Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation

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 prospective...

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Bibliographic Details
Published in:Experimental and therapeutic medicine 2020-07, Vol.20 (1), p.561-571
Main Authors: Markousis-Mavrogenis, George, Giannakopoulou, Aikaterini, Andreou, Nikolaos, Papadopoulos, George, Vartela, Vasiliki, Kolovou, Genovefa, Bacopoulou, Flora, Tsarouhas, Konstantinos, Kanaka-Gantenbein, Christina, Spandidos, Demetrios A, Mavrogeni, Sophie I
Format: Article
Language:English
Subjects:
Age
Arrhythmia
Athletes
Cardiology
Cardiomyopathy
Children & youth
Diagnosis
Electrocardiography
Ionizing radiation
Magnetic resonance imaging
Medical examination
Methods
Musculoskeletal system
Patients
Regression analysis
Tachycardia
Teenage athletes
Ultrasonic imaging
Variables
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Summary: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
ISSN:1792-0981
1792-1015
DOI:10.3892/etm.2020.8693