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Open Access 01-05-2021 | Magnetic Resonance Imaging | Cardiac

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

Authors: Mareike Gastl, Vera Lachmann, Aikaterini Christidi, Nico Janzarik, Verena Veulemans, Sebastian Haberkorn, Leonie Holzbach, Christoph Jacoby, Bernhard Schnackenburg, Susanne Berrisch-Rahmel, Tobias Zeus, Malte Kelm, Florian Bönner

Published in: European Radiology | Issue 5/2021

Abstract

Objectives

Distinguishing hypertrophic cardiomyopathy (HCM) from left ventricular hypertrophy (LVH) due to systematic training (athlete’s heart, AH) from morphologic assessment remains challenging. The purpose of this study was to examine the role of T2 mapping and deformation imaging obtained by cardiovascular magnetic resonance (CMR) to discriminate AH from HCM with (HOCM) or without outflow tract obstruction (HNCM).

Methods

Thirty-three patients with HOCM, 9 with HNCM, 13 strength-trained athletes as well as individual age- and gender-matched controls received CMR. For T2 mapping, GRASE-derived multi-echo images were obtained and analyzed using dedicated software. Besides T2 mapping analyses, left ventricular (LV) dimensional and functional parameters were obtained including LV mass per body surface area (LVMi), interventricular septum thickness (IVS), and global longitudinal strain (GLS).

Results

While LVMi was not significantly different, IVS was thickened in HOCM patients compared to athlete’s. Absolute values of GLS were significantly increased in patients with HOCM/HNCM compared to AH. Median T2 values were elevated compared to controls except in athlete’s heart. ROC analysis revealed T2 values (AUC 0.78) and GLS (AUC 0.91) as good parameters to discriminate AH from overall HNCM/HOCM.

Conclusion

Discrimination of pathologic from non-pathologic LVH has implications for risk assessment of competitive sports in athletes. Multiparametric CMR with parametric T2 mapping and deformation imaging may add information to distinguish AH from LVH due to HCM.

Key Points

• Structural analyses using T2 mapping cardiovascular magnetic resonance imaging (CMR) may help to further distinguish myocardial diseases.

• To differentiate pathologic from non-pathologic left ventricular hypertrophy, CMR including T2 mapping was obtained in patients with hypertrophic obstructive/non-obstructive cardiomyopathy (HOCM/HNCM) as well as in strength-trained athletes.

• Elevated median T2 values in HOCM/HNCM compared with athlete’s may add information to distinguish athlete’s heart from pathologic left ventricular hypertrophy.

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Title: Cardiac magnetic resonance T2 mapping and feature tracking in athlete’s heart and HCM
Authors: Mareike Gastl
Vera Lachmann
Aikaterini Christidi
Nico Janzarik
Verena Veulemans
Sebastian Haberkorn
Leonie Holzbach
Christoph Jacoby
Bernhard Schnackenburg
Susanne Berrisch-Rahmel
Tobias Zeus
Malte Kelm
Florian Bönner
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Cardiomyopathy
Published in: European Radiology / Issue 5/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07289-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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