The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Myocardial Fibrosis in Young and Veteran Athletes: Insights From a Meta-Analysis

Background: Cardiac magnetic resonance (CMR) combined with late gadolinium enhancement (LGE) has revealed a non-negligible increased incidence of myocardial fibrosis (MF) in athletes compared to healthy sedentary controls.Objective: The aim of this systematic research and meta-analysis is to investigate and present our perspective regarding CMR indices in athletes compared to sedentary controls, including T1 values, myocardial extracellular volume (ECV) and positive LGE indicative of non-specific fibrosis, also to discuss the differences between young and veteran athletes.Methods: The protocol included searching, up to October 2021, of MEDLINE, EMBASE, SPORTDiscus, Web of Science and Cochrane databases for original studies assessing fibrosis via CMR in athletes. A mean age of 40 years differentiated studies' athletic populations to veteran and young.Results: The research yielded 14 studies including in total 1,312 individuals. There was a statistically significant difference in LGE fibrosis between the 118/759 athletes and 16/553 controls (Z = 5.2, P < 0.001, I2 = 0%, PI = 0.45). Notably, LGE fibrosis differed significantly between 546 (14.6%) veteran and 140 (25.7%) young athletes (P = 0.002). At 1.5T, T1 values differed between 117 athletes and 48 controls (P < 0.0001). A statistically significant difference was also shown at 3T (110 athletes vs. 41 controls, P = 0.0004), as well as when pooling both 1.5T and 3T populations (P < 0.00001). Mean ECV showed no statistically significant difference between these groups.Conclusions: Based on currently available data, we reported that overall LGE based non-specific fibrosis and T1 values differ between athletes and sedentary controls, in contrast to ECV values. Age of athletes seems to have impact on the incidence of MF. Future prospective studies should focus on the investigation of the underlying pathophysiological mechanisms.

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Late gadolinium enhancement cardiac magnetic resonance imaging for the prediction of ventricular tachyarrhythmic events: a meta-analysis

European Journal of Heart Failure ◽

10.1093/eurjhf/hft053 ◽

2013 ◽

Vol 15 (9) ◽

pp. 1019-1027 ◽

Cited By ~ 62

Author(s):

Paul A. Scott ◽

James A. Rosengarten ◽

Nick P. Curzen ◽

John M. Morgan

Keyword(s):

Magnetic Resonance Imaging ◽

Cardiac Magnetic Resonance ◽

Late Gadolinium Enhancement ◽

Magnetic Resonance ◽

Cardiac Magnetic Resonance Imaging ◽

Meta Analysis ◽

Resonance Imaging ◽

Gadolinium Enhancement

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Cardiac Magnetic Resonance Imaging - A Predictor Tool for Sudden Cardiac Death

University Heart Journal ◽

10.3329/uhj.v6i2.7253 ◽

1970 ◽

Vol 6 (2) ◽

pp. 90-92

Author(s):

Nilufar Fatema ◽

Md Abu Siddique ◽

Sajal Krishna Banerjee ◽

Syde Ali Ahsan ◽

Fazlur Rahman ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Cardiac Death ◽

Resonance Imaging ◽

Gadolinium Enhancement ◽

Gadolinium Contrast ◽

Contrast Administration ◽

Malignant Arrhythmia ◽

Prognostic Importance

Cardiovascular magnetic resonance (CMR) detects myocardial fibrosis, which appears as late gadolinium enhancement (LGE) after gadolinium contrast administration and may convey prognostic importance. Myocardial fibrosis is the source of malignant arrhythmia like ventricular tachycardia or ventricular fibrillation. Sudden cardiac death occurs in these group patients. By detecting myocardial fibrosis we can select these groups of patients for implantable cardioverter defibrillator. Thus sudden cardiac death can be prevented in some extent.Keywords: Cardiac MRI; Sudden cardiac death. DOI: 10.3329/uhj.v6i2.7253University Heart Journal Vol. 6, No. 2, July 2010 pp.90-92

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Myocardial fibrosis evaluated by look-locker and late gadolinium enhancement magnetic resonance imaging in apical hypertrophic cardiomyopathy: Association with ventricular tachyarrhythmia and risk factors

