Changes in cardiac morphologic characteristics and function in elite triathletes, as measured with cardiac MR imaging, reflect a combination of eccentric and concentric remodeling with regulative enlargement of atrial and ventricular chambers. These findings are different from what has been observed in previous studies in other types of elite athletes.

SummaryTransient elastography (TE, Fibroscan) has been established as a noninvasive assessment tool of liver fibrosis. We evaluated potentials and limitations of TE for identifying renal allograft fibrosis. The technical possibility of kidney examination by TE was assessed in two 10-week-old German landrace pigs and kidney stiffness (KS) was evaluated in 164 renal transplant patients. KS could be determined in all animals at the pole and pars media (29 AE 10 kPa vs. 31 AE 17 kPa). In human renal allografts KS was successfully performed in 94.5% of the test series with reliable results in 72% of the measurements. Mean KS at the pole or pars media were comparable (35.0 AE 19.9 kPa vs. 33.2 AE 18.6 kPa). Significantly higher KS was detected in renal allografts with histologically confirmed advanced fibrosis. Bodymass-index, skin-allograft distance, and peri or intrarenal fluid accumulation were important confounders of successful KS measurements (BMI: r = À0.31; P < 0.001; distance: r = À0.50; P < 0.001). Notably, KS did not correlate with renal function. TE represents a noninvasive approach in selected transplant recipients to identify allografts with severe fibrosis. The heterogeneous kidney morphology and several other confounding factors negatively affect measurability of KS by TE. Further technical modifications are required to improve applicability of TE for kidney assessment.

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Aerobic exercise positively impacts cardiometabolic risk factors and diseases; however, the most effective exercise training strategies have yet to be identified. To determine the effect of high intensity (interval) training (HI(I)T) versus moderate intensity continuous exercise (MICE) training on cardiometabolic risk factors and cardiorespiratory fitness we conducted a 16-week crossover RCT with partial blinding. Eighty-one healthy untrained middle-aged males were randomly assigned to two study arms: (1) a HI(I)T-group and (2) a sedentary control/MICE-group that started their MICE protocol after their control status. HI(I)T focused on interval training (90 sec to 12 min >85–97.5% HRmax) intermitted by active recovery (1–3 min at 65–70% HRmax), while MICE consisted of continuous running at 65–75% HRmax. Both exercise groups progressively performed 2–4 running sessions/week of 35 to 90 min/session; however, protocols were adjusted to attain similar total work (i.e., isocaloric conditions). With respect to cardiometabolic risk factors and cardiorespiratory fitness both exercise groups demonstrated similar significant positive effects on MetS-Z-Score (HI(I)T: −2.06 ± 1.31, P = .001 versus MICE: −1.60 ± 1.77, P = .001) and (relative) VO2max (HI(I)T: 15.6 ± 9.3%, P = .001 versus MICE: 10.6 ± 9.6%, P = .001) compared with the sedentary control group. In conclusion, both exercise programs were comparably effective for improving cardiometabolic indices and cardiorespiratory fitness in untrained middle-aged males.

Automated tube voltage adaptation combined with high-pitch protocols allows for a substantial radiation dose reduction while substantially increasing the image quality, even at large-volume exposure.

TVA between 100 and 120 kV in combination with TCM led to a radiation dose reduction compared to TCM alone, while keeping CNR constant though maintaining diagnostic image quality.

Background-To prospectively evaluate whether short-term high-intensity (interval) training (HI(I)T) induces detectable morphological cardiac changes in previously untrained men in cardiovascular magnetic resonance imaging. Methods and Results-Eighty-four untrained volunteers were randomly assigned to a HI(I) T group (n=42; 44.1±4.7 years) or an inactive control group (n=42; 42.3±5.6 years). HI(I)T focused on interval runs (intensity: 95%-105% of individually calculated heart rate at the anaerobic threshold). Before and after 16 weeks, all subjects underwent physiological examination, stepwise treadmill test with blood lactate analysis, and contrast-enhanced cardiovascular magnetic resonance imaging (cine, tagging, and delayed enhancement). Indexed left ventricular (LV) and right ventricular (RV) volume (LV, 77.1±8.5-83.9±8.6; RV, 80.5±8.5-86.6±8.1) and mass (LV, RV,.1) significantly increased with HI(I)T. Changes in LV and RV morphological parameters with HI(I)T were highly correlated with an increase in maximal aerobic capacity (VO 2max ) and a decrease in blood lactate concentration at the anaerobic threshold. Mean LV and RV remodeling index of HI(I)T group did not alter with training (0.76 ±0.09 and 0.24±0.10 g/mL, respectively [P=0. 97 and P=0.72]), indicating balanced cardiac adaptation. Myocardial circumferential strain decreased after HI(I)T within all 6 basal segments (anteroseptal, P=0.01 and anterolateral, P<0.001). There was no late gadolinium enhancement in any of the participants before or post HI(I)T. Conclusions-Sixteen Scharf et al Cardiac Adaptation to HI(I)Tinvestigations revealed enlargement and reduced contractility of the RV, which might be associated with ventricular tachycardia. 15The Running Study and Heart (RUSH) trial was designed to address these issues. Physiological and morphological data were collected and cardiopulmonary exercise testing with blood lactate analysis as well as CMR imaging was performed in a randomized controlled trial. Methods Study PopulationThe study (www.clinicaltrials.gov, NCT01406730) was approved by the institutional review board and written informed consent was obtained from all subjects. Sample size was determined with G*power (version 3.1.3; 2009, Faul et al,16 Dusseldorf, Germany). We estimated that a sample size of 32 individuals in each group would have a power of 90% to detect a between-group difference of 8±10 mL in end-diastolic volume (EDV) with α=0.05. Assuming a dropout rate of 20%, our goal was to recruit 40 subjects per group. Study subjects were recruited by local newspaper advertisement from January until March 2011. The study was conducted from April 2011 until July 2012. Participants were randomly assigned to a training and restgroup.Eighty-eight male volunteers, who were either completely sedentary or did not engage in any routine (ie, >3 hours per week) physical training, were enrolled in this study. All participants completed a medical history and physical activity questionnaire. All subjects denied the use of illicit substances and un...