Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness
Objectives To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial inflammation in patients with exertional heat illness (EHI). Methods This prospective study enrolled 28 males with EHI (18 patients with exertional heat exhaustion (EHE) and 10 w...
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| Veröffentlicht in: | European radiology 2023-11, Vol.33 (11), p.8165-8176 |
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| creator | Luo, Song Xu, Shu Tian Zhang, Jun Schoepf, U. Joseph Varga-Szemes, Akos Carpenter, Charles R. T. Zhang, Ling Yan Ma, Yan Li, Zhe Wang, Yang Huang, Wei Wei Zhi, Bei Bei Dou, Wei Qiang Qi, Li Zhang, Long Jiang |
| description | Objectives
To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial inflammation in patients with exertional heat illness (EHI).
Methods
This prospective study enrolled 28 males with EHI (18 patients with exertional heat exhaustion (EHE) and 10 with exertional heat stroke (EHS)) and 18 age-matched male healthy controls (HC). All subjects underwent multiparametric CMR, and 9 patients had follow-up CMR measurements 3 months after recovery from EHI. CMR-derived left ventricular geometry, function, strain, native T1, extracellular volume (ECV), T2, T2*, and late gadolinium enhancement (LGE) were obtained and compared among different groups.
Results
Compared with HC, EHI patients showed increased global ECV, T2, and T2* values (22.6% ± 4.1 vs. 19.7% ± 1.7; 46.8 ms ± 3.4 vs. 45.1 ms ± 1.2; 25.5 ms ± 2.2 vs. 23.8 ms ± 1.7; all
p
|
| doi_str_mv | 10.1007/s00330-023-09706-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2810923464</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2810923464</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c43c0877bd3ecf47b5e43aa81c64cd66224976bafd23d279dc5b18030f3a4a333</originalsourceid><addsrcrecordid>eNp9kctu1jAQhS0EoqXwAiyQJTZsAuNL4mSJqnKRitjA2po4k9ZV4gTb4acbnh3_pFzEgpWPPd85tnwYeyrgpQAwrxKAUlCBVBV0BprqcI-dCq1kJaDV9__SJ-xRSjcA0AltHrITZYSuRQ2n7PuHbcp-xYgz5egddxgHj47PeBUol4NIaQkYHBX1lXBKfKWYfMoUMp9vl90wcR_GCecZs19C2fC1qIIkfvD5mtM3isdJAa8JM_fTFCilx-zBWCLpyd16xj6_ufh0_q66_Pj2_fnry8opU-fKaeWgNaYfFLlRm74mrRBb4RrthqaRUnem6XEcpBqk6QZX96IFBaNCjUqpM_Ziz13j8mWjlO3sk6NpwkDLlqxsBXRS6UYX9Pk_6M2yxfLwI1WwunzeMVDulItLSpFGu0Y_Y7y1AuyxHbu3Y0s79mc79lBMz-6it36m4bflVx0FUDuQyihcUfxz939ifwC1LZ3n</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2881053713</pqid></control><display><type>article</type><title>Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Luo, Song ; Xu, Shu Tian ; Zhang, Jun ; Schoepf, U. Joseph ; Varga-Szemes, Akos ; Carpenter, Charles R. T. ; Zhang, Ling Yan ; Ma, Yan ; Li, Zhe ; Wang, Yang ; Huang, Wei Wei ; Zhi, Bei Bei ; Dou, Wei Qiang ; Qi, Li ; Zhang, Long Jiang</creator><creatorcontrib>Luo, Song ; Xu, Shu Tian ; Zhang, Jun ; Schoepf, U. Joseph ; Varga-Szemes, Akos ; Carpenter, Charles R. T. ; Zhang, Ling Yan ; Ma, Yan ; Li, Zhe ; Wang, Yang ; Huang, Wei Wei ; Zhi, Bei Bei ; Dou, Wei Qiang ; Qi, Li ; Zhang, Long Jiang</creatorcontrib><description>Objectives
To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial inflammation in patients with exertional heat illness (EHI).
