Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study

Olivier Ghekiere; Lieven Herbots; Benjamin Peters; Baptiste Vande Berg; Tom Dresselaers; Wouter Franssen; Bernard Padovani; Dorothee Ducreux; Emile Ferrari; Alain Nchimi; Sophie Demanez; Ruben De Bosscher; Rik Willems; Hein Heidbuchel; Andre La Gerche; Guido Claessen; Jan Bogaert; Bert O. Eijnde

doi:10.1007/s00421-023-05259-4

Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study

Olivier Ghekiere^*, Lieven Herbots, Benjamin Peters, Baptiste Vande Berg, Tom Dresselaers, Wouter Franssen, Bernard Padovani, Dorothee Ducreux, Emile Ferrari, Alain Nchimi, Sophie Demanez, Ruben De Bosscher, Rik Willems, Hein Heidbuchel, Andre La Gerche, Guido Claessen, Jan Bogaert, Bert O. Eijnde

^*Corresponding author for this work

NUTRIM - Obesity, diabetes and cardiovascular health

Research output: Contribution to journal › Article › Academic › peer-review

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: NCT 04940650 06/18/2021. NCT 05138003 06/18/2021.

Original language	English
Article number	123
Pages (from-to)	2107-2117
Number of pages	11
Journal	European Journal of Applied Physiology
Volume	123
Issue number	10
Early online date	22 Jul 2023
DOIs	https://doi.org/10.1007/s00421-023-05259-4
Publication status	Published - Oct 2023

Keywords

Cardiac troponin
High intensity cycling
Myocardial edema
T1 mapping

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10.1007/s00421-023-05259-4Licence: CC BY

Cite this

Ghekiere, O., Herbots, L., Peters, B., Berg, B. V., 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, B. O. (2023). Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study. European Journal of Applied Physiology, 123(10), 2107-2117. Article 123. https://doi.org/10.1007/s00421-023-05259-4

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title = "Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study",

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 {\textquoteleft}L{\textquoteright}{\'e}tape du tour de France” (EDT) 2021{\textquoteright} (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: NCT 04940650 06/18/2021. NCT 05138003 06/18/2021.",

keywords = "Cardiac troponin, High intensity cycling, Myocardial edema, T1 mapping",

author = "Olivier Ghekiere and Lieven Herbots and Benjamin Peters and Berg, {Baptiste Vande} and Tom Dresselaers and Wouter Franssen and Bernard Padovani and Dorothee Ducreux and Emile Ferrari and Alain Nchimi and Sophie Demanez and {De Bosscher}, Ruben and Rik Willems and Hein Heidbuchel and {La Gerche}, Andre and Guido Claessen and Jan Bogaert and Eijnde, {Bert O.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = oct,

doi = "10.1007/s00421-023-05259-4",

language = "English",

volume = "123",

pages = "2107--2117",

journal = "European Journal of Applied Physiology",

issn = "1439-6319",

publisher = "Springer, Cham",

number = "10",

}

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 2023, 'Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study', European Journal of Applied Physiology, vol. 123, no. 10, 123, pp. 2107-2117. https://doi.org/10.1007/s00421-023-05259-4

TY - JOUR

T1 - Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists

T2 - a CMR study

AU - Ghekiere, Olivier

AU - Herbots, Lieven

AU - Peters, Benjamin

AU - Berg, Baptiste Vande

AU - Dresselaers, Tom

AU - Franssen, Wouter

AU - Padovani, Bernard

AU - Ducreux, Dorothee

AU - Ferrari, Emile

AU - Nchimi, Alain

AU - Demanez, Sophie

AU - De Bosscher, Ruben

AU - Willems, Rik

AU - Heidbuchel, Hein

AU - La Gerche, Andre

AU - Claessen, Guido

AU - Bogaert, Jan

AU - Eijnde, Bert O.

PY - 2023/10

Y1 - 2023/10

N2 - 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: NCT 04940650 06/18/2021. NCT 05138003 06/18/2021.

AB - 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: NCT 04940650 06/18/2021. NCT 05138003 06/18/2021.

KW - Cardiac troponin

KW - High intensity cycling

KW - Myocardial edema

KW - T1 mapping

U2 - 10.1007/s00421-023-05259-4

DO - 10.1007/s00421-023-05259-4

M3 - Article

C2 - 37480391

SN - 1439-6319

VL - 123

SP - 2107

EP - 2117

JO - European Journal of Applied Physiology

JF - European Journal of Applied Physiology

IS - 10

M1 - 123

ER -