR including cine SSFP series, late gadolinium enhancement (LGE) imaging and T1 mapping. Functional and morphological parameters were obtained, and CMR-based LV diastolic filling parameters such as the early peak-filling rate (EPFR), atrial peak-filling rate (APFR) and peak-filling rate ratio (PFRR = EPFR/APFR) were determined by time-volume analysis of the cine series.RESULTS: Non-ischemic LGE was detected in 20 triathletes (20 %) and in none of the controls. Compared to controls LGE-negative (LGE-) triathletes showed similar EPFR (216 ± 58 ml/s/m2 vs 224 ± 69 ml/s/m2, P = 0.52) but lower APFR (120 ± 46 ml/s/m2 vs 147 ± 55 ml/s/m2, P < 0.05), resulting in higher PFRR (2.1 ± 1 vs 1.6 ± 0.5, P < 0.01). LGE-positive (LGE + ) triathletes had similar EPFR (212 ± 73 ml/s/m2, P = 0.798), but higher APFR (149 ± 50 ml/s/m2, P < 0.05) and decreased PFRR (1.6 ± 0.7, P < 0.05) compared to LGE- triathletes. LGE + triathletes had increased LV mass index (88 ± 10 g/m2 vs 80 ± 12 g/m2, P < 0.01) and extracellular volume (ECV) fraction (26.2 ± 2.7 % vs 24.4 ± 1.7 %, P < 0.001) compared to LGE- triathletes.CONCLUSIONS: Athletic activity leads to "supernormal" LV diastolic filling pattern in LGE- triathletes, which may be attributable to increased LV myocardial flexibility and elasticity. However, LGE + triathletes demonstrate a pseudo-normalization characterized by compensatory increase of atrial contraction. Possibly, due to reduced passive elasticity associated myocardial fibrosis.
AB - PURPOSE: To investigate the influence of myocardial fibrosis on left ventricular (LV) diastolic filling patterns in triathletes compared to sedentary controls by cardiac magnetic resonance (CMR) imaging.METHOD: 101 male triathletes (43 ± 11 years) and 28 controls (41 ± 10 years) were recruited and underwent 1.5 T CMR including cine SSFP series, late gadolinium enhancement (LGE) imaging and T1 mapping. Functional and morphological parameters were obtained, and CMR-based LV diastolic filling parameters such as the early peak-filling rate (EPFR), atrial peak-filling rate (APFR) and peak-filling rate ratio (PFRR = EPFR/APFR) were determined by time-volume analysis of the cine series.RESULTS: Non-ischemic LGE was detected in 20 triathletes (20 %) and in none of the controls. Compared to controls LGE-negative (LGE-) triathletes showed similar EPFR (216 ± 58 ml/s/m2 vs 224 ± 69 ml/s/m2, P = 0.52) but lower APFR (120 ± 46 ml/s/m2 vs 147 ± 55 ml/s/m2, P < 0.05), resulting in higher PFRR (2.1 ± 1 vs 1.6 ± 0.5, P < 0.01). LGE-positive (LGE + ) triathletes had similar EPFR (212 ± 73 ml/s/m2, P = 0.798), but higher APFR (149 ± 50 ml/s/m2, P < 0.05) and decreased PFRR (1.6 ± 0.7, P < 0.05) compared to LGE- triathletes. LGE + triathletes had increased LV mass index (88 ± 10 g/m2 vs 80 ± 12 g/m2, P < 0.01) and extracellular volume (ECV) fraction (26.2 ± 2.7 % vs 24.4 ± 1.7 %, P < 0.001) compared to LGE- triathletes.CONCLUSIONS: Athletic activity leads to "supernormal" LV diastolic filling pattern in LGE- triathletes, which may be attributable to increased LV myocardial flexibility and elasticity. However, LGE + triathletes demonstrate a pseudo-normalization characterized by compensatory increase of atrial contraction. Possibly, due to reduced passive elasticity associated myocardial fibrosis.
KW - Humans
KW - Male
KW - Contrast Media
KW - Atrial Fibrillation
KW - Magnetic Resonance Imaging, Cine
KW - Gadolinium
KW - Cardiomyopathies/pathology
KW - Myocardium/pathology
KW - Fibrosis
KW - Magnetic Resonance Spectroscopy
KW - Ventricular Function, Left
KW - Predictive Value of Tests
U2 - 10.1016/j.ejrad.2022.110615
DO - 10.1016/j.ejrad.2022.110615
M3 - SCORING: Journal article
C2 - 36434969
VL - 158
JO - EUR J RADIOL
JF - EUR J RADIOL
SN - 0720-048X
M1 - 110615
ER -