Methods
This prospective study enrolled 28 males with EHI (18 patients with exertional heat exhaustion (EHE) and 10 with exertional heat stroke (EHS)) and 18 age-matched male healthy controls (HC). All subjects underwent multiparametric CMR, and 9 patients had follow-up CMR measurements 3 months after recovery from EHI. CMR-derived left ventricular geometry, function, strain, native T1, extracellular volume (ECV), T2, T2*, and late gadolinium enhancement (LGE) were obtained and compared among different groups.
Results
Compared with HC, EHI patients showed increased global ECV, T2, and T2* values (22.6% ± 4.1 vs. 19.7% ± 1.7; 46.8 ms ± 3.4 vs. 45.1 ms ± 1.2; 25.5 ms ± 2.2 vs. 23.8 ms ± 1.7; all
p
< 0.05). Subgroup analysis showed that ECV was higher in the EHS patients than those in EHE and HC groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both
p
< 0.05). Repeated CMR measurements at 3 months after baseline CMR showed persistently higher ECV than HC (
p
= 0.042).
Conclusions
With multiparametric CMR, EHI patients demonstrated increased global ECV, T2, and persistent myocardial inflammation at 3-month follow-up after EHI episode. Therefore, multiparametric CMR might be an effective method in evaluating myocardial inflammation in patients with EHI.
Clinical relevance statement
This study showed persistent myocardial inflammation after an exertional heat illness (EHI) episode demonstrated by multiparametric CMR, which is a potential promising method to evaluate the severity of myocardial inflammation and guide return to work, play, or duty in EHI patients.
Key Points
•
EHI patients showed an increased global extracellular volume (ECV), late gadolinium enhancement, and T2 value, indicating myocardial edema and fibrosis.
•
ECV was higher in the exertional heat stroke patients than exertional heat exhaustion and healthy control groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both p < 0.05).
•
EHI patients showed persistent myocardial inflammation with higher ECV than healthy controls 3 months after index CMR (22.3% ± 2.4 vs. 19.7% ± 1.7, p = 0.042).</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-09706-w</identifier><identifier>PMID: 37145150</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cardiac ; Case-Control Studies ; Contrast Media - pharmacology ; Diagnostic Radiology ; Edema ; Fibrosis ; Gadolinium ; Heart ; Heat ; Heat Exhaustion - pathology ; Heat stroke ; Heat Stroke - complications ; Heat Stroke - diagnostic imaging ; Heat Stroke - pathology ; Heatstroke ; Humans ; Illnesses ; Imaging ; Inflammation ; Inflammation - diagnostic imaging ; Inflammation - pathology ; Internal Medicine ; Interventional Radiology ; Magnetic resonance ; Magnetic Resonance Imaging, Cine ; Magnetic Resonance Spectroscopy ; Male ; Medicine ; Medicine & Public Health ; Myocarditis ; Myocardium - pathology ; Neuroradiology ; Predictive Value of Tests ; Prospective Studies ; Radiology ; Subgroups ; Ultrasound ; Ventricle ; Ventricular Function, Left</subject><ispartof>European radiology, 2023-11, Vol.33 (11), p.8165-8176</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c43c0877bd3ecf47b5e43aa81c64cd66224976bafd23d279dc5b18030f3a4a333</citedby><cites>FETCH-LOGICAL-c375t-c43c0877bd3ecf47b5e43aa81c64cd66224976bafd23d279dc5b18030f3a4a333</cites><orcidid>0000-0002-5546-6823</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-023-09706-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-023-09706-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37145150$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luo, Song</creatorcontrib><creatorcontrib>Xu, Shu Tian</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Schoepf, U. Joseph</creatorcontrib><creatorcontrib>Varga-Szemes, Akos</creatorcontrib><creatorcontrib>Carpenter, Charles R. T.</creatorcontrib><creatorcontrib>Zhang, Ling Yan</creatorcontrib><creatorcontrib>Ma, Yan</creatorcontrib><creatorcontrib>Li, Zhe</creatorcontrib><creatorcontrib>Wang, Yang</creatorcontrib><creatorcontrib>Huang, Wei Wei</creatorcontrib><creatorcontrib>Zhi, Bei Bei</creatorcontrib><creatorcontrib>Dou, Wei Qiang</creatorcontrib><creatorcontrib>Qi, Li</creatorcontrib><creatorcontrib>Zhang, Long Jiang</creatorcontrib><title>Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial inflammation in patients with exertional heat illness (EHI).
