van Hattum Juliette C, van Diepen Maarten A, Verwijs Sjoerd M, Boekholdt S Matthijs, van Randen Adrienne, Groenink Maarten, Planken R Nils, Moen Maarten H, Daems Joëlle J N, Prakken Niek H J, van de Sande Danny A J P, Velthuis Birgitta K, de Vries Suzanna, Walhout Ronald J, Pinto Yigal M, Wilde Arthur A M, Jørstad Harald T
Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Room D3-221, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Amsterdam Cardiovascular Sciences - Heart Failure and Arrhythmias, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Eur Heart J Cardiovasc Imaging. 2025 Jun 30;26(7):1199-1207. doi: 10.1093/ehjci/jeaf111.
Differentiating physiological exercise-induced cardiac remodelling (EICR) from pathology is challenging, especially in female athletes, where studies using state-of-the-art imaging techniques are lacking. We aimed to investigate extreme phenotypes of EICR in female elite athletes using magnetic resonance imaging (MRI).
Cross-sectional, multicentre study in female elite athletes using contrast-enhanced cardiac MRI. Left and right ventricle (LV, RV) indices and LV mass (LVM)-to-LV end-diastolic volume (EDV) ratios were investigated, indexed by body surface area (BSA). Cardiac remodelling was determined comparing cardiac MRI metrics to female reference values, stratified by ESC sports classification (endurance, mixed, power/skill). In 173 female elite athletes (median age 25 years, median 18 h training/week, 97% Caucasian), mean LV EDV/BSA and LVM/BSA were 108 ± 13 mL/m2 and 50 ± 10 g/m2, with lower LVM/LV EDV ratios (0.5 ± 0.1) than the general population (0.7 ± 0.1 g/mL; P < 0.001). Most athletes (71%) had isolated LV EDV increases; LVM increases (18%) commonly coincided with LV EDV increases. Compared with the general population (45 ± 7 g/m2), only mixed (48 ± 9 g/m2; P = 0.021) and endurance athletes (53 ± 11 g/m2; P < 0.001) exhibited greater mean LVM with endurance athletes surpassing mixed athletes (P = 0.004). Mixed and endurance showed comparably greater median biventricular EDV compared with power/skill athletes [LV: 109 (103-119) and 111 (101-118) vs. 99 (92-105); RV: 110 (103-118) and 112 (105-124) vs. 101 (95-104) mL/m2; P < 0.001]. Maximum wall thickness > 11 mm was rare (2%). Global T1 time was 968 ± 22 ms; extracellular volume was 25 ± 4%.
Female elite athletes, particularly endurance-trained athletes, display EICR marked by increased ventricular volumes, without prominent increases in LVM or wall thickness.
NL9328.
区分生理性运动诱导的心脏重塑（EICR）与病理性重塑具有挑战性，尤其是在女性运动员中，目前缺乏使用先进成像技术的研究。我们旨在使用磁共振成像（MRI）研究女性精英运动员EICR的极端表型。
对女性精英运动员进行横断面、多中心研究，采用对比增强心脏MRI。研究左、右心室（LV、RV）指标以及LV质量（LVM）与LV舒张末期容积（EDV）的比值，并按体表面积（BSA）进行索引。通过将心脏MRI指标与女性参考值进行比较来确定心脏重塑，参考值按欧洲心脏病学会运动分类（耐力、混合、力量/技巧）进行分层。在173名女性精英运动员中（年龄中位数25岁，每周训练中位数18小时，9７%为白种人），平均LV EDV/BSA和LVM/BSA分别为108±13 mL/m²和50±10 g/m²，LVM/LV EDV比值（0.5±0.1）低于一般人群（0.7±0.1 g/mL；P<0.001）。大多数运动员（71%）仅有LV EDV增加；LVM增加（18%）通常与LV EDV增加同时出现。与一般人群（45±7 g/m²）相比，只有混合项目（48±9 g/m²；P=0.021）和耐力项目运动员（53±11 g/m²；P<0.001）的平均LVM更高，且耐力项目运动员超过混合项目运动员（P=0.004）。与力量/技巧项目运动员相比，混合项目和耐力项目的双心室EDV中位数更高[LV：109（103-119）和111（101-118） vs. 99（92-105）；RV：110（103-118）和112（105-124） vs. 101（95-104）mL/m²；P<0.001]。最大壁厚>11 mm的情况很少见（2%）。整体T1时间为968±22 ms；细胞外容积为25±4%。
女性精英运动员，尤其是耐力训练的运动员，表现出以心室容积增加为特征的EICR，而LVM或壁厚没有明显增加。
NL9328。
