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Assessment of Myocardial Microvascular Function in Athletes Using Resting Cardiac Magnetic Resonance First-Pass
Qian Liu1, Cao Li1, Wan-Yin Qi1
1Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Background:
Impaired myocardial microvascular function may promote cardiac remodeling (CR) and myocardial fibrosis (MF), increasing cardiovascular risks in athletes. Early assessment of myocardial microcirculatory perfusion presents potential for improving athlete care.
Purpose:
To evaluate the characteristics of myocardial microvascular function in athletes using resting cardiac MRI first-pass perfusion.
Study Type:
Prospective.
Population:
One hundred and eighty-six athletes (median age 24 years, range 18-57; 167 males; mean 10 h/week exercise for 5 years) and 43 controls (median age 25 years, range 21-56; 35 males; < 3 h/week exercise).
Field Strength/Sequence:
Balanced steady-state free precession, gradient echo sequence, and phase sensitive inversion recovery late gadolinium enhancement sequences at 3.0 T.
Assessment:
CR was defined as any cardiac parameters exceeding the 99th percentile upper reference limits. MF was visually evaluated by three independent radiologists. Left ventricular resting first-pass perfusion parameters were assessed and compared across different groups. A predictive model was developed to screen athletes with and without CR/MF.
Statistical Tests:
Univariate analysis and Pearson coefficient were used. Area under the receiver operating characteristic curve (AUC) was used to assess the performance of the predictive model. A p < 0.05 was considered significant.
Results:
Athletes exhibited lower upslope (2.12 [1.72; 2.56] vs. 2.77 [1.94; 3.22]) and maximum signal intensity (MaxSI) (20.8 [18.3; 23.6] vs. 29.5 [26.8; 33.0]), longer time to maximum signal intensity (TTM) (35.1 [31.0; 47.7] vs. 29.5 [26.8; 33.0] s) than controls. Male athletes with CR and/or MF showed lower upslope (1.54 [1.29; 1.96] vs. 1.94 [1.62; 2.43]) and MaxSI (18.0 [15.5; 21.7] vs. 21.2 [19.0; 23.5]), higher TTM (40.3 [31.5; 53.9] vs. 34.5 [29.0; 44.0] s) than those without. These perfusion parameters of athletes showed a negative correlation with global T2 mapping, QRS and corrected QT interval (r = -0.210 to -0.292). The AUC for the prediction model of CR and/or MF was 0.837.
Data Conclusion:
Athletes showed lower resting myocardial perfusion than controls, especially in those with CR and/or MF, suggesting an association between perfusion reduction and CR/MF.
Evidence Level:
1.
Technical Efficacy:
Stage 2.
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