Methods
This prospective study enrolled 28 males with EHI (18 patients with exertional heat exhaustion (EHE) and 10 with exertional heat stroke (EHS)) and 18 age-matched male healthy controls (HC). All subjects underwent multiparametric CMR, and 9 patients had follow-up CMR measurements 3 months after recovery from EHI. CMR-derived left ventricular geometry, function, strain, native T1, extracellular volume (ECV), T2, T2*, and late gadolinium enhancement (LGE) were obtained and compared among different groups.
Results
Compared with HC, EHI patients showed increased global ECV, T2, and T2* values (22.6% ± 4.1 vs. 19.7% ± 1.7; 46.8 ms ± 3.4 vs. 45.1 ms ± 1.2; 25.5 ms ± 2.2 vs. 23.8 ms ± 1.7; all
p
< 0.05). Subgroup analysis showed that ECV was higher in the EHS patients than those in EHE and HC groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both
p
< 0.05). Repeated CMR measurements at 3 months after baseline CMR showed persistently higher ECV than HC (
p
= 0.042).
Conclusions
With multiparametric CMR, EHI patients demonstrated increased global ECV, T2, and persistent myocardial inflammation at 3-month follow-up after EHI episode. Therefore, multiparametric CMR might be an effective method in evaluating myocardial inflammation in patients with EHI.
Clinical relevance statement
This study showed persistent myocardial inflammation after an exertional heat illness (EHI) episode demonstrated by multiparametric CMR, which is a potential promising method to evaluate the severity of myocardial inflammation and guide return to work, play, or duty in EHI patients.
Key Points
•
EHI patients showed an increased global extracellular volume (ECV), late gadolinium enhancement, and T2 value, indicating myocardial edema and fibrosis.
•
ECV was higher in the exertional heat stroke patients than exertional heat exhaustion and healthy control groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both p < 0.05).
•
EHI patients showed persistent myocardial inflammation with higher ECV than healthy controls 3 months after index CMR (22.3% ± 2.4 vs. 19.7% ± 1.7, p = 0.042).</description><subject>Cardiac</subject><subject>Case-Control Studies</subject><subject>Contrast Media - pharmacology</subject><subject>Diagnostic Radiology</subject><subject>Edema</subject><subject>Fibrosis</subject><subject>Gadolinium</subject><subject>Heart</subject><subject>Heat</subject><subject>Heat Exhaustion - pathology</subject><subject>Heat stroke</subject><subject>Heat Stroke - complications</subject><subject>Heat Stroke - diagnostic imaging</subject><subject>Heat Stroke - pathology</subject><subject>Heatstroke</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Imaging</subject><subject>Inflammation</subject><subject>Inflammation - diagnostic imaging</subject><subject>Inflammation - pathology</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myocarditis</subject><subject>Myocardium - pathology</subject><subject>Neuroradiology</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radiology</subject><subject>Subgroups</subject><subject>Ultrasound</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kctu1jAQhS0EoqXwAiyQJTZsAuNL4mSJqnKRitjA2po4k9ZV4gTb4acbnh3_pFzEgpWPPd85tnwYeyrgpQAwrxKAUlCBVBV0BprqcI-dCq1kJaDV9__SJ-xRSjcA0AltHrITZYSuRQ2n7PuHbcp-xYgz5egddxgHj47PeBUol4NIaQkYHBX1lXBKfKWYfMoUMp9vl90wcR_GCecZs19C2fC1qIIkfvD5mtM3isdJAa8JM_fTFCilx-zBWCLpyd16xj6_ufh0_q66_Pj2_fnry8opU-fKaeWgNaYfFLlRm74mrRBb4RrthqaRUnem6XEcpBqk6QZX96IFBaNCjUqpM_Ziz13j8mWjlO3sk6NpwkDLlqxsBXRS6UYX9Pk_6M2yxfLwI1WwunzeMVDulItLSpFGu0Y_Y7y1AuyxHbu3Y0s79mc79lBMz-6it36m4bflVx0FUDuQyihcUfxz939ifwC1LZ3n</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Luo, Song</creator><creator>Xu, Shu Tian</creator><creator>Zhang, Jun</creator><creator>Schoepf, U. Joseph</creator><creator>Varga-Szemes, Akos</creator><creator>Carpenter, Charles R. T.