Mangold S, Kramer U, Franzen E, Erz G, Bretschneider C, Seeger A, Claussen C D, Niess A M, Burgstahler C
Department of Diagnostic and Interventional Radiology, University of Tuebingen.
Rofo. 2013 Dec;185(12):1167-74. doi: 10.1055/s-0033-1350130. Epub 2013 Jul 29.
Sudden cardiac death [SCD] in competitive athletes is caused by a diverse set of cardiovascular diseases such as hypertrophic and dilated cardiomyopathy [HCM/DCM], myocarditis, coronary anomalies or even coronary artery disease. In order to identify potential risk factors responsible for SCD, elite athletes underwent cardiac magnetic resonance [CMR] imaging.
73 male [M] and 22 female [F] athletes (mean age 35.2 ± 11.4 years) underwent CMR imaging. ECG-gated breath-hold cine SSFP sequences were used for the evaluation of wall motion abnormalities and myocardial hypertrophy as well as for quantitative analysis (left and right ventricular [LV, RV] end-diastolic and end-systolic volume [EDV, ESV], stroke volume [SV], ejection fraction [EF] and myocardial mass [MM]). Furthermore, left and right atrial sizes were assessed by planimetry and delayed enhancement imaging was performed 10 minutes after the application of contrast agent. Coronary arteries were depicted using free-breathing Flash-3 D MR angiography.
The quantitative analyses showed eccentric hypertrophy of the left ventricle (remodeling index [MM/LV-EDV]: M 0.75, F 0.665), enlargement of the RV volumes (RV-EDV: M 122.6 ± 19.0 ml/m², F 99.9 ± 7.2 ml/m²) and an increased SV (LV-SV: M 64.7 ± 10.0 ml/m², F 56.5 ± 5.7 ml/m²; RV-SV; M 66.7 ± 10.4 ml/m², F 54.2 ± 7.1 ml/m²). Abnormal findings were detected in 6 athletes (6.3 %) including one benign variant of coronary anomaly and abnormal late gadolinium enhancement in 2 cases. None of the athletes showed wall motion abnormalities or signs of myocardial ischemia.
CMR imaging of endurance athletes revealed abnormal findings in more than 5 % of the athletes. However, the prognostic significance remains unclear. Thus, cardiac MRI cannot be recommended as a routine examination in the care of athletes.
竞技运动员心源性猝死（SCD）由多种心血管疾病引起，如肥厚型和扩张型心肌病（HCM/DCM）、心肌炎、冠状动脉异常甚至冠状动脉疾病。为了确定导致SCD的潜在危险因素，对精英运动员进行了心脏磁共振（CMR）成像检查。
73名男性（M）和22名女性（F）运动员（平均年龄35.2±11.4岁）接受了CMR成像检查。采用心电图门控屏气电影稳态自由进动序列评估室壁运动异常和心肌肥厚情况，并进行定量分析（左、右心室舒张末期和收缩末期容积[EDV、ESV]、每搏输出量[SV]、射血分数[EF]和心肌质量[MM]）。此外，通过平面测量评估左、右心房大小，并在注射造影剂10分钟后进行延迟强化成像。使用自由呼吸三维快速成像稳态进动序列（Flash-3D MR angiography）描绘冠状动脉。
定量分析显示左心室呈离心性肥厚（重塑指数[MM/LV-EDV]：男性为0.75，女性为0.665），右心室容积增大（RV-EDV：男性为122.6±19.0ml/m²，女性为99.9±7.2ml/m²），每搏输出量增加（LV-SV：男性为64.7±10.0ml/m²，女性为56.5±5.7ml/m²；RV-SV：男性为66.7±10.4ml/m²，女性为54.2±7.1ml/m²）。6名运动员（6.3%）检测到异常结果，其中包括1例良性冠状动脉异常变异，2例出现异常钆延迟强化。所有运动员均未显示室壁运动异常或心肌缺血迹象。
耐力运动员的CMR成像检查显示超过5%的运动员存在异常结果。然而，其预后意义尚不清楚。因此，不建议将心脏磁共振成像作为运动员常规检查项目。
