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Claessen G, De Bosscher R, Janssens K, Young P, Dausin C, Claeys M, Claus P, Goetschalckx K, Bogaert J, Mitchell AM, Flannery MD, Elliott AD, Yu C, Ghekiere O, Robyns T, Van De Heyning CM, Sanders P, Kalman JM, Ohanian M, Soka M, Rath E, Giannoulatou E, Johnson R, Lacaze P, Herbots L, Willems R, Fatkin D, Heidbuchel H, La Gerche A. Reduced Ejection Fraction in Elite Endurance Athletes: Clinical and Genetic Overlap With Dilated Cardiomyopathy. Circulation 2024; 149:1405-1415. [PMID: 38109351 PMCID: PMC11062611 DOI: 10.1161/circulationaha.122.063777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 10/30/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Exercise-induced cardiac remodeling can be profound, resulting in clinical overlap with dilated cardiomyopathy, yet the significance of reduced ejection fraction (EF) in athletes is unclear. The aim is to assess the prevalence, clinical consequences, and genetic predisposition of reduced EF in athletes. METHODS Young endurance athletes were recruited from elite training programs and underwent comprehensive cardiac phenotyping and genetic testing. Those with reduced EF using cardiac magnetic resonance imaging (defined as left ventricular EF <50%, or right ventricular EF <45%, or both) were compared with athletes with normal EF. A validated polygenic risk score for indexed left ventricular end-systolic volume (LVESVi-PRS), previously associated with dilated cardiomyopathy, was assessed. Clinical events were recorded over a mean of 4.4 years. RESULTS Of the 281 elite endurance athletes (22±8 years, 79.7% male) undergoing comprehensive assessment, 44 of 281 (15.7%) had reduced left ventricular EF (N=12; 4.3%), right ventricular EF (N=14; 5.0%), or both (N=18; 6.4%). Reduced EF was associated with a higher burden of ventricular premature beats (13.6% versus 3.8% with >100 ventricular premature beats/24 h; P=0.008) and lower left ventricular global longitudinal strain (-17%±2% versus -19%±2%; P<0.001). Athletes with reduced EF had a higher mean LVESVi-PRS (0.57±0.13 versus 0.51±0.14; P=0.009) with athletes in the top decile of LVESVi-PRS having an 11-fold increase in the likelihood of reduced EF compared with those in the bottom decile (P=0.034). Male sex and higher LVESVi-PRS were the only significant predictors of reduced EF in a multivariate analysis that included age and fitness. During follow-up, no athletes developed symptomatic heart failure or arrhythmias. Two athletes died, 1 from trauma and 1 from sudden cardiac death, the latter having a reduced right ventricular EF and a LVESVi-PRS >95%. CONCLUSIONS Reduced EF occurs in approximately 1 in 6 elite endurance athletes and is related to genetic predisposition in addition to exercise training. Genetic and imaging markers may help identify endurance athletes in whom scrutiny about long-term clinical outcomes may be appropriate. REGISTRATION URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374976&isReview=true; Unique identifier: ACTRN12618000716268.
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Affiliation(s)
- Guido Claessen
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center (LCRC), Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium (G.C., O.G., L.H.)
- Hartcentrum Hasselt (G.C., L.H.), KU Leuven, Belgium
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
| | - Ruben De Bosscher
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
- Department of Cardiovascular Diseases (R.D.B., K.G., T.R., R.W.), University Hospitals Leuven, Belgium
| | - Kristel Janssens
- HEART (Heart Exercise and Research Trials) Lab, St Vincent’s Institute of Medical Research, Fitzroy, Australia (K.J., A.M.M., A.L.G.)
- Exercise and Nutrition Research Program, The Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne Australia (K.J.)
| | - Paul Young
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
| | | | - Mathias Claeys
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
| | - Piet Claus
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
| | - Kaatje Goetschalckx
- Department of Cardiovascular Diseases (R.D.B., K.G., T.R., R.W.), University Hospitals Leuven, Belgium
| | - Jan Bogaert
- Department of Imaging and Pathology (J.B.), KU Leuven, Belgium
- Department of Radiology (J.B.), University Hospitals Leuven, Belgium
| | - Amy M. Mitchell
- HEART (Heart Exercise and Research Trials) Lab, St Vincent’s Institute of Medical Research, Fitzroy, Australia (K.J., A.M.M., A.L.G.)
| | - Michael D. Flannery
- Department of Medicine, University of Melbourne, Parkville, Australia (M.D.F., J.M.K., A.L.G.)
| | - Adrian D. Elliott
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Australia (A.D.E., P.S.)
| | - Chenglong Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (C.Y., P.L.)
| | - Olivier Ghekiere
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center (LCRC), Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium (G.C., O.G., L.H.)
- Department of Radiology (O.G.), KU Leuven, Belgium
| | - Tomas Robyns
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
- Department of Cardiovascular Diseases (R.D.B., K.G., T.R., R.W.), University Hospitals Leuven, Belgium
| | - Caroline M. Van De Heyning
- Department of Cardiovascular Sciences, University of Antwerp, Belgium (C.M.V.D.H., H.H.)
- Department of Cardiology, University Hospital Antwerp, Belgium (C.M.V.D.H., H.H.)
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Australia (A.D.E., P.S.)
| | - Jonathan M. Kalman
- Department of Medicine, University of Melbourne, Parkville, Australia (M.D.F., J.M.K., A.L.G.)
- Department of Cardiology, Royal Melbourne Hospital, Australia (J.M.K.)
| | - Monique Ohanian
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
| | - Magdalena Soka
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
| | - Emma Rath
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
| | - Eleni Giannoulatou
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
| | - Renee Johnson
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia (R.J., D.F.)
| | - Paul Lacaze
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (C.Y., P.L.)
| | - Lieven Herbots
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center (LCRC), Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium (G.C., O.G., L.H.)
- Hartcentrum Hasselt (G.C., L.H.), KU Leuven, Belgium
| | - Rik Willems
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
- Department of Cardiovascular Diseases (R.D.B., K.G., T.R., R.W.), University Hospitals Leuven, Belgium
| | - Diane Fatkin
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia (R.J., D.F.)
- Cardiology Department, St Vincent’s Hospital, Darlinghurst, Australia (D.F.)
| | - Hein Heidbuchel
- Department of Cardiovascular Sciences, University of Antwerp, Belgium (C.M.V.D.H., H.H.)
