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- Open Access
Comprehensive cardiac mri protocol of athletes' hearts at 3 T: preliminary results
https://doi.org/10.1186/1532-429X-12-S1-P201
© Heidary et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
Keywords
- Right Ventricular
- Left Ventricular Mass
- Hypertrophic Cardiomyopathy
- Left Ventricular Wall
- Young Athlete
Introduction
High-level athletic training is associated with increased left ventricular (LV) and right ventricular (RV) chamber sizes and LV wall thickness/mass. Sudden cardiac death (SCD) in healthy, young athletes is associated with cardiac abnormalities, including hypertrophic cardiomyopathy (HCM), anomalous coronary arteries, aortic dissection, and arrhythmogenic right ventricular dysplasia (ARVD). The EKG can screen athletes for underlying cardiac conditions. CMR may provide a more comprehensive evaluation of athletes.
Purpose
This study evaluated a comprehensive 3 T CMR protocol in healthy intercollegiate athletes with an abnormal screening EKG.
Methods
CMR was performed on 21 intercollegiate athletes (12 men; 9 women) with EKG abnormalities from a screened cohort (N = 658). A whole-body 3 T MRI was used (Signa HDx, GE Healthcare, Inc.). The CMR protocol included: 1) cine imaging in LV 2, 3, and 4-chamber long axis planes as well as the short-axis plane from base to apex, using a breath-held steady-state free precession sequence (FOV = 33-35 cm, Thick = 8 mm, TR = 4.2 ms, TE = 1.9 ms, Flip Angle = 45°, Matrix = 224 × 224, 20 phases), 2) black-blood imaging in both axial and short-axis planes using a breath-held double-inversion recovery fast spin echo sequence (FOV = 28-34 cm, Thick = 5 mm, TR = 2 heartbeats, TE = 41 ms, Matrix = 256 × 256), and 3) coronary imaging at the level of the aortic root using a breath-held spiral gradient-echo sequence (FOV = 24 cm, Thick = 3 mm, TR = 1 heartbeat, TE = 5.8 ms, Flip Angle = 60°, 16 interleaves). LV and RV volume and function and LV wall thickness/mass were quantified using MASS software (MASS Analysis Plus Version 6.0, Leiden University) and compared to published normal ranges.
Results
Table 1
Male | Female | p value | |
|---|---|---|---|
LVEDV (ml) | 218.9 ± 37.5 | 149.3 ± 25.6 | 0.0001 |
LVESV (ml) | 87.2 ± 23.5 | 56.0 ± 17.0 | 0.001 |
LVSV (ml) | 131.7 ± 31.2 | 93.2 ± 13.8 | 0.001 |
LVEDV norm (ml/m2) | 102.9 ± 12.7 | 87.2 ± 13.9 | 0.01 |
LVESV norm (ml/m2) | 41.2 ± 11.7 | 32.6 ± 9.6 | 0.04 |
LVEF (%) | 61.8 ± 6.6 | 62.2 ± 6.0 | 0.45 |
RVEDV (ml) | 232.2 ± 28.7 | 167.1 ± 23.6 | 0.0001 |
RVESV (ml) | 108.8 ± 23.3 | 75.2 ± 13.4 | 0.001 |
RVSV (ml) | 123.6 ± 14.7 | 92.0 ± 15.2 | 0.0001 |
RVEDV norm (ml/m2) | 109.6 ± 10.9 | 97.5 ± 11.7 | 0.01 |
RVESV norm (ml/m2) | 51.3 ± 10.2 | 43.9 ± 7.3 | 0.04 |
RVEF (%) | 54.7 ± 5.7 | 54.9 ± 4.8 | 0.46 |
SWTd (mm) | 9.7 ± 1.2 | 8.8 ± 1.0 | 0.04 |
PWTd (mm) | 9.8 ± 1.0 | 8.5 ± 0.8 | 0.004 |
LV mass dias (g) | 175.8 ± 40.0 | 112.9 ± 14.1 | 0.0001 |
LV mass dias norm (g/m2) | 82.8 ± 17.0 | 65.8 ± 6.0 | 0.005 |
Aorta Sinuses (mm) | 32.6 ± 3.1 | 26.4 ± 3.4 | 0.0002 |
Aorta Sinuses Norm (mm/m2) | 15.5 ± 1.7 | 15.5 ± 2.0 | 0.50 |
Conclusion
CMR provides a comprehensive evaluation of young athletes found to have abnormalities on EKG. While no HCM, anomalous coronaries, Marfan's or ARVD was identified, increased ventricular size or mass was present in the majority of athletes. Further prospective study of CMR in athletes with and without EKG abnormalities is warranted.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd.
