Quick Fire Session
SCMR 22nd Annual Scientific Sessions
Long-term intensive training leads to functional and morphological adaptation of the heart, known as athlete's heart. However, myocardial fibrosis detected by late gadolinium enhancement (LGE) cardiac MRI (CMR) has been found in competitive athletes in variable frequency. The purpose of this study was to analyse the differences in competition activity between triathletes with and without late gadolinium enhancement.
54 competitive male triathletes (44 ±10 years) underwent a CMR study performed on a 1.5 T Achieva (Philips). CMR protocol included SSFP cine, LGE imaging as well as T1 mapping. Image analysis was performed on cvi42 (Circle Cardiovascular Imaging). CMR parameters are given as the mean of two independent observers. The parameters of physical fitness were determined by an exercise test. Triathletes reported their competition history with information about the number, distance and duration of events they participated in.
9 out of 54 triathletes (17%) exhibit a non-ischaemic myocardial fibrosis of the left ventricle (LGE+). LGE+ triathletes completed significantly longer total (5,852 ±3,517 vs. 2,406 ±2,025 km, p <0.0001), swimming (64±32 vs. 31 ±25 km, p <0.01) and cycling distances (4,418 ±3,094 vs. 1,490 ±1,114 km, p <0.0001). The LV mass index was significantly higher in LGE+ triathletes (93 ±7 vs. 84 ±11 g/m2, p <0.05). Likewise, the extracellular volume (ECV) was significantly higher in LGE+ triathletes (25 ±3 vs. 21 ±3 g/m2, p <0.001). LGE+ triathletes had higher peak excercise systolic blood pressure compared to LGE- triathletes (213 ±24 vs. 194 ±26 mmHg, p <0.05). Eventhough having comparable LVEF (62 ±7 vs. 63 ±5%), LGE+ triathletes showed significantly higher nt-pro-BNP values (89 ±160 vs. 38 ±31 pg/ml, p <0.05), which had a significantly negative correlation with LVEF.
LGE+ triathletes (17%) completed significantly longer distances compared to LGE- triathletes in their life-time competition history suggesting that the amount of exercise has an impact on myocardial fibrosis. Also, increase of nt-pro-BNP values in LGE+ triathletes may imply an early sub-clinical impairment of the LV myocardium.