- Department of Cardiology, University Hospital Antwerp, Belgium (C.M.V.D.H., H.H.)
| | - André La Gerche
- Jessa Ziekenhuis, Belgium. Department of Cardiovascular Sciences (G.C., R.D.B., M.C., P.C., T.R., R.W., A.L.G.), KU Leuven, Belgium
- HEART (Heart Exercise and Research Trials) Lab, St Vincent’s Institute of Medical Research, Fitzroy, Australia (K.J., A.M.M., A.L.G.)
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia (P.Y., M.O., M.S., E.R., E.G., R.J., D.F., A.L.G.)
- Department of Medicine, University of Melbourne, Parkville, Australia (M.D.F., J.M.K., A.L.G.)
- Cardiology Department, St Vincent’s Hospital Melbourne, Fitzroy, Australia (A.L.G.)
- National Centre for Sports Cardiology, Fitzroy, Australia (A.L.G.)
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Van Oeteren I, Achten R, Ghekiere O, Koopman P, Van Leuven O, Timmermans PJ. Hidden in plain sight: complex tachycardias in a young thalassaemia patient. Acta Cardiol 2023; 78:1057-1060. [PMID: 37318083 DOI: 10.1080/00015385.2023.2223014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/10/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Affiliation(s)
| | | | | | | | - O Van Leuven
- Universitair Ziekenhuis Antwerpen (UZA), Belgium
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Ghekiere O, Herbots L, Peters B, Berg BV, Dresselaers T, Franssen W, Padovani B, Ducreux D, Ferrari E, Nchimi A, Demanez S, De Bosscher R, Willems R, Heidbuchel H, La Gerche A, Claessen G, Bogaert J, Eijnde BO. Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study. Eur J Appl Physiol 2023; 123:2107-2117. [PMID: 37480391 PMCID: PMC10492712 DOI: 10.1007/s00421-023-05259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Although cardiac troponin I (cTnI) increase following strenuous exercise has been observed, the development of exercise-induced myocardial edema remains unclear. Cardiac magnetic resonance (CMR) native T1/T2 mapping is sensitive to the pathological increase of myocardial water content. Therefore, we evaluated exercise-induced acute myocardial changes in recreational cyclists by incorporating biomarkers, echocardiography and CMR. METHODS Nineteen male recreational participants (age: 48 ± 5 years) cycled the 'L'étape du tour de France" (EDT) 2021' (175 km, 3600 altimeters). One week before the race, a maximal graded cycling test was conducted to determine individual heart rate (HR) training zones. One day before and 3-6 h post-exercise 3 T CMR and echocardiography were performed to assess myocardial native T1/T2 relaxation times and cardiac function, and blood samples were collected. All participants were asked to cycle 2 h around their anaerobic gas exchange threshold (HR zone 4). RESULTS Eighteen participants completed the EDT stage in 537 ± 58 min, including 154 ± 61 min of cycling time in HR zone 4. Post-race right ventricular (RV) dysfunction with reduced strain and increased volumes (p < 0.05) and borderline significant left ventricular global longitudinal strain reduction (p = 0.05) were observed. Post-exercise cTnI (0.75 ± 5.1 ng/l to 69.9 ± 41.6 ng/l; p < 0.001) and T1 relaxation times (1133 ± 48 ms to 1182 ± 46 ms, p < 0.001) increased significantly with no significant change in T2 (p = 0.474). cTnI release correlated with increase in T1 relaxation time (p = 0.002; r = 0.703), post-race RV dysfunction (p < 0.05; r = 0.562) and longer cycling in HR zone 4 (p < 0.05; r = 0.607). CONCLUSION Strenuous exercise causes early post-race cTnI increase, increased T1 relaxation time and RV dysfunction in recreational cyclists, which showed interdependent correlation. The long-term clinical significance of these changes needs further investigation. TRIAL REGISTRATION NUMBERS AND DATE NCT04940650 06/18/2021. NCT05138003 06/18/2021.
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Affiliation(s)
- Olivier Ghekiere
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium.
- Department of Radiology and Department of Jessa & Science, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
| | - Lieven Herbots
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Heart Centre, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Benjamin Peters
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Department of Radiology and Department of Jessa & Science, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | | | - Tom Dresselaers
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Wouter Franssen
- SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Nutrition and Movement Sciences; NUTRIM, School for Nutrition and Translation Research Maastricht, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | | | - Emile Ferrari
- Department of Cardiology, University Hospital Nice, Nice, France
| | - Alain Nchimi
- Department of Radiology, Centre Hospitalier Universitaire Luxembourg, Luxembourg, Luxembourg
| | - Sophie Demanez
- Department of Cardiology, Centre Cardiologique Orban, Liège, Belgium
| | - Ruben De Bosscher
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Rik Willems
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Andre La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Guido Claessen
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Heart Centre, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Bert O Eijnde
- SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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De Bosscher R, Dausin C, Claus P, Bogaert J, Dymarkowski S, Goetschalckx K, Ghekiere O, Van De Heyning CM, Van Herck P, Paelinck B, Addouli HE, La Gerche A, Herbots L, Willems R, Heidbuchel H, Claessen G, Claeys M, Hespel P, Dresselaers T, Miljoen H, Belmans A, Favere K, Vermeulen D, Witvrouwen I, Hansen D, Eijnde BO, Thijs D, Vanvoorden P, Van Soest S. Lifelong endurance exercise and its relation with coronary atherosclerosis. Eur Heart J 2023; 44:2388-2399. [PMID: 36881712 PMCID: PMC10327878 DOI: 10.1093/eurheartj/ehad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
AIMS The impact of long-term endurance sport participation (on top of a healthy lifestyle) on coronary atherosclerosis and acute cardiac events remains controversial. METHODS AND RESULTS The Master@Heart study is a well-balanced prospective observational cohort study. Overall, 191 lifelong master endurance athletes, 191 late-onset athletes (endurance sports initiation after 30 years of age), and 176 healthy non-athletes, all male with a low cardiovascular risk profile, were included. Peak oxygen uptake quantified fitness. The primary endpoint was the prevalence of coronary plaques (calcified, mixed, and non-calcified) on computed tomography coronary angiography. Analyses were corrected for multiple cardiovascular risk factors. The median age was 55 (50-60) years in all groups. Lifelong and late-onset athletes had higher peak oxygen uptake than non-athletes [159 (143-177) vs. 155 (138-169) vs. 122 (108-138) % predicted]. Lifelong endurance sports was associated with having ≥1 coronary plaque [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.17-2.94], ≥ 1 proximal plaque (OR 1.96, 95% CI 1.24-3.11), ≥ 1 calcified plaques (OR 1.58, 95% CI 1.01-2.49), ≥ 1 calcified proximal plaque (OR 2.07, 95% CI 1.28-3.35), ≥ 1 non-calcified plaque (OR 1.95, 95% CI 1.12-3.40), ≥ 1 non-calcified proximal plaque (OR 2.80, 95% CI 1.39-5.65), and ≥1 mixed plaque (OR 1.78, 95% CI 1.06-2.99) as compared to a healthy non-athletic lifestyle. CONCLUSION Lifelong endurance sport participation is not associated with a more favourable coronary plaque composition compared to a healthy lifestyle. Lifelong endurance athletes had more coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile. Longitudinal research is needed to reconcile these findings with the risk of cardiovascular events at the higher end of the endurance exercise spectrum.
