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

Research output: Contribution to journalArticleAcademicpeer-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 languageEnglish
Article number123
Pages (from-to)2107-2117
Number of pages11
JournalEuropean Journal of Applied Physiology
Volume123
Issue number10
Early online date22 Jul 2023
DOIs
Publication statusPublished - Oct 2023

Keywords

  • Cardiac troponin
  • High intensity cycling
  • Myocardial edema
  • T1 mapping

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