Magnetic resonance imaging of athlete's heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries

Zandrino, F.; Molinari, Giulia; Smeraldi, Attilio; Odaglia, G; Masperone, M. A.; Sardanelli, Francesco

doi:10.1007/s003300050051

Cited by 29 publications

(11 citation statements)

References 43 publications

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“…Physiologic ventricular hypertrophy is associated with increased coronary diameter, indicating that adaptive change in coronary arteries occurs from higher flow and shear alone. 23 Our results, however, cast doubt on the notion that LV hypertrophy or increased myocardial blood flow requirement, such as in hypertension, alone predispose towards TCA. Moreover, a recent large cross-sectional study demonstrated that the prevalence of hypertension was not higher in patients with TCA.…”

Section: Discussionmentioning

confidence: 55%

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Oehler

Minnier

Lindner

2017

Journal of the American Society of Echocardiography

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Background The mechanistic basis for tortuosity of the coronary arteries (TCA) is unclear. We hypothesized that the relative degree of systolic longitudinal shortening of the LV which deforms co-axially-oriented coronary arteries is associated with TCA. Methods Adult subjects undergoing coronary angiography and comprehensive echocardiography within 3 months were classified dichotomously as with (n=32) or without (n=42) TCA defined based on number and severity of coronary angles. Systolic LV longitudinal deformation was determined by mitral annular plane systolic excursion (MAPSE) from both B-mode displacement and tissue Doppler time-velocity integral; data were indexed to LV diastolic long-axis length. Results There were no differences between groups with respect to age, gender, hypertension, or coronary artery disease. Patients with TCA had significantly (p<0.01) lower LV mass index and a shorter total LV diastolic long-axis length (8.3±1.9 vs 9.1±2.2 cm, p<0.01). Despite having a shorter length, those with TCA had a greater MAPSE by both methods. MAPSE normalized to diastolic length was significantly greater (p<0.01) in those with TCA, and remained the case after excluding subjects with reduced LV ejection fraction. Multiple linear regression found that lateral annular MAPSE had the largest effect size with a 13-fold increase in likelihood for TCA for every 0.1 of normalized MAPSE. Conclusions TCA is not associated with increased LV mass but rather with smaller hearts that have greater relative longitudinal shortening of the LV. This finding suggests that TCA could represent an adaptive response to longitudinal systolic distortion of co-axially-oriented coronary arteries that dynamically produce shear stresses associated with expansive coronary remodeling.

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Section: Discussionmentioning

confidence: 55%

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Oehler

Minnier

Lindner

2017

Journal of the American Society of Echocardiography

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“…Long term endurance training is well known to increase peak oxygen uptake () and to induce changes in left ventricular dimensions and morphology [1-9]. However, it is not completely understood how and cardiac dimensions are related and how endurance training affect the right ventricle and the total heart volume (THV).…”

Section: Introductionmentioning

confidence: 99%

Relation between cardiac dimensions and peak oxygen uptake

Steding

Engblom

Buhre

et al. 2010

Journal of Cardiovascular Magnetic Resonance

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BackgroundLong term endurance training is known to increase peak oxygen uptake () and induce morphological changes of the heart such as increased left ventricular mass (LVM). However, the relationship between and the total heart volume (THV), considering both the left and right ventricular dimensions in both males and females, is not completely described. Therefore, the aim of this study was to test the hypothesis that THV is an independent predictor of and to determine if the left and right ventricles enlarge in the same order of magnitude in males and females with a presumed wide range of THV.Methods and ResultsThe study population consisted of 131 subjects of whom 71 were athletes (30 female) and 60 healthy controls (20 female). All subjects underwent cardiovascular MR and maximal incremental exercise test. Total heart volume, LVM and left- and right ventricular end-diastolic volumes (LVEDV, RVEDV) were calculated from short-axis images. was significantly correlated to THV, LVM, LVEDV and RVEDV in both males and females. Multivariable analysis showed that THV was a strong, independent predictor of (R2 = 0.74, p < 0.001). As LVEDV increased, RVEDV increased in the same order of magnitude in both males and females (R2 = 0.87, p < 0.001).ConclusionTotal heart volume is a strong, independent predictor of maximal work capacity for both males and females. Long term endurance training is associated with a physiologically enlarged heart with a balance between the left and right ventricular dimensions in both genders.

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“…5,[30][31][32] Many athletes have what is referred to as "athletic heart," or global, mild, dilated LV hypertrophy. 31,32 To differentiate athletic heart from pathologic LV hypertrophy, the thickness of the LV wall is compared with the end-diastolic dimension of the LV cavity. In athletes with borderline LV-wall thickening (13-15 mm), examination of the LV end-diastolic dimension might help differentiate.…”

Section: Screening For Signs Of Sudden Cardiac Deathmentioning

confidence: 99%

Sudden Cardiac Death in Athletes: What Sport-Rehabilitation Specialists Need to Know

Evans¹,

Cassady²

2003

Journal of Sport Rehabilitation

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Objective: To describe the underlying conditions that predispose athletes to sudden cardiac death (SCD) and review signs and symptoms that indicate an athlete is at risk. Data Sources: MEDLINE, the Los Angeles Times and Triathlon Times archives, and other sources identified in the references of articles initially located therein. A total of 43 references were included. Conclusions: Most cases of SCD in younger athletes (≤35 years) are attributable to multiple hereditary conditions, with familial hypertrophic cardiomyopathy being the primary cause, whereas the major cause of SCD in older athletes (>35 years) is coronary artery disease. Health-care professionals evaluating athletes should pay particular attention to past medical and family history. Items in an athlete's screening that suggest increased risk include a history of chest pain, syncope, excessive shortness of breath, irregular heart rate or murmur, or a history of SCD in an immediate family member. Key Words: familial hypertrophic cardiomyopathy, cardiovascular screening Evans CC, Cassady SL. Sudden cardiac death in athletes: what sport-rehabilitation specialists need to know. J Sport Rehabil. 2003;12:259-271.

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Magnetic resonance imaging of athlete's heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries

Cited by 29 publications

References 43 publications

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Increased Coronary Tortuosity Is Associated with Increased Left Ventricular Longitudinal Myocardial Shortening

Relation between cardiac dimensions and peak oxygen uptake

Sudden Cardiac Death in Athletes: What Sport-Rehabilitation Specialists Need to Know

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