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Affiliation(s)
- Ruben De Bosscher
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Christophe Dausin
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Bogaert
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Steven Dymarkowski
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kaatje Goetschalckx
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Olivier Ghekiere
- Division of Radiology, Jessa Ziekenhuis, Stadsomvaat 11, 3500 Hasselt, Belgium
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Caroline M Van De Heyning
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Paul Van Herck
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Bernard Paelinck
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Haroun El Addouli
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Lieven Herbots
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- Division of Cardiology, Hartcentrum, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hein Heidbuchel
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- Department of Cardiology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
- Division of Cardiology, Hartcentrum, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Mathias Claeys
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter Hespel
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Tom Dresselaers
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hielko Miljoen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Ann Belmans
- I-BioStat, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kasper Favere
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Dorien Vermeulen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Isabel Witvrouwen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Dominique Hansen
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- REVAL/BIOMED, Hasselt University, Agoralaan Gebouw C, 3590 Diepenbeek, Belgium
| | - Bert Op’t Eijnde
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- REVAL/BIOMED, Hasselt University, Agoralaan Gebouw C, 3590 Diepenbeek, Belgium
| | - Daisy Thijs
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Peter Vanvoorden
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Sofie Van Soest
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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De Bosscher R, Claeys M, Dausin C, Goetschalckx K, Claus P, Herbots L, Ghekiere O, Van De Heyning C, Paelinck BP, Janssens K, Wright L, Flannery MD, La Gerche A, Willems R, Heidbuchel H, Bogaert J, Claessen G. Three-dimensional echocardiography of the athlete's heart: a comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2023; 39:295-306. [PMID: 36151432 DOI: 10.1007/s10554-022-02726-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/03/2022] [Indexed: 01/28/2023]
Abstract
Three-dimensional echocardiography (3DE) is the most accurate cardiac ultrasound technique to assess cardiac structure. 3DE has shown close correlation with cardiac magnetic resonance imaging (CMR) in various populations. There is limited data on the accuracy of 3DE in athletes and its value in detecting alterations during follow-up. Indexed left and right ventricular end-diastolic volume (LVEDVi, RVEDVi), end-systolic volume, ejection fraction (LVEF, RVEF) and left ventricular mass (LVMi) were assessed by 3DE and CMR in two-hundred and one competitive endurance athletes (79% male) from the Pro@Heart trial. Sixty-four athletes were assessed at 2 year follow-up. Linear regression and Bland-Altman analyses compared 3DE and CMR at baseline and follow-up. Interquartile analysis evaluated the agreement as cardiac volumes and mass increase. 3DE showed strong correlation with CMR (LVEDVi r = 0.91, LVEF r = 0.85, LVMi r = 0.84, RVEDVi r = 0.84, RVEF r = 0.86 p < 0.001). At follow up, the percentage change by 3DE and CMR were similar (∆LVEDVi r = 0.96 bias - 0.3%, ∆LVEF r = 0.94, bias 0.7%, ∆LVMi r = 0.94 bias 0.8%, ∆RVESVi r = 0.93, bias 1.2%, ∆RVEF r = 0.87 bias 0.4%). 3DE underestimated volumes (LVEDVi bias - 18.5 mL/m2, RVEDVi bias - 25.5 mL/m2) and the degree of underestimation increased with larger dimensions (Q1vsQ4 LVEDVi relative bias - 14.5 versus - 17.4%, p = 0.016; Q1vsQ4 RVEDVi relative bias - 17 versus - 21.9%, p = 0.005). Measurements of cardiac volumes, mass and function by 3DE correlate well with CMR and 3DE accurately detects changes over time. 3DE underestimates volumes and the relative bias increases with larger cardiac size.
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Affiliation(s)
- Ruben De Bosscher
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. .,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. .,Department of Cardiovascular Medicine, University Hospitals Leuven, B-3000, Leuven, Belgium.
| | - Mathias Claeys
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Lieven Herbots
- Department of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.,REVAL/BIOMED, Hasselt University, Diepenbeek, Belgium
| | - Olivier Ghekiere
- REVAL/BIOMED, Hasselt University, Diepenbeek, Belgium.,Department of Radiology, Jessa Ziekenhuis, Hasselt, Belgium
| | - Caroline Van De Heyning
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Bernard P Paelinck
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Kristel Janssens
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Leah Wright
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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6
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De Bosscher R, Janssens K, Dausin C, Goetschalckx K, Bogaert J, Ghekiere O, Van De Heyning C, Elliott A, Sanders P, Kalman J, Herbots L, Willems R, Heidbuchel H, La Gerche A, Claessen G. The prevalence and clinical significance of a reduced ventricular ejection fraction in asymptomatic young elite endurance athletes. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council of Australia
Background
Ventricular ejection fraction (EF) is the most widely used parameter to evaluate ventricular systolic function. Endurance athletes presenting with a reduced ventricular EF often raise the question of an underlying dilated or arrhythmogenic cardiomyopathy. The clinical significance of a reduced EF in athletes remains to be elucidated.
Purpose
To investigate the prevalence and clinical significance of a reduced EF in asymptomatic endurance athletes.
Methods
Two hundred eighteen asymptomatic young elite endurance athletes were evaluated at baseline. Cardiac magnetic resonance imaging (CMR) was performed to assess cardiac volumes, left ventricular and right ventricular EF (LVEF and RVEF), mass and fibrosis. Athletes with reduced EF (ATrEF) were defined as those having LVEF<50% and/or RVEF<45%. Ventricular systolic and diastolic function were assessed by trans-thoracic echocardiography. A 12-lead ECG and 24-hour holtermonitoring assessed electrical alterations and arrhythmias. In 145 athletes, LV and RV contractile reserve was evaluated by exercise CMR. Cardiopulmonary testing was performed in all athletes to measure maximal oxygen uptake (VO2max).
