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CMR normative reference values of biventricular size and function in athlete's heart

Session New insights into pathophysiology and improved diagnosis and prognosis

Speaker Assistant Professor Flavio D'Ascenzi

Event : EuroEcho 2018

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance
  • Session type : Rapid Fire Abstracts

Authors : F D'ascenzi (Siena,IT), F Anselmi (Siena,IT), P Piu (Siena,IT), C Fiorentini Naccari (Siena,IT), M Cameli (Siena,IT), M Focardi (Siena,IT), M Bonifazi (Siena,IT), S Mondillo (Siena,IT)

Authors:
F D'ascenzi1 , F Anselmi1 , P Piu2 , C Fiorentini Naccari1 , M Cameli1 , M Focardi1 , M Bonifazi2 , S Mondillo1 , 1University of Siena, Department of Medical Biotechnologies, Division of Cardiology - Siena - Italy , 2University of Siena, Department of Medicine, Surgery, and Neuroscience - Siena - Italy ,

Citation:
European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 1 ), i790

Background. Exercise-induced enlargement of cardiac chambers is commonly observed in competitive athletes. Unfortunately, ventricular dilatation is also a common phenotypic expression of life-threatening cardiomyopathies. The use of cardiac magnetic resonance (CMR) for the exclusion of pathology is growing. However, normative reference values have not been established for athletes. 
Objectives. The aim of this meta-analysis was to derive normative reference values of biventricular size and function estimated by CMR in competitive athletes. 
Methods. We conducted a systematic review of English-language studies in MEDLINE, Scopus, and Cochrane databases investigating biventricular size and function by CMR in athletes. Athletes were divided in endurance, combined and mixed according to the sport practised. The potential impact of training volume was also evaluated. 
Results. Twenty-seven studies and 983 competitive athletes were included for CMR quantification of biventricular size and function. In this review we present normal reference values for biventricular size and function to be applied in male competitive athletes according to the disciplines practised. A significant impact of training volume was demonstrated for the RV: athletes practicing the highest amount of training hours per week were those exhibiting the greatest degree of RV remodeling (Figure 1). Notably, biventricular function was not significantly affected by training volume. 
Conclusions. The present meta-analysis defines the normative limits of biventricular size and function estimated by CMR in competitive athletes. We suggest using these normative reference values as an alternative to standard upper limits used for the general population in order to appropriately interpreting CMR analysis in competitive athletes.

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