</creator><creator>Zhang, Ling Yan</creator><creator>Ma, Yan</creator><creator>Li, Zhe</creator><creator>Wang, Yang</creator><creator>Huang, Wei Wei</creator><creator>Zhi, Bei Bei</creator><creator>Dou, Wei Qiang</creator><creator>Qi, Li</creator><creator>Zhang, Long Jiang</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5546-6823</orcidid></search><sort><creationdate>20231101</creationdate><title>Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness</title><author>Luo, Song ; Xu, Shu Tian ; Zhang, Jun ; Schoepf, U. Joseph ; Varga-Szemes, Akos ; Carpenter, Charles R. T. ; Zhang, Ling Yan ; Ma, Yan ; Li, Zhe ; Wang, Yang ; Huang, Wei Wei ; Zhi, Bei Bei ; Dou, Wei Qiang ; Qi, Li ; Zhang, Long Jiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c43c0877bd3ecf47b5e43aa81c64cd66224976bafd23d279dc5b18030f3a4a333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiac</topic><topic>Case-Control Studies</topic><topic>Contrast Media - pharmacology</topic><topic>Diagnostic Radiology</topic><topic>Edema</topic><topic>Fibrosis</topic><topic>Gadolinium</topic><topic>Heart</topic><topic>Heat</topic><topic>Heat Exhaustion - pathology</topic><topic>Heat stroke</topic><topic>Heat Stroke - complications</topic><topic>Heat Stroke - diagnostic imaging</topic><topic>Heat Stroke - pathology</topic><topic>Heatstroke</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Imaging</topic><topic>Inflammation</topic><topic>Inflammation - diagnostic imaging</topic><topic>Inflammation - pathology</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Magnetic resonance</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Myocarditis</topic><topic>Myocardium - pathology</topic><topic>Neuroradiology</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radiology</topic><topic>Subgroups</topic><topic>Ultrasound</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luo, Song</creatorcontrib><creatorcontrib>Xu, Shu Tian</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Schoepf, U. Joseph</creatorcontrib><creatorcontrib>Varga-Szemes, Akos</creatorcontrib><creatorcontrib>Carpenter, Charles R. T.</creatorcontrib><creatorcontrib>Zhang, Ling Yan</creatorcontrib><creatorcontrib>Ma, Yan</creatorcontrib><creatorcontrib>Li, Zhe</creatorcontrib><creatorcontrib>Wang, Yang</creatorcontrib><creatorcontrib>Huang, Wei Wei</creatorcontrib><creatorcontrib>Zhi, Bei Bei</creatorcontrib><creatorcontrib>Dou, Wei Qiang</creatorcontrib><creatorcontrib>Qi, Li</creatorcontrib><creatorcontrib>Zhang, Long Jiang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>Proquest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luo, Song</au><au>Xu, Shu Tian</au><au>Zhang, Jun</au><au>Schoepf, U. Joseph</au><au>Varga-Szemes, Akos</au><au>Carpenter, Charles R. T.</au><au>Zhang, Ling Yan</au><au>Ma, Yan</au><au>Li, Zhe</au><au>Wang, Yang</au><au>Huang, Wei Wei</au><au>Zhi, Bei Bei</au><au>Dou, Wei Qiang</au><au>Qi, Li</au><au>Zhang, Long Jiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>33</volume><issue>11</issue><spage>8165</spage><epage>8176</epage><pages>8165-8176</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial inflammation in patients with exertional heat illness (EHI).