Results
Thirty-one ATrEF (14.2%) were compared to 187 athletes with a preserved EF (ATpEF). ATrEF were more frequently males (93 vs 77% male, p=0.033) but did not differ from ATpEF with regard to age (18.8±2.1 vs 18.3±2.1 years, p=0.25). Ten athletes had an isolated reduced LVEF, 10 had an isolated reduced RVEF and 11 had both a reduced LVEF and RVEF. ATrEF had similar end-diastolic volumes and cardiac mass but differed by higher end-systolic volumes.
Peak exercise LVEF and RVEF determined by exercise CMR remained lower in ATrEF (68±3 vs 73±4% and 62±6 vs 69±5%, p<0.001) but contractile reserve was greater (ΔLVEF 18±5 vs 14±4% and ΔRVEF 19±5 vs 15±5%, p<0.01).
A reduced EF was not associated with lower exercise capacity, in fact VO2max was higher in ATrEF than in ATpEF (65±6 vs 62±9mL/kg/min, p=0.020) and the percentage of predicted VO2max by the Wasserman equation were similar (151±14 vs 149±21%, p=0.533).
Fibrosis was present in 3 ATrEF and 18 ATpEF (9.7 vs 9.6%, p=0.993) and was isolated to the RV hinge-points in all but 3 ATpEF who had midmyocardial LV lateral wall fibrosis. LV systolic strain (-17.5±2.0 vs -19±2.1%, p<0.001) was lower in ATrEF whereas RV free wall systolic strain (-24.9±3.7 vs -25.1±3.5%, p=0.776) was similar. Diastolic function was normal in all ATrEF and ATpEF. Pathologic T-wave inversions were present in 2 ATrEF and 13 ATpEF (6.5 vs 7%, p=0.999). Ventricular premature beats (VPB) were infrequent but more prevalent in ATrEF than in ATpEF (2[0-18] vs 1[0-2]/24h, p=0.025; 16.1 vs 2.7% >100/24h, p=0.006).
Conclusion
A reduced ventricular EF is common in asymptomatic young elite endurance athletes, is more frequent in males but is not associated with structural, functional or electrical abnormalities apart from a minor excess in VPB.
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Affiliation(s)
- R De Bosscher
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - K Janssens
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - C Dausin
- University of Leuven, Movement Sciences, Leuven, Belgium
| | - K Goetschalckx
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - J Bogaert
- University Hospitals (UZ) Leuven, Radiology, Leuven, Belgium
| | - O Ghekiere
- Virga Jesse Hospital, Radiology, Hasselt, Belgium
| | | | - A Elliott
- Royal Adelaide Hospital, Cardiology, Adelaide, Australia
| | - P Sanders
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - J Kalman
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - L Herbots
- Virga Jesse Hospital, Cardiology, Hasselt, Belgium
| | - R Willems
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - A La Gerche
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - G Claessen
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
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7
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Berton L, Van Ballaer V, Ghekiere O, De Caluwé E. Primary cardiac diffuse large B-cell lymphoma presenting with cardiac tamponade: a case report. Eur Heart J Case Rep 2022; 6:ytac151. [PMID: 35528120 PMCID: PMC9071390 DOI: 10.1093/ehjcr/ytac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/09/2021] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Primary cardiac tumours are extremely rare with an autopsy incidence of 0.05%. They can present with a variety of symptoms, including life-threatening arrhythmia and cardiac tamponade. In this case report, we focus on the diagnostic process and management of a primary cardiac lymphoma (PCL) presenting with cardiac tamponade. CASE SUMMARY We report on a 71-year-old male presenting with a large pericardial effusion, tamponade, and a mass in the right atrioventricular groove. Multimodality imaging was performed, including transthoracic echocardiography, computed tomography, magnetic resonance imaging, positron emission tomography, and computed tomography-guided transthoracic biopsy. The final diagnosis of a double-hit diffuse large-cell B-cell lymphoma was made, for which treatment consisting of a combination of chemotherapy and immunotherapy was initiated. Low-dose colchicine was also added to the treatment. DISCUSSION Primary cardiac lymphoma remains a very rare diagnosis and this case highlights the need for multimodality imaging and imaging-guided biopsy to differentiate cardiac masses. First-line treatment for PCL remains a combination of chemotherapy with immunotherapy, with the addition of low-dose colchicine to prevent recurrence of malignant pericardial effusion.
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Affiliation(s)
| | | | - Olivier Ghekiere
- Department of Radiology, Jessa Hospital, 3500 Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Cardiology and Organ systems, Hasselt University, 3500 Hasselt, Belgium
| | - Eva De Caluwé
- Department of Cardiology, Sint-Trudo Hospital, 3800 Sint-Truiden, Belgium
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8
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De Bosscher R, Dausin C, Janssens K, Bogaert J, Elliott A, Ghekiere O, Van De Heyning CM, Sanders P, Kalman J, Fatkin D, Herbots L, Willems R, Heidbuchel H, La Gerche A, Claessen G. Rationale and design of the PROspective ATHletic Heart (Pro@Heart) study: long-term assessment of the determinants of cardiac remodelling and its clinical consequences in endurance athletes. BMJ Open Sport Exerc Med 2022; 8:e001309. [PMID: 35368514 PMCID: PMC8935177 DOI: 10.1136/bmjsem-2022-001309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 12/25/2022] Open
Abstract
Background Exercise-induced cardiac remodelling (EICR) results from the structural, functional and electrical adaptations to exercise. Despite similar sports participation, EICR varies and some athletes develop phenotypic features that overlap with cardiomyopathies. Training load and genotype may explain some of the variation; however, exercise ‘dose’ has lacked rigorous quantification. Few have investigated the association between EICR and genotype. Objectives (1) To identify the impact of training load and genotype on the variance of EICR in elite endurance athletes and (2) determine how EICR and its determinants are associated with physical performance, health benefits and cardiac pathology. Methods The Pro@Heart study is a multicentre prospective cohort trial. Three hundred elite endurance athletes aged 14–23 years will have comprehensive cardiovascular phenotyping using echocardiography, cardiac MRI, 12-lead ECG, exercise-ECG and 24-hour-Holter monitoring. Genotype will be determined using a custom cardiomyopathy gene panel and high-density single-nucleotide polymorphism arrays. Follow-up will include online tracking of training load. Cardiac phenotyping will be repeated at 2, 5, 10 and 20 years. Results The primary endpoint of the Pro@Heart study is the association of EICR with both training load and genotype. The latter will include rare variants in cardiomyopathy-associated genes and polygenic risk scores for cardiovascular traits. Secondary endpoints are the incidence of atrial and ventricular arrhythmias, physical performance and health benefits and their association with training load and genotype. Conclusion The Pro@Heart study is the first long-term cohort study to assess the impact of training load and genotype on EICR. Trial registration number NCT05164328; ACTRN12618000716268.
