What does this research mean for the field?

Cardiovascular magnetic resonance utilizing T2 mapping and global longitudinal strain accurately discriminates athlete's heart from hypertrophic cardiomyopathy, yielding AUCs of 0.78 and 0.91, respectively. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 15, 2020European RadiologyOpen Access

Cardiac magnetic resonance T2 mapping and feature tracking in athlete’s heart and HCM

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Hypertrophic cardiomyopathy and Athlete's heart (n=110). Intervention: Cardiovascular magnetic resonance with T2 mapping and feature tracking. Primary outcome: Discrimination of athlete's heart from hypertrophic cardiomyopathy (AUC 0.78 for T2 values; AUC 0.91 for GLS).

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Key result

Cardiovascular magnetic resonance with T2 mapping and global longitudinal strain accurately discriminated athlete's heart from hypertrophic cardiomyopathy with AUCs of 0.78 and 0.91, respectively.

Why the study?

Distinguishing hypertrophic cardiomyopathy from left ventricular hypertrophy due to systematic training based on morphologic assessment remains challenging.

Does cardiovascular magnetic resonance with T2 mapping and deformation imaging distinguish athlete's heart from hypertrophic cardiomyopathy?

Comparison

HOCM vs HNCM vs athlete's heart vs matched controls

Design

Observational cross-sectional study

Authors

MGMareike GastlHeinrich Heine University Düsseldorf VLVera LachmannHeinrich Heine University Düsseldorf ACAikaterini ChristidiEuromedica

Discussion

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Implication

May support CMR differentiation of athlete's heart from HCM; hypothesis-generating pending prospective validation.

Study Design

Type

Observational (n=110)

Multicenter

Structured PICO

Does cardiovascular magnetic resonance with T2 mapping and deformation imaging distinguish athlete's heart from hypertrophic cardiomyopathy?

Population

110 participants including 42 patients with hypertrophic cardiomyopathy, 13 strength-trained athletes, and 55 matched healthy controls who underwent cardiovascular magnetic resonance imaging.

Exposure

Cardiovascular magnetic resonance (CMR) with T2 mapping and deformation imaging (feature tracking)

Comparator

Comparison between groups (HCM vs athlete's heart vs healthy controls)

Outcome

Discrimination of athlete's heart from hypertrophic cardiomyopathy using T2 values and global longitudinal strain (GLS)surrogate

Main Result

Effect estimate: AUC 0.78 for T2 values; AUC 0.91 for GLS

Multiparametric CMR incorporating T2 mapping and global longitudinal strain can help differentiate physiologic left ventricular hypertrophy in athletes from pathologic hypertrophy in hypertrophic cardiomyopathy.

Limitations

Single-center study with a small sample size, especially for the HNCM and athlete groups, which may hamper statistical analysis and introduce potential type II errors.
The CMR protocol did not include systematic T1 mapping.
Inability to control for performance-enhancing substance abuse by blood sampling.
Only male athletes were included in the study.
Lack of further testing such as catheterization to rule out other cardiovascular diseases with absolute certainty in the athlete group.

Cite This Study

Gastl et al. (2020) conducted an observational in Hypertrophic cardiomyopathy and Athlete's heart (n=110). Cardiovascular magnetic resonance with T2 mapping and feature tracking was evaluated on Discrimination of athlete's heart from hypertrophic cardiomyopathy (AUC 0.78 for T2 values; AUC 0.91 for GLS). Cardiovascular magnetic resonance with T2 mapping and global longitudinal strain accurately discriminated athlete's heart from hypertrophic cardiomyopathy with AUCs of 0.78 and 0.91, respectively.

synapsesocial.com/papers/6a1ea77b00756c160baf1ebe https://doi.org/10.1007/s00330-020-07289-4

Topics

Hypertrophic cardiomyopathy

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Cardiac magnetic resonance T2 mapping and feature tracking in athlete’s heart and HCM

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Cardiac magnetic resonance T2 mapping and feature tracking in athlete’s heart and HCM

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider