title: Detection of cardiovascular disease in elite athletes using cardiac magnetic resonance imaging.
abstract: OBJECTIVE
  Sudden cardiac death [SCD] in competitive athletes is caused by a diverse set of cardiovascular diseases such as hypertrophic and dilated cardiomyopathy [HCM/DCM], myocarditis, coronary anomalies or even coronary artery disease. In order to identify potential risk factors responsible for SCD, elite athletes underwent cardiac magnetic resonance [CMR] imaging.
  
  
  METHODS
  73 male [M] and 22 female [F] athletes (mean age 35.2 ± 11.4 years) underwent CMR imaging. ECG-gated breath-hold cine SSFP sequences were used for the evaluation of wall motion abnormalities and myocardial hypertrophy as well as for quantitative analysis (left and right ventricular [LV, RV] end-diastolic and end-systolic volume [EDV, ESV], stroke volume [SV], ejection fraction [EF] and myocardial mass [MM]). Furthermore, left and right atrial sizes were assessed by planimetry and delayed enhancement imaging was performed 10 minutes after the application of contrast agent. Coronary arteries were depicted using free-breathing Flash-3 D MR angiography.
  
  
  RESULTS
  The quantitative analyses showed eccentric hypertrophy of the left ventricle (remodeling index [MM/LV-EDV]: M 0.75, F 0.665), enlargement of the RV volumes (RV-EDV: M 122.6 ± 19.0 ml/m², F 99.9 ± 7.2 ml/m²) and an increased SV (LV-SV: M 64.7 ± 10.0 ml/m², F 56.5 ± 5.7 ml/m²; RV-SV; M 66.7 ± 10.4 ml/m², F 54.2 ± 7.1 ml/m²). Abnormal findings were detected in 6 athletes (6.3 %) including one benign variant of coronary anomaly and abnormal late gadolinium enhancement in 2 cases. None of the athletes showed wall motion abnormalities or signs of myocardial ischemia.
  
  
  CONCLUSIONS
  CMR imaging of endurance athletes revealed abnormal findings in more than 5 % of the athletes. However, the prognostic significance remains unclear. Thus, cardiac MRI cannot be recommended as a routine examination in the care of athletes.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Tuebingen.
authors.forename: S
authors.initials: S
authors.lastname: Mangold
authors.forename: U
authors.initials: U
authors.lastname: Kramer
authors.forename: E
authors.initials: E
authors.lastname: Franzen
authors.forename: G
authors.initials: G
authors.lastname: Erz
authors.forename: C
authors.initials: C
authors.lastname: Bretschneider
authors.forename: A
authors.initials: A
authors.lastname: Seeger
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.forename: A M
authors.initials: AM
authors.lastname: Niess
authors.forename: C
authors.initials: C
authors.lastname: Burgstahler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D056352:Athletes; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology; D006331:Heart Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D055815:Young Adult
chemical_list: D003287:Contrast Media