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Affiliation(s)
- Ruben De Bosscher
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | | | - Kristel Janssens
- Cardiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jan Bogaert
- Radiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Adrian Elliott
- Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia
| | - Olivier Ghekiere
- Cardiology, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Cardivacsular Sciences, University Hasselt Biomedical Research Institute Rehabilitation Research Center, Diepenbeek, Belgium
| | - Caroline M Van De Heyning
- Cardiology, University of Antwerp, Antwerpen, Belgium.,Cardiovascular Sciences, University Hospital Antwerp, Edegem, Belgium
| | - Prashanthan Sanders
- Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Kalman
- Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Diane Fatkin
- Inherited Heart Diseases, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Lieven Herbots
- Cardiology, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Cardivacsular Sciences, University Hasselt Biomedical Research Institute Rehabilitation Research Center, Diepenbeek, Belgium
| | - Rik Willems
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Cardiology, University Hospital Antwerp, Edegem, Belgium.,Cardiovascular Sciences, University of Antwerp, Antwerpen, Belgium
| | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Guido Claessen
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
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9
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De Bosscher R, Dausin C, Claus P, Bogaert J, Dymarkowski S, Goetschalckx K, Ghekiere O, Belmans A, Van De Heyning CM, Van Herck P, Paelinck B, El Addouli H, La Gerche A, Herbots L, Heidbuchel H, Willems R, Claessen G. Endurance exercise and the risk of cardiovascular pathology in men: a comparison between lifelong and late-onset endurance training and a non-athletic lifestyle - rationale and design of the Master@Heart study, a prospective cohort trial. BMJ Open Sport Exerc Med 2021; 7:e001048. [PMID: 33927885 PMCID: PMC8055127 DOI: 10.1136/bmjsem-2021-001048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 01/14/2023] Open
Abstract
Introduction Low and moderate endurance exercise is associated with better control of cardiovascular risk factors, a decreased risk of coronary artery disease and atrial fibrillation (AF). There is, however, a growing proportion of individuals regularly performing strenuous and prolonged endurance exercise in which the health benefits have been challenged. Higher doses of endurance exercise have been associated with a greater coronary atherosclerotic plaque burden, risk of AF and myocardial fibrosis (MF). Methods and analysis Master@Heart is a multicentre prospective cohort study aiming to assess the incidence of coronary atherosclerosis, AF and MF in lifelong endurance athletes compared to late-onset endurance athletes (initiation of regular endurance exercise after the age of 30 years) and healthy non-athletes. The primary endpoint is the incidence of mixed coronary plaques. Secondary endpoints include coronary calcium scores, coronary stenosis >50%, the prevalence of calcified and soft plaques and AF and MF presence. Tertiary endpoints include ventricular arrhythmias, left and right ventricular function at rest and during exercise, arterial stiffness and carotid artery intima media thickness. Two hundred male lifelong athletes, 200 late-onset athletes and 200 healthy non-athletes aged 45–70 will undergo comprehensive cardiovascular phenotyping using CT, coronary angiography, echocardiography, cardiac MRI, 12-lead ECG, exercise ECG and 24-hour Holter monitoring at baseline. Follow-up will include online tracking of sports activities, telephone calls to assess clinical events and a 7-day ECG recording after 1 year. Ethics and dissemination Local ethics committees approved the Master@Heart study. The trial was launched on 18 October 2018, recruitment is complete and inclusions are ongoing. Trial registration number NCT03711539.
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Affiliation(s)
- Ruben De Bosscher
- Cardiovascular Sciences, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Christophe Dausin
- Movement Sciences, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
| | - Piet Claus
- Cardiovascular Sciences, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Jan Bogaert
- Radiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Steven Dymarkowski
- Radiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Kaatje Goetschalckx
- Cardiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Olivier Ghekiere
- Radiology, Jessa Ziekenhuis Campus Virga Jesse, Hasselt, Limburg, Belgium
| | - Ann Belmans
- Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Flanders, Belgium
| | | | - Paul Van Herck
- Cardiology, University Hospital Antwerp, Edegem, Belgium
| | | | | | - André La Gerche
- Cardiology, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Lieven Herbots
- Cardiology, Jessa Ziekenhuis Campus Virga Jesse, Hasselt, Limburg, Belgium
| | | | - Rik Willems
- Cardiovascular Sciences, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Guido Claessen
- Cardiovascular Sciences, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
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10
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De Bosscher R, Claeys M, Dausin C, Goetschalckx K, Bogaert J, Van De Heyning C, Ghekiere O, Herbots L, Claus P, Kalman J, Sanders P, Elliott A, Heidbuchel H, La Gerche A, Claessen G. Hinge point fibrosis in athletes is not associated with structural, functional or electrical consequences: a comparison between young and middle-aged elite endurance athletes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The health benefits of extensive endurance training have been debated due to the report of myocardial fibrosis (MF), arrhythmias and temporary post-race cardiac impairment in middle-aged and veteran athletes. The extent of these changes is unknown in elite young athletes.
Purpose
To assess the prevalence of MF and its structural, functional and electrical impact in highly trained young endurance athletes (YA, 15–23 years) as compared to middle-aged athletes (MA, 30–50 years). We hypothesised that MF would be more frequent in MA and associated with more structural, functional and electrical abnormalities.
Methods
We prospectively assessed 197 YA and 34 MA. All had ECG, maximal oxygen consumption (VO2max) testing, cardiac magnetic resonance imaging (CMR), echocardiography and 24h-holter. Indexed left ventricular and right ventricular end diastolic volume (LVEDVi, RVEDVi), ejection fraction (LVEF, RVEF), left ventricular mass (LVMi), and MF defined as delayed gadolinium enhancement were assessed by CMR. LV and RV free wall strain (LVSL, RVfwSL) were assessed by 2D speckle tracking echocardiography. Ventricular premature beats (VPB) and non-sustained ventricular tachycardia (nsVT) were assessed by 24h-holter.
