2020/09 - Prevalence and pattern of cardiovascular magnetic resonance late gadolinium enhancement in highly trained endurance athletes [ Journal Club ]-Video

Video Transcription

Video Summary

The JCMR Journal Club introduced and discussed a recent study on late gadolinium enhancement (LGE) and extracellular volume (ECV) in highly trained endurance athletes. The presenter explained that regular exercise lowers cardiovascular risk, but the effects of intense competitive endurance training are less certain. The study enrolled 93 healthy endurance athletes and 72 age-matched recreationally active controls, all evaluated with clinical testing and cardiac MRI.<br /><br />Results showed that endurance athletes had larger ventricular cavities and slightly lower but still normal ventricular ejection fractions, consistent with athlete’s heart. LGE was found in 37% of athletes versus 2.8% of controls, and it was always a small, non-ischemic pattern located at the right ventricular insertion point (hinge point). Athletes with LGE had higher ECV values than those without LGE, though still within normal limits. The authors suggested this may reflect benign remodeling from mechanical stress, but the prognostic significance remains unknown.<br /><br />During discussion, the authors emphasized the need for longitudinal follow-up, particularly to determine whether these findings relate to future arrhythmias or atrial fibrosis. They also noted limitations, including self-reported training load and limited T1 mapping data.

Keywords

late gadolinium enhancement

extracellular volume

endurance athletes

cardiac MRI

athlete's heart

right ventricular insertion point

ventricular remodeling

arrhythmias

T1 mapping