Prevalence and pattern of cardiovascular magnetic resonance late gadolinium enhancement in highly trained endurance athl
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RESEARCH
Open Access
Prevalence and pattern of cardiovascular magnetic resonance late gadolinium enhancement in highly trained endurance athletes B. Domenech-Ximenos1,2* , M. Sanz-de la Garza2,3, S. Prat-González2, A. Sepúlveda-Martínez4,5, F. Crispi4, K. Duran-Fernandez2, R. J. Perea1,2,3,4,5,6, B. Bijnens6,7,8 and M. Sitges2,3
Abstract Background: Intensive endurance exercise may induce a broad spectrum of right ventricular (RV) adaptation/ remodelling patterns. Late gadolinium enhancement (LGE) has also been described in cardiovascular magnetic resonance (CMR) of some endurance athletes and its clinical meaning remains controversial. Our aim was to characterize the features of contrast CMR and the observed patterns of the LGE distribution in a cohort of highly trained endurance athletes. Methods: Ninety-three highly trained endurance athletes (> 12 h training/week at least during the last 5 years; 36 ± 6 years old; 53% male) and 72 age and gender-matched controls underwent a resting contrast CMR. In a subgroup of 28 athletes, T1 mapping was also performed. Results: High endurance training load was associated with larger bi-ventricular and bi-atrial sizes and a slight reduction of biventricular ejection fraction, as compared to controls in both genders (p < 0.05). Focal LGE was significantly more prevalent in athletes than in healthy subjects (37.6% vs 2.8%; p < 0.001), with a typical pattern in the RV insertion points. In T1 mapping, those athletes who had focal LGE had higher extracellular volume (ECV) at the remote myocardium than those without (27 ± 2.2% vs 25.2 ± 2.1%; p < 0.05). Conclusions: Highly trained endurance athletes showed a ten-fold increase in the prevalence of focal LGE as compared to control subjects, always confined to the hinge points. Additionally, those athletes with focal LGE demonstrated globally higher myocardial ECV values. This matrix remodelling and potential presence of myocardial fibrosis may be another feature of the athlete’s heart, of which the clinical and prognostic significance remains to be determined. Keywords: Athletes, Fibrosis, Magnetic resonance imaging
* Correspondence: [email protected] 1 Radiology Department, Hospital Clinic, Barcelona, Spain 2 Cardiovascular Institute, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use i
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