Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging
BackgroundStrenuous exercise has been associated with functional and structural cardiac changes due to local and systemic inflammatory responses, reflecting oxidative, metabolic, hormonal, and thermal stress, even in healthy individuals. We aimed to assess changes in myocardial structure and functio...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.908619/full |
| _version_ | 1818015256713101312 |
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| author | Fabrizio Ricci Fabrizio Ricci Giovanni Donato Aquaro Carlo De Innocentiis Serena Rossi Cesare Mantini Francesca Longo Mohammed Y. Khanji Mohammed Y. Khanji Mohammed Y. Khanji Sabina Gallina Alessandro Pingitore |
| author_facet | Fabrizio Ricci Fabrizio Ricci Giovanni Donato Aquaro Carlo De Innocentiis Serena Rossi Cesare Mantini Francesca Longo Mohammed Y. Khanji Mohammed Y. Khanji Mohammed Y. Khanji Sabina Gallina Alessandro Pingitore |
| author_sort | Fabrizio Ricci |
| collection | DOAJ |
| description | BackgroundStrenuous exercise has been associated with functional and structural cardiac changes due to local and systemic inflammatory responses, reflecting oxidative, metabolic, hormonal, and thermal stress, even in healthy individuals. We aimed to assess changes in myocardial structure and function using cardiovascular magnetic resonance (CMR) imaging in master triathletes early after a full-distance Ironman Triathlon race.Materials and methodsTen master triathletes (age 45 ± 8 years) underwent CMR within 3 h after a full-distance Ironman Triathlon race (3.8 km swimming, 180 km cycling, and 42.2 km running) completed with a mean time of 12 ± 1 h. All the triathletes had a 30-day follow-up CMR. Cine balanced steady-state free precession, T2-short tau inversion recovery (STIR), tagging, and late gadolinium enhancement (LGE) imaging sequences were performed on a 1.5-T MR scanner. Myocardial edema was defined as a region with increased T2 signal intensity (SI) of at least two SDs above the mean of the normal myocardium. The extent of myocardial edema was expressed as the percentage of left ventricular (LV) mass. Analysis of LV strain and torsion by tissue tagging included the assessment of radial, longitudinal, and circumferential peak systolic strain, rotation, and twist.ResultsCompared with postrace, biventricular volumes, ejection fraction, and LV mass index remained unchanged at 30-day follow-up. Global T2 SI was significantly higher in the postrace CMR (postrace 10.5 ± 6% vs. follow-up 3.9 ± 3.8%, P = 0.004) and presented with a relative apical sparing distribution (P < 0.001) matched by reduction of radial peak systolic strain of basal segments (P = 0.003). Apical rotation and twist were significantly higher immediately after the competition compared with follow-up (P < 0.05).ConclusionStrenuous exercise in master triathletes is associated with a reversible regional increase in myocardial edema and reduction of radial peak systolic strain, both presenting with a relative apical sparing pattern. |
| first_indexed | 2024-04-14T06:55:29Z |
| format | Article |
| id | doaj.art-ad5a312b507146c78b9ad6d9af94b479 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-14T06:55:29Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ad5a312b507146c78b9ad6d9af94b4792022-12-22T02:06:55ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.908619908619Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imagingFabrizio Ricci0Fabrizio Ricci1Giovanni Donato Aquaro2Carlo De Innocentiis3Serena Rossi4Cesare Mantini5Francesca Longo6Mohammed Y. Khanji7Mohammed Y. Khanji8Mohammed Y. Khanji9Sabina Gallina10Alessandro Pingitore11Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, ItalyDepartment of Clinical Sciences, Clinical Research Center, Lund University, Malmö, SwedenMRI Laboratory, Fondazione Toscana G. Monasterio, Pisa, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, ItalyInterventional Cath Lab, ASL 2 Abruzzo, Chieti, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, ItalyUniversity of Trieste, Trieste, ItalyNewham University Hospital, Barts Health NHS Trust, London, United KingdomWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United KingdomBarts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United KingdomDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, ItalyClinical Physiology Institute, CNR, Pisa, ItalyBackgroundStrenuous exercise has been associated with functional and structural cardiac changes due to local and systemic inflammatory responses, reflecting oxidative, metabolic, hormonal, and thermal stress, even in healthy individuals. We aimed to assess changes in myocardial structure and function using cardiovascular magnetic resonance (CMR) imaging in master triathletes early after a full-distance Ironman Triathlon race.Materials and methodsTen master triathletes (age 45 ± 8 years) underwent CMR within 3 h after a full-distance Ironman Triathlon race (3.8 km swimming, 180 km cycling, and 42.2 km running) completed with a mean time of 12 ± 1 h. All the triathletes had a 30-day follow-up CMR. Cine balanced steady-state free precession, T2-short tau inversion recovery (STIR), tagging, and late gadolinium enhancement (LGE) imaging sequences were performed on a 1.5-T MR scanner. Myocardial edema was defined as a region with increased T2 signal intensity (SI) of at least two SDs above the mean of the normal myocardium. The extent of myocardial edema was expressed as the percentage of left ventricular (LV) mass. Analysis of LV strain and torsion by tissue tagging included the assessment of radial, longitudinal, and circumferential peak systolic strain, rotation, and twist.ResultsCompared with postrace, biventricular volumes, ejection fraction, and LV mass index remained unchanged at 30-day follow-up. Global T2 SI was significantly higher in the postrace CMR (postrace 10.5 ± 6% vs. follow-up 3.9 ± 3.8%, P = 0.004) and presented with a relative apical sparing distribution (P < 0.001) matched by reduction of radial peak systolic strain of basal segments (P = 0.003). Apical rotation and twist were significantly higher immediately after the competition compared with follow-up (P < 0.05).ConclusionStrenuous exercise in master triathletes is associated with a reversible regional increase in myocardial edema and reduction of radial peak systolic strain, both presenting with a relative apical sparing pattern.https://www.frontiersin.org/articles/10.3389/fcvm.2022.908619/fullCMRdeformation imagingmaster triathletesIronmanathlete’s heart |
| spellingShingle | Fabrizio Ricci Fabrizio Ricci Giovanni Donato Aquaro Carlo De Innocentiis Serena Rossi Cesare Mantini Francesca Longo Mohammed Y. Khanji Mohammed Y. Khanji Mohammed Y. Khanji Sabina Gallina Alessandro Pingitore Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging Frontiers in Cardiovascular Medicine CMR deformation imaging master triathletes Ironman athlete’s heart |
| title | Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging |
| title_full | Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging |
| title_fullStr | Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging |
| title_full_unstemmed | Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging |
| title_short | Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging |
| title_sort | exercise induced myocardial edema in master triathletes insights from cardiovascular magnetic resonance imaging |
| topic | CMR deformation imaging master triathletes Ironman athlete’s heart |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.908619/full |
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