Results
YA and MA (18±2 vs 38±5 years [p<0.01]; 78% vs 80% male [p=0.99]) with an elite level of fitness (VO2max 61±8 vs 54±10 mL/min/kg [p<0.01]; % predicted VO2max 150±20 vs 158±30 [p=0.02]) had a large variance in LV and RV remodelling (Figure 1). MF was seen in 28 athletes (12.5%) and more prevalent in MA than in YA (23.5 vs 10.5%, p=0.048). MF was limited to the hinge points in all 8 MA with MF and 17 YA. 3 YA had LV lateral wall subepicardial MF. 27 of 187 (14.4%) male athletes had MF compared to 1 of 50 (2%) female athletes (p=0.01).
MF+ MA(A) and YA(B) as well as MF− MA(C) and YA(D) had similar structural remodelling (LVEDVi 110±14 vs 118±14 vs 113±19 vs 110±16 mL/m2; RVEDVi 120±14 vs 128±17 vs 117±19 vs 125±23mL/m2; LVMi 77±11 vs 83±14 vs 81±14 vs 77±15g/m2, p>0.05). LVEF, LVSL and RVSL were similar (59±3 vs 58±5 vs 61±6 vs 58±6%; −18.8±2 vs −18.8±2 vs −19.8±2 vs −19.3±2%; −26.3±2.4 vs −24.4±2.4; −26.3±3 vs −25.8±3.5% respectively, p>0.05). LVEF <50% was seen in 19 (8.2%) athletes (0 [0%] vs [5%] 1 vs 1 [3.8%] vs 17 [9.6%]; p=0.51). RVEF was higher in D compared to C without further differences between groups (54±4 vs 54±6 vs 53±6 vs 57±5, p=0.005). RVEF<45% was seen 21 (9.1%) athletes (0 [0%] vs 1 [5%] vs 0 [0%] vs 20 [11.3%]; p=0.14). Abnormal T-wave inversion was similar (12.5 vs 5 vs 7.4 vs 6.2%, p=0.93) as was the prevalence of >100VPB/24h (12.5 vs 5 vs 11.1 vs 5.1%, p=0.42). 2 athletes had nsVT, both in D. All had similar exercise capacity (% predicted VO2max 157±26 vs 152±15 vs 147±24 vs 158±32%; p=0.11).
Conclusion
Hinge-point fibrosis was more prevalent in MA, possibly due to repeated hemodynamic stress during exercise, but is not associated with structural, functional or electrical consequences.
Figure 1. Cardiac remodelling in elite athletes
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Fonds voor Wetenschappelijk Onderzoek (FWO)
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Affiliation(s)
- R De Bosscher
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - M Claeys
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | | | - K Goetschalckx
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - J Bogaert
- University Hospitals (UZ) Leuven, Radiology, Leuven, Belgium
| | | | - O Ghekiere
- Virga Jesse Hospital, Radiology, Hasselt, Belgium
| | - L Herbots
- Virga Jesse Hospital, Cardiology, Hasselt, Belgium
| | | | - J Kalman
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - P Sanders
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - A Elliott
- Royal Adelaide Hospital, Cardiology, Adelaide, Australia
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - A La Gerche
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - G Claessen
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
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11
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Ghekiere O, Bielen J, Leipsic J, Dewilde W, Mancini I, Hansen D, Dendale P, Nchimi A. Correlation of FFR-derived from CT and stress perfusion CMR with invasive FFR in intermediate-grade coronary artery stenosis. Int J Cardiovasc Imaging 2018; 35:559-568. [PMID: 30284138 DOI: 10.1007/s10554-018-1464-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/26/2018] [Indexed: 01/15/2023]
Abstract
Only one-third of intermediate-grade coronary artery stenosis (i.e. 40-70% diameter narrowing) causes myocardial ischemia, requiring most often additional invasive work-up with invasive fractional flow reserve (FFR). To evaluate the correlations between FFR estimates derived from computed tomography (FFRCT) and adenosine perfusion cardiac magnetic resonance (CMR) with invasive FFR in intermediate-grade stenosis. Thirty-seven patients (mean age 61 ± 9 years; 25 men) who underwent adenosine perfusion CMR, quantitative coronary angiography and FFR in the work-up for intermediate-grade stenoses (n = 39) diagnosed at coronary CT angiography were retrospectively evaluated. Blinded FFRCT analysis was computed on each intermediate-grade lesion and correlated to the FFR values. On adenosine CMR, subendocardial time-enhancement maximal upslopes, normalized by respective left ventricle cavity upslopes, were obtained distal to a coronary stenosis (RISK area) and in remote myocardium (REMOTE area). The perfusion was subsequently assessed without (uncorrected RISK) and after correction for remote perfusion (relative myocardial perfusion index = REMOTE/RISK ratio), and then correlated to the FFR values. Differences in correlations were tested with z statistics and considered statistically significant different at a p < 0.05 level. The average FFR value was 0.85 ± 0.10 (0.60-0.98 range), 28% (n = 11) was ≤ 0.80. FFR value correlated poorly with uncorrected RISK upslopes (r = 0.151; p = 0.36), but equally strongly with FFRCT (r = 0.675; p < 0.001) and the relative myocardial perfusion index (r = - 0.63) (p < 0.001; z = 6.72) for assessment of lesion-specific ischemia. Both FFRCT and adenosine perfusion CMR strongly correlate with invasive FFR measurements for intermediate-grade stenosis. These preliminary findings pave the way for further studies evaluating non-invasively intermediate coronary stenosis in clinical practice.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Rue de Hesbaye, 75, 4000, Liège, Belgium. .,Department of Radiology, Jessa Ziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium. .,Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, 3500, Hasselt, Belgium.
