Cardiac MRI findings to differentiate athlete's heart from hypertrophic (HCM), arrhythmogenic right ventricular (ARVC) and dilated (DCM) cardiomyopathy
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Published:2021-05-21
Issue:8
Volume:37
Page:2501-2515
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ISSN:1569-5794
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Container-title:The International Journal of Cardiovascular Imaging
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language:en
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Short-container-title:Int J Cardiovasc Imaging
Author:
Kübler J.ORCID, Burgstahler C.ORCID, Brendel J. M., Gassenmaier S., Hagen F., Klingel K., Olthof S.-C., Blume K., Wolfarth B., Mueller K. A. L., Greulich S., Krumm P.ORCID
Abstract
AbstractTo provide clinically relevant criteria for differentiation between the athlete’s heart and similar appearing hypertrophic (HCM), dilated (DCM), and arrhythmogenic right-ventricular cardiomyopathy (ARVC) in MRI. 40 top-level athletes were prospectively examined with cardiac MR (CMR) in two university centres and compared to retrospectively recruited patients diagnosed with HCM (n = 14), ARVC (n = 18), and DCM (n = 48). Analysed MR imaging parameters in the whole study cohort included morphology, functional parameters and late gadolinium enhancement (LGE). Mean left-ventricular enddiastolic volume index (LVEDVI) was high in athletes (105 ml/m2) but significantly lower compared to DCM (132 ml/m2; p = 0.001). Mean LV ejection fraction (EF) was 61% in athletes, below normal in 7 (18%) athletes vs. EF 29% in DCM, below normal in 46 (96%) patients (p < 0.0001). Mean RV-EF was 54% in athletes vs. 60% in HCM, 46% in ARVC, and 41% in DCM (p < 0.0001). Mean interventricular myocardial thickness was 10 mm in athletes vs. 12 mm in HCM (p = 0.0005), 9 mm in ARVC, and 9 mm in DCM. LGE was present in 1 (5%) athlete, 8 (57%) HCM, 10 (56%) ARVC, and 21 (44%) DCM patients (p < 0.0001). Healthy athletes’ hearts are characterized by both hypertrophy and dilation, low EF of both ventricles at rest, and increased interventricular septal thickness with a low prevalence of LGE. Differentiation of athlete’s heart from other non-ischemic cardiomyopathies in MRI can be challenging due to a significant overlap of characteristics also seen in HCM, ARVC, and DCM.
Funder
Bundesinstitut für Sportwissenschaft Universitätsklinikum Tübingen
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging
Reference36 articles.
1. Fagard R (2002) Athlete’s heart. J Am Coll Cardiol. https://doi.org/10.1016/S0735-1097(02)02478-6 2. Zandrino F, Molinari G, Smeraldi A, Odaglia G, Masperone MA, Sardanelli F (2000) Magnetic resonance imaging of athlete’s heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries. Eur Radiol 10:319–325. https://doi.org/10.1007/s003300050051 3. Equi PL, Knottenbelt DC (2011) Cardiac response to exercise—the athlete’s heart, are hoof disord. Dermatological Not Orthop. Challenges? http://www.ivis.org/proceedings/weva/2011/84.pdf?LA=1 4. Writing Group Members, Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després J-P, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB, American Heart Association Statistics Committee, Stroke Statistics Subcommittee (2016) Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation 133:e38–e60. https://doi.org/10.1161/CIR.0000000000000350 5. D’Ascenzi F, Solari M, Corrado D, Zorzi A, Mondillo S (2018) Diagnostic differentiation between arrhythmogenic cardiomyopathy and athlete’s heart by using imaging. JACC Cardiovasc Imaging. https://doi.org/10.1016/j.jcmg.2018.04.031
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