Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre-participation evaluation
δείτε την πρωτότυπη σελίδα τεκμηρίου στον ιστότοπο του αποθετηρίου του φορέα για περισσότερες πληροφορίες και για να δείτε όλα τα ψηφιακά αρχεία του τεκμηρίου*
Cardiovascular magnetic resonance clarifies arrhythmogenicity in
asymptomatic young athletes with ventricular arrhythmias undergoing
pre-participation evaluation
Markousis-Mavrogenis, George
Giannakopoulou, Aikaterini
Andreou,
Nikolaos
Papadopoulos, George
Vartela, Vasiliki
Kolovou,
Genovefa
Bacopoulou, Flora
Tsarouhas, Konstantinos and
Kanaka-Gantenbein, Christina
A. Spandidos, Demetrios
I.
Mavrogeni, Sophie
Pre-participation sports examination (PPE) is a frequent reason for
consultation. However, the exact role of cardiovascular magnetic
resonance (CMR) in PPE remains undefined. The additive value of CMR in
adolescent athletes with ventricular rhythm disturbances (VRDs) was
investigated. We prospectively recruited and evaluated with CMR 50
consecutive, asymptomatic young athletes referred to our tertiary center
after identification of VRDs on electrocardiogram (ECG) with otherwise
normal standard PPE and echocardiography, and 20 age- and sex-matched
healthy volunteer athletes who underwent the same evaluations. The
primary outcome was case-control status and the secondary outcome was
the discrimination between athletes with VRDs with and without
non-sustained ventricular tachycardia (VT). CMR identified
arrhythmogenic substrates in all athletes with VRDs. The predominant
condition was myocarditis and arrhythmogenic right ventricular
cardiomyopathy in patients with and without VT, respectively. Based on
penalized regression analysis, late gadolinium enhancement (LGE), early
gadolinium enhancement (EGE), extracellular volume fraction (ECV), and
T2-mapping, best distinguished between case-control status. The
aforementioned indices predicted case-control status independent of age
and sex: EGE [Odds ratio (95% confidence interval): 6.89 (2.19-21.62)
per 0.5-unit, P<0.001], LGE (perfect prediction), ECV [1.66
(1.25-2.22), P<0.001] and T2 mapping [1.40 (1.13-1.72), P=0.002],
among other independent CMR-derived predictors. Only indexed ventricular
volumes independently discriminated between VRD patients with and
without VT. In this study, asymptomatic young athletes with VRDs and
normal PPE/echocardiography were optimally discriminated from healthy
control athletes by CMR-derived indices, and CMR allowed for the
identification of arrhythmogenic substrates in all cases.
(EN)
*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.
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