| | - Jurgen Bielen
- Department of Radiology, Jessa Ziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jonathon Leipsic
- Department of Radiology, St Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC, BCV6Z 1Y6, Canada
| | - Willem Dewilde
- Department of Cardiology, Imelda Hospital, Imeldalaan 9, 2820, Bonheiden, Belgium
| | - Isabelle Mancini
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Rue de Hesbaye, 75, 4000, Liège, Belgium
| | - Dominic Hansen
- Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, 3500, Hasselt, Belgium
| | - Paul Dendale
- Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, 3500, Hasselt, Belgium.,Heart Center Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Alain Nchimi
- Centre Hospitalier de Luxembourg, 4, Rue Ernest Barble L-1120, LU 1210, Luxembourg City, Luxembourg
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12
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De Mol A, Nicolielo L, Ghekiere O, Jacobs R, Politis C. Dislocation of a mandibular condyle in the middle cranial fossa, diagnosed 54 years after trauma. J Surg Case Rep 2017; 2017:rjx149. [PMID: 28775843 PMCID: PMC5534009 DOI: 10.1093/jscr/rjx149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 06/18/2017] [Accepted: 07/07/2017] [Indexed: 11/17/2022] Open
Abstract
Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma. We report the remarkable case of a 63-year-old patient in whom trauma 54 years prior to consultation resulted in intrusion of the right mandibular condyle into the middle cranial fossa. The diagnosis was missed because of insufficient data provided by conventional radiographies. Failure of timely diagnosis and lack of appropriate treatment resulted in temporomandibular joint ankylosis with functional impairment, disturbance of mandibular growth and dentofacial asymmetry. We emphasize the need for careful radiological investigation in case of a suspected condylar fracture or dislocation, especially when the mechanism of injury is likely to facilitate condylar intrusion. The use of CT and MR-imaging is therefore advocated.
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Affiliation(s)
- Antoni De Mol
- Faculty of Medicine, KU Leuven, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Laura Nicolielo
- OMFS IMPATH Research Group, Department of Imaging and Pathology Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Olivier Ghekiere
- Department of Radiology, Jessa Hospital Hasselt and CHC Liège and Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH research group, Department of Imaging and Pathology Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH research group, Department of Imaging and Pathology Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
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Ghekiere O, Salgado R, Buls N, Leiner T, Mancini I, Vanhoenacker P, Dendale P, Nchimi A. Image quality in coronary CT angiography: challenges and technical solutions. Br J Radiol 2017; 90:20160567. [PMID: 28055253 PMCID: PMC5605061 DOI: 10.1259/bjr.20160567] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/13/2016] [Accepted: 01/03/2017] [Indexed: 11/05/2022] Open
Abstract
Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations. In this review, we discuss several key elements that may adversely affect coronary CTA image quality as well as potential measures that can be taken to mitigate their impact. In addition, several recent vendor-specific advances and future directions to improve image quality are discussed.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Liège, Belgium
- Department of Radiology, Jessa Ziekenhuis, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Rodrigo Salgado
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Nico Buls
- Department of Radiology, UZ Brussel, Brussels, Belgium
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Isabelle Mancini
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Liège, Belgium
| | | | - Paul Dendale
- Heart Center Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
| | - Alain Nchimi
- GIGA Cardiovascular Sciences, Liège University (ULg), Domaine Universitaire du Sart Tilman, Rue de l'hôpital, Liège, Belgium
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Ghekiere O, Nchimi A, Djekic J, El Hachemi M, Mancini I, Hansen D, Vanhoenacker P, de Roos A, Dendale P. Coronary Computed Tomography Angiography: Patient-related factors determining image quality using a second-generation 320-slice CT scanner. Int J Cardiol 2016; 221:970-6. [PMID: 27441477 DOI: 10.1016/j.ijcard.2016.07.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/07/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the diagnostic confidence of Coronary Computed Tomography Angiography (CCTA) and the effect of patient-related factors on CCTA image quality using a second-generation 320-slice scanner. METHODS AND RESULTS 200 consecutive patients (mean age 60±12years; 109 men) prospectively underwent CCTA. The mean body mass index (BMI) was 27.1±4.9kg/m(2); the median heart rate (HR) was 60.0 (interquartile range (IQR), 53.9-66.1) beats per minute (bpm). The median segment's diameter was 2.8 (IQR, 2.2-3.4) mm. For each coronary segment ≥1.5mm in diameter, two readers scored: diameter narrowing as < or ≥50%, overall diagnostic confidence and motion-related image quality, with interobserver agreement kappa-values of 0.89, 0.91 and 0.61 respectively. Seventy-nine of the 2505 evaluated segments (3.2%) had non-diagnostic image quality because of coronary calcifications (66/79; 83.5%), stent- (6/79; 7.5%), pacemaker- (2/79; 2.5%) or motion-related artifacts (5/79; 6.5%). The effect of patient-related factors on motion-related image quality was investigated by multinomial logistic regression in 181 patients with calcium score (IQR, 0-446.5). Increasing coronary diameter was the most improving image quality factor (odds ratio (OR), 1.8637; p<0.001), marginally followed by lower HR (OR, 0.9547; p<0.001) and calcium score (OR, 0.9997; p=0.04). Gender (p=0.70), age (p=0.24) and BMI (p=0.45) did not affect image quality. CONCLUSION Using a second-generation 320-slice scanner, CCTA diagnostic confidence is predominantly affected by coronary calcifications, whereas motion-related image quality is non-diagnostic only in exceptional cases and mainly influenced by the coronary diameter. For future developments, our study findings therefore suggest greater requirements concerning spatial resolution and calcium-related artifact removal than concerning temporal resolution, especially to improve diagnostic confidence in patient groups with smaller coronary diameters.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Rue de Hesbaye, 75, B-4000 Liège, Belgium; Department of Radiology, Jessa Hospital, Stadsomvaart 11, B-3500 Hasselt, Belgium; Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, B-3500 Hasselt, Belgium.