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.24357 ◽

2013 ◽

Vol 40 (2) ◽

pp. 407-412 ◽

Cited By ~ 5

Author(s):

Yasuo Amano ◽

Minako Takeda ◽

Masaki Tachi ◽

Mitsunobu Kitamura ◽

Shinichiro Kumita

Keyword(s):

Magnetic Resonance Imaging ◽

Risk Factors ◽

Late Gadolinium Enhancement ◽

Hypertrophic Cardiomyopathy ◽

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Ventricular Tachyarrhythmia ◽

Resonance Imaging ◽

Gadolinium Enhancement ◽

Apical Hypertrophic Cardiomyopathy

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Role of magnetic resonance imaging in fetuses with mild or moderate ventriculomegaly in the era of fetal neurosonography: systematic review and meta‐analysis

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.20197 ◽

2019 ◽

Vol 54 (2) ◽

pp. 164-171 ◽

Cited By ~ 17

Author(s):

D. Di Mascio ◽

F. G. Sileo ◽

A. Khalil ◽

G. Rizzo ◽

N. Persico ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Meta Analysis ◽

Resonance Imaging

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Heart arrhythmias and conduction disorders in patients with acromegaly: the role of cardiac magnetic resonance imaging

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.10.000787 ◽

2020 ◽

Vol 92 (10) ◽

pp. 70-77

Author(s):

K. V. Melkozerov ◽

E. G. Przhiyalkovskaya ◽

N. V. Tarbaeva ◽

A. A. Almaskhanova ◽

M. D. Kuklina ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Cardiac Mri ◽

Somatostatin Analogs ◽

Cardiac Conduction ◽

Resonance Imaging ◽

Functional Changes ◽

Conduction Disorders

Cardiovascular complications including arrhythmias and cardiac conduction disorders are one of the main reasons of high mortality rate in acromegaly, while they have not been well explored. Aim.To estimate arrhythmias frequency in acromegaly, identify risk factors leading to the development of arrhythmia and cardiac conduction disorder, to determine the role of cardiac MRI in detecting structural and functional changes. Materials and methods.A single-center prospective cohort study, which included 461 patients (151 men and 310 women) with acromegaly, was conducted. All the patients underwent a standard medical examination, including hormonal blood test, electrocardiogram, echocardiography, electrocardiogram daily monitoring. 18 patients with arrhythmias (11 men and 7 women) had cardiac MRI with gadolinium-based contrast. Results.The results of our research show high frequency of arrhythmias and cardiac conduction disorders in patients with acromegaly 42%. Most frequent kinds of arrhythmias and cardiac conduction disorders were sinus bradycardia 19.1% of the cases and conduction disorders of bundle branch blocks 14.5%. Men were more likely to suffer from arrhythmias and cardiac conduction disorders than women (54.2% and 37.4%, respectively,p=0.0005). Not acromegaly activity but duration of the disease was a main risk factor of arrhythmias and cardiac conduction disorders. Patients with arrhythmias had a long anamnesis of acromegaly (10 and 7 years, respectively, p=0.04). Meanwhile, cardiac conduction disorders were commonly observed in the patients who were treated with somatostatin analogs comparing to the patients who didnt undergo this therapy (50% and 38.6% respectively,p=0.004). We showed that 61% of patients with acromegaly and cardiac conduction disorders who underwent magnetic resonance imaging (MRI) had the signs of myocardial fibrosis. The value of the ejection fraction of the left ventricle according to MRI was higher than with echocardiography (p=0.04). Conclusion.Arrhythmias and cardiac conduction disorders are often observed in patients with acromegaly even with remission of the disease. High risk group need careful diagnostic and monitoring approaches. Cardiac MRI is the gold standard for visualization of structural and morphological changes in the heart. Use of cardiac MRI in acromegalic patients expands our understanding of arrhythmias and cardiac conduction disorders in this disease. There are no specific laboratory markers of diffuse myocardial fibrosis, and the role of myocardial fibrosis in the occurrence of cardiac arrhythmias and conduction disorders needs further studying.

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