Journal Article
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
European Journal of Applied Physiology · Vol. 123, Issue 10 · pp. 2107-2117 · 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 NCT 04940650 06/18/2021. NCT 05138003 06/18/2021.