CMR native T1 and T2 mapping in Olympic athletes: the influence of sports discipline and sex

Aims: Cardiac magnetic resonance (CMR) has a growing role in evaluating athletes' hearts. Mapping techniques provide added value for tissue characterization, but data on athletes and sports disciplines are lacking. To describe native mapping values in a cohort of Olympic athletes and evaluate the influence of sports discipline and sex.

Methods and results: A group of 300 Olympic athletes (13% skill, 20% power, 25% mixed, 42% endurance, 58% male) with unremarkable cardiovascular screening and a control group of 42 sedentary subjects (52% male) underwent CMR without contrast administration. Athletes were divided based on sex and sports categories according to the ESC classification. Among athletes of different sports categories and controls, endurance presented the lowest value of T1 mapping (P < 0.001). No differences in T2 mapping were observed (P = 0.472). Female athletes had higher values of T1 native myocardial mapping compared with males (P = 0.001), while there were no differences in T2 mapping (P = 0.817). Male athletes with higher left ventricular mass indexed (LV-Massi) had lower values of T1 mapping (P = 0.006) and slightly higher values of T2 mapping, even if not significant (P = 0.150). Female athletes with higher LV-Massi did not show significant differences in T1 and T2 mapping (P = 0.053 and P = 0.438).

Conclusion: T1 native myocardial mapping showed significant differences related to sports disciplines and gender. Athletes with the largest LV remodelling, mostly endurance and mixed, showed the lowest values of T1 mapping. Male athletes showed lower values of T1 mapping than females. No significant differences were observed in T2 mapping related to sports disciplines and gender.