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Cardiac magnetic resonance T2 mapping and feature tracking in athlete's heart and HCM

Mareike Gastl1, Vera Lachmann2, Aikaterini Christidi2

  • 1Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany. Mareike.Cramer@med.uni-duesseldorf.de.

European Radiology
|October 16, 2020
PubMed

Insights

Cardiovascular magnetic resonance (CMR) with T2 mapping and deformation imaging can differentiate hypertrophic cardiomyopathy (HCM) from athlete's heart (AH). These advanced imaging techniques help distinguish pathological left ventricular hypertrophy (LVH) in athletes for better risk assessment.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Sports Medicine

Background:

  • Distinguishing hypertrophic cardiomyopathy (HCM) from athlete's heart (AH), a form of left ventricular hypertrophy (LVH) due to training, is challenging based on morphology alone.
  • Accurate differentiation is crucial for risk assessment in competitive athletes.

Purpose of the Study:

  • To evaluate the utility of T2 mapping and deformation imaging via cardiovascular magnetic resonance (CMR) in differentiating AH from HCM (both obstructive and non-obstructive).

Main Methods:

  • CMR including T2 mapping and strain analysis (global longitudinal strain - GLS) was performed on patients with HCM (HOCM/HNCM) and strength-trained athletes (AH).
  • Left ventricular (LV) parameters such as LV mass index (LVMi) and interventricular septum thickness (IVS) were assessed.
  • T2 values and GLS were analyzed and compared between groups.

Main Results:

  • While LVMi did not differ, interventricular septum thickness was greater in HOCM patients compared to athletes.
  • Global longitudinal strain (GLS) was significantly higher in HCM patients (HOCM/HNCM) than in athletes (AH).
  • Median T2 values were elevated in HCM patients compared to controls, but not in athletes. ROC analysis showed T2 values (AUC 0.78) and GLS (AUC 0.91) effectively discriminate AH from HCM.

Conclusions:

  • Multiparametric CMR, incorporating T2 mapping and deformation imaging, provides valuable information to distinguish athlete's heart from hypertrophic cardiomyopathy.
  • These advanced CMR techniques aid in differentiating pathological LVH from physiological changes in athletes, impacting sports participation decisions.
Abstract

Keywords:
AthletesCardiomyopathy, hypertrophicHypertrophyLeft ventricularMultiparametric magnetic resonance imaging

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