Cardiovascular magnetic resonance to differentiate veteran athlete’s heart with cavity dilatation and mild dilated cardiomyopathy

作者：Wasim Javed, Raluca Tomoaia, Maryum Farooq, B.R. Chambers, Ioannis Botis, Ze Ming Goh, Benjamin Brown, Louise Brown, Jonathan Farley, Hui Xue, Eylem Levelt, Erica Dall’Armellina, John P. Greenwood, Peter Kellman, Sven Plein, Peter Swoboda · 发表于：European Heart Journal - Cardiovascular Imaging · 年份：2025 · DOI：10.1093/ehjci/jeaf234 · 被引用次数：4 · 研究领域：Cardiovascular Effects of Exercise、Cardiac Imaging and Diagnostics、Coronary Artery Anomalies

AIMS: This study aimed to investigate the distribution of myocardial fibrosis and patterns of tissue characteristics on cardiovascular magnetic resonance (CMR) between athletes with left ventricular (LV) dilatation and mild dilated cardiomyopathy (DCM) patients. METHODS AND RESULTS: We prospectively recruited male cyclists/triathletes aged ≥50 years who undertook ≥10 h/week of exercise for ≥15 years along with age-/sex-matched patients with non-ischaemic heart failure (HF). Participants underwent clinical assessment, 12-lead ECG, stress-perfusion CMR with fibrosis assessment, and parametric tissue mapping.Following CMR, included participants in both groups had left ventricular ejection fraction (LVEF) > 40% and left ventricular end-diastolic volume indexed to body surface area (LVEDVi) ≥ 110 mL/m2 without ischaemic heart disease or significant cardiac pathology on CMR likely to cause HF. Of 113 participants (64 athletes and 49 mild DCM patients), athletes with fibrosis demonstrated a greater prevalence of inferolateral fibrosis (87.5% vs. 50.0%, P = 0.002), whereas inferoseptal fibrosis was more common in mild DCM patients (45.8% vs. 9.4%, P = 0.002). Native T1 (1249.0 ± 38.1 vs. 1308.3 ± 47.1 ms, P < 0.001) and extracellular volume (ECV) (22.0 ± 2.1 vs. 25.9 ± 3.5%, P < 0.001) were lower in athletes. Athletes had greater right ventricular end-diastolic volume indexed to body surface area (RVEDVi) (121.0 ± 14.3 vs. 97.6 ± 25.2%, P < 0.001), myocardial perfusion reserve (MPR) ...