Methods
This prospective study enrolled 28 males with EHI (18 patients with exertional heat exhaustion (EHE) and 10 with exertional heat stroke (EHS)) and 18 age-matched male healthy controls (HC). All subjects underwent multiparametric CMR, and 9 patients had follow-up CMR measurements 3 months after recovery from EHI. CMR-derived left ventricular geometry, function, strain, native T1, extracellular volume (ECV), T2, T2*, and late gadolinium enhancement (LGE) were obtained and compared among different groups.
Results
Compared with HC, EHI patients showed increased global ECV, T2, and T2* values (22.6% ± 4.1 vs. 19.7% ± 1.7; 46.8 ms ± 3.4 vs. 45.1 ms ± 1.2; 25.5 ms ± 2.2 vs. 23.8 ms ± 1.7; all
p
< 0.05). Subgroup analysis showed that ECV was higher in the EHS patients than those in EHE and HC groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both
p
< 0.05). Repeated CMR measurements at 3 months after baseline CMR showed persistently higher ECV than HC (
p
= 0.042).
Conclusions
With multiparametric CMR, EHI patients demonstrated increased global ECV, T2, and persistent myocardial inflammation at 3-month follow-up after EHI episode. Therefore, multiparametric CMR might be an effective method in evaluating myocardial inflammation in patients with EHI.
Clinical relevance statement
This study showed persistent myocardial inflammation after an exertional heat illness (EHI) episode demonstrated by multiparametric CMR, which is a potential promising method to evaluate the severity of myocardial inflammation and guide return to work, play, or duty in EHI patients.
Key Points
•
EHI patients showed an increased global extracellular volume (ECV), late gadolinium enhancement, and T2 value, indicating myocardial edema and fibrosis.
•
ECV was higher in the exertional heat stroke patients than exertional heat exhaustion and healthy control groups (24.7% ± 4.9 vs. 21.4% ± 3.2, 24.7% ± 4.9 vs. 19.7% ± 1.7; both p < 0.05).
•
EHI patients showed persistent myocardial inflammation with higher ECV than healthy controls 3 months after index CMR (22.3% ± 2.4 vs. 19.7% ± 1.7, p = 0.042).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37145150</pmid><doi>10.1007/s00330-023-09706-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-5546-6823</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | European radiology, 2023-11, Vol.33 (11), p.8165-8176 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2810923464 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Cardiac Case-Control Studies Contrast Media - pharmacology Diagnostic Radiology Edema Fibrosis Gadolinium Heart Heat Heat Exhaustion - pathology Heat stroke Heat Stroke - complications Heat Stroke - diagnostic imaging Heat Stroke - pathology Heatstroke Humans Illnesses Imaging Inflammation Inflammation - diagnostic imaging Inflammation - pathology Internal Medicine Interventional Radiology Magnetic resonance Magnetic Resonance Imaging, Cine Magnetic Resonance Spectroscopy Male Medicine Medicine & Public Health Myocarditis Myocardium - pathology Neuroradiology Predictive Value of Tests Prospective Studies Radiology Subgroups Ultrasound Ventricle Ventricular Function, Left |
| title | Multiparametric cardiac magnetic resonance reveals persistent myocardial inflammation in patients with exertional heat illness |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-14T06%3A32%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Multiparametric%20cardiac%20magnetic%20resonance%20reveals%20persistent%20myocardial%20inflammation%20in%20patients%20with%20exertional%20heat%20illness&rft.jtitle=European%20radiology&rft.au=Luo,%20Song&rft.date=2023-11-01&rft.volume=33&rft.issue=11&rft.spage=8165&rft.epage=8176&rft.pages=8165-8176&rft.issn=1432-1084&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-023-09706-w&rft_dat=%3Cproquest_cross%3E2810923464%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2881053713&rft_id=info:pmid/37145150&rfr_iscdi=true |