| | - Alain Nchimi
- Liège University (ULg), GIGA Cardiovascular Sciences, Domaine Universitaire du Sart Tilman, Rue de l'hôpital, 1, B-4000 Liège, Belgium
| | - Julien Djekic
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Rue de Hesbaye, 75, B-4000 Liège, Belgium
| | - Mounia El Hachemi
- Liège University (ULg), GIGA Cardiovascular Sciences, Domaine Universitaire du Sart Tilman, Rue de l'hôpital, 1, B-4000 Liège, Belgium
| | - Isabelle Mancini
- Department of Radiology, Centre Hospitalier Chrétien (CHC), Rue de Hesbaye, 75, B-4000 Liège, Belgium
| | - Dominique Hansen
- Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, B-3500 Hasselt, Belgium
| | - Piet Vanhoenacker
- Department of Radiology, OLV Hospital Aalst, Moorselbaan 164, B-9300 Aalst, Belgium
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Albinusdreef, 2, NL-2333 ZA Leiden, The Netherlands
| | - Paul Dendale
- Faculty of Medicine and Life Sciences, Biomed and Reval, Hasselt University, Agoralaan, Building A and C, B-3500 Hasselt, Belgium; Heart Center Hasselt, Jessa Hospital, Stadsomvaart, 11, B-3500 Hasselt, Belgium
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Ghekiere O, Nchimi A. Cardiac CT angiography: technical aspects in 2012. JBR-BTR 2013; 96:401-402. [PMID: 24617199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- O Ghekiere
- Department of Radiology, CHC Clinique St-Joseph, Liege, Belgium
| | - A Nchimi
- Department of Radiology, CHU Sart Tilman Liege, Belgium
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Ghekiere O, Hamoir X, Hamoir V, Kirsch J. Malignant right coronary artery. JBR-BTR 2008; 91:20. [PMID: 18447127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- O Ghekiere
- Dpt of Radiology, Clinique Notre Dame, Tournai, Belgium
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Ghekiere O, Lesnik A, Hoa D, Laffargue G, Uriot C, Taourel P. Value of computed tomography in the diagnosis of the cause of nontraumatic gastrointestinal tract perforation. J Comput Assist Tomogr 2007; 31:169-76. [PMID: 17414748 DOI: 10.1097/01.rct.0000237809.11123.8e] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify computed tomographic features with a high predictive value to differentiate gastroduodenal ulcer perforations from other causes of perforations in patients with a non-traumatic-free pneumoperitoneum. MATERIALS AND METHODS Computed tomographic scans of 81 patients with a non-traumatic-free pneumoperitoneum were reviewed for direct visualization of the perforation site and indirect findings of the perforation, including the presence, amount, and localization of air and ascites in the peritoneal cavity, mural thickness of the gastrointestinal tract, perigastrointestinal fat stranding, intestinal ischemia, fecal peritonitis, abscess, and portomesenteric venous gas. RESULTS The perforation site was directly visualized in 16 (41%) of 39 patients with gastroduodenal ulcer perforation and in 5 (12%) of 42 patients with other causes of perforation. The findings with a positive predictive value of more than 90% for gastroduodenal ulcer perforation were the presence of local fluid between the duodenum and the pancreatic head and the combination of local gastroduodenal wall thickening and fat stranding. The presence of abscess in the peritoneal cavity or fecal peritonitis, portomesenteric gas, or bowel ischemia findings had a positive predictive value of 100% for the diagnosis of other perforations. CONCLUSIONS Indirect computed tomographic findings are helpful for differentiating gastroduodenal ulcer perforation from other causes of perforations.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Centre Hospitalier Universitaire Lapeyronie, Montpellier, France
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Ghekiere O, Lesnik A, Millet I, Hoa D, Guillon F, Taourel P. Direct visualization of perforation sites in patients with a non-traumatic free pneumoperitoneum: added diagnostic value of thin transverse slices and coronal and sagittal reformations for multi-detector CT. Eur Radiol 2007; 17:2302-9. [PMID: 17340104 DOI: 10.1007/s00330-007-0585-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 11/08/2006] [Accepted: 01/09/2007] [Indexed: 12/20/2022]
Abstract
The incremental diagnostic value of adding 1.25-mm slices and coronal and sagittal reformatting to 5-mm axial reconstructions for direct visualization of the perforation site in patients with non-traumatic free pneumoperitoneum was assessed. Forty patients with non-traumatic bowel perforation and free pneumoperitoneum underwent computed tomography (CT). The perforation was gastroduodenal in 18 patients and involved the small or large bowel in 22 patients. Transverse scans were reconstructed with 5-mm thick sections at 5-mm intervals and 1.25-mm-thick sections at 1.25-mm intervals. The second data set was reformatted coronally and sagittaly with 3-mm-thick sections at 3-mm intervals. Three independent blinded readers interpreted 5-mm transverse scans, then combined 1.25-mm and 5-mm-transverse scans, and then combined transverse, coronal and sagittal scans. The rate of identification of the perforation site ranged from 43% to 53% with the combined axial, sagittal and coronal scans, from 28% to 48% with the 1.25- and 5-mm transverse scans, and from 5% to 20% only with the 5-mm thick transverse scans. The agreement between readers was significantly higher with thin slices and reformatting. The use of 1.25-mm axial slices and reformations intrinsically contained more useful diagnostic information than 5-mm axial slices alone for diagnosis of the perforation site in patients with pneumoperitoneum.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Hospital Lapeyronie, Centre Hospitalier Universitaire Montpellier, 371, avenue du Doyen Gaston Giraud, Montpellier, 34295, France
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Ghekiere O, Laffargue G, Bolivar J, Taourel P. Dissection of the infrarenal abdominal aorta in blunt trauma. JBR-BTR 2006; 89:49. [PMID: 16607878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- O Ghekiere
- Department of Radiology, Hôpital Lapeyronie, Centre Hospitalier Universitaire, Montpellier, France
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Ghekiere O, Galant C, Vande Berg B. Intravenous pyogenic granuloma or intravenous lobular capillary hemangioma. Skeletal Radiol 2005; 34:343-6. [PMID: 15565332 DOI: 10.1007/s00256-004-0860-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2004] [Revised: 08/18/2004] [Accepted: 08/18/2004] [Indexed: 02/02/2023]
Abstract
Lobular capillary hemangioma is a vascular neoplasm that commonly occurs as a cutaneous tumor. When it involves the skin and mucosal surfaces, ulceration and suppuration may occur, hence the classic term of pyogenic granuloma. Intravenous pyogenic granuloma is a rare solitary form of lobular capillary hemangioma that usually occurs in the veins of the neck and upper extremities. We report the ultrasonographic and magnetic resonance imaging findings of a pyogenic intravenous granuloma localized in the right cephalic vein. The imaging and pathological findings and the differential diagnoses are discussed.
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Affiliation(s)
- Olivier Ghekiere
- Department of Radiology, Cliniques Universitaires St. Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium
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Ghekiere O, Hernalsteen D, Peeters A, Lecouvet F, Cosnard G. Spontaneous vertebral artery dissection presenting as symptomatic spinal subarachnoid haemorrhage. JBR-BTR 2005; 88:82-3. [PMID: 15906580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- O Ghekiere
- Department of Radiology, Cliniques Universitaries St. Luc, Brussels, Belgium
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Ghekiere O, Weynand B, Collard P, Coche E. Progressive dyspnoea in a 40-yr-old female. Eur Respir J 2003; 21:728-31. [PMID: 12762364 DOI: 10.1183/09031936.03.00072803a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- O Ghekiere
- Dept of Radiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
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