PMID- 19332846
OWN - NLM
STAT- MEDLINE
DCOM- 20090422
LR  - 20230120
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 251
IP  - 1
DP  - 2009 Apr
TI  - Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic 
      relevance in marathon runners.
PG  - 50-7
LID - 10.1148/radiol.2511081118 [doi]
AB  - PURPOSE: To prospectively analyze the myocardial distribution of late gadolinium 
      enhancement (LGE) with delayed-enhancement cardiac magnetic resonance (MR) 
      imaging, to compare the prevalence of this distribution in nonprofessional male 
      marathon runners with that in asymptomatic control subjects, and to examine the 
      prognostic role of LGE. MATERIALS AND METHODS: Institutional review board and 
      ethics committee approval were obtained for this study, and all subjects provided 
      written informed consent. Two-dimensional inversion-recovery segmented k-space 
      gradient-echo MR sequences were performed after administration of a 
      gadolinium-containing contrast agent in 102 ostensibly healthy male runners aged 
      50-72 years who had completed at least five marathons during the past 3 years and 
      in 102 age-matched control subjects. Predominantly subendocardial regions of LGE 
      typical of myocardial infarction (hereafter, coronary artery disease [CAD] 
      pattern) were distinguished from a predominantly midmyocardial patchy pattern of 
      LGE (hereafter, non-CAD pattern). Marathon runners with LGE underwent repeat 
      cardiac MR imaging and additional adenosine perfusion imaging. Runners were 
      followed up for a mean of 21 months +/- 3 (standard deviation) after initial 
      presentation. The chi(2), Fisher exact, and McNemar exact tests were used for 
      comparisons. Event-free survival rates were estimated with the Kaplan-Meier 
      method, and overall group differences were evaluated with log-rank statistics. 
      RESULTS: Of the 102 runners, five had a CAD pattern of LGE, and seven had a 
      non-CAD pattern of LGE. The CAD pattern of LGE was located in the territory of 
      the left anterior descending coronary artery more frequently than was the non-CAD 
      pattern (P = .0027, Fisher exact test). The prevalence of LGE in runners was 
      higher than that in age-matched control subjects (12% vs 4%; P = .077, McNemar 
      exact test). The event-free survival rate was lower in runners with myocardial 
      LGE than in those without myocardial LGE (P < .0001, log-rank test). CONCLUSION: 
      Ostensibly healthy marathon runners have an unexpectedly high rate of myocardial 
      LGE, and this may have diagnostic and prognostic relevance.
FAU - Breuckmann, Frank
AU  - Breuckmann F
AD  - Department of Cardiology, West German Heart Center Essen, Essen, Germany.
FAU - Mohlenkamp, Stefan
AU  - Mohlenkamp S
FAU - Nassenstein, Kai
AU  - Nassenstein K
FAU - Lehmann, Nils
AU  - Lehmann N
FAU - Ladd, Susanne
AU  - Ladd S
FAU - Schmermund, Axel
AU  - Schmermund A
FAU - Sievers, Burkhard
AU  - Sievers B
FAU - Schlosser, Thomas
AU  - Schlosser T
FAU - Jockel, Karl-Heinz
AU  - Jockel KH
FAU - Heusch, Gerd
AU  - Heusch G
FAU - Erbel, Raimund
AU  - Erbel R
FAU - Barkhausen, Jorg
AU  - Barkhausen J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - Radiology. 2009 Apr;251(1):3-5. PMID: 19332839
MH  - Aged
MH  - Causality
MH  - Comorbidity
MH  - Coronary Artery Disease/*diagnosis/*epidemiology
MH  - *Gadolinium
MH  - Germany/epidemiology
MH  - Humans
MH  - Incidence
MH  - Magnetic Resonance Imaging/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Physical Endurance
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Running/*statistics & numerical data
MH  - Sensitivity and Specificity
MH  - Ventricular Dysfunction, Left/*diagnosis/*epidemiology
EDAT- 2009/04/01 09:00
MHDA- 2009/04/23 09:00
CRDT- 2009/04/01 09:00
PHST- 2009/04/01 09:00 [entrez]
PHST- 2009/04/01 09:00 [pubmed]
PHST- 2009/04/23 09:00 [medline]
AID - 251/1/50 [pii]
AID - 10.1148/radiol.2511081118 [doi]
PST - ppublish
SO  - Radiology. 2009 Apr;251(1):50-7. doi: 10.1148/radiol.2511081118.