Open Access

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

  • Authors:
    • George Markousis‑Mavrogenis
    • Aikaterini Giannakopoulou
    • Nikolaos Andreou
    • George Papadopoulos
    • Vasiliki Vartela
    • Genovefa Kolovou
    • Flora Bacopoulou
    • Konstantinos Tsarouhas
    • Christina Kanaka‑Gantenbein
    • Demetrios A. Spandidos
    • Sophie I. Mavrogeni
  • View Affiliations

  • Published online on: April 29, 2020     https://doi.org/10.3892/etm.2020.8693
  • Pages: 561-571
  • Copyright: © Markousis‑Mavrogenis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

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.
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July-2020
Volume 20 Issue 1

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Online ISSN:1792-1015

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Spandidos Publications style
Markousis‑Mavrogenis G, Giannakopoulou A, Andreou N, Papadopoulos G, Vartela V, Kolovou G, Bacopoulou F, Tsarouhas K, Kanaka‑Gantenbein C, Spandidos DA, Spandidos DA, et al: Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation. Exp Ther Med 20: 561-571, 2020
APA
Markousis‑Mavrogenis, G., Giannakopoulou, A., Andreou, N., Papadopoulos, G., Vartela, V., Kolovou, G. ... Mavrogeni, S.I. (2020). Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation. Experimental and Therapeutic Medicine, 20, 561-571. https://doi.org/10.3892/etm.2020.8693
MLA
Markousis‑Mavrogenis, G., Giannakopoulou, A., Andreou, N., Papadopoulos, G., Vartela, V., Kolovou, G., Bacopoulou, F., Tsarouhas, K., Kanaka‑Gantenbein, C., Spandidos, D. A., Mavrogeni, S. I."Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation". Experimental and Therapeutic Medicine 20.1 (2020): 561-571.
Chicago
Markousis‑Mavrogenis, G., Giannakopoulou, A., Andreou, N., Papadopoulos, G., Vartela, V., Kolovou, G., Bacopoulou, F., Tsarouhas, K., Kanaka‑Gantenbein, C., Spandidos, D. A., Mavrogeni, S. I."Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation". Experimental and Therapeutic Medicine 20, no. 1 (2020): 561-571. https://doi.org/10.3892/etm.2020.8693