Characterizing Exercise-Induced Changes in Myocardial Microcirculation Using CMR First-Pass Perfusion Imaging

Motivation: The assessment of myocardial microcirculation in athletes using a rest first-pass perfusion sequence of cardiac magnetic resonance (CMR) has been relatively underexplored. Goal(s): Our study aims to investigate the changes in myocardial microcirculation following exercise using first-pass perfusion imaging. Approach: Continuous 186 amateur athletes and 23 healthy sedentary controls were prospectively enrolled to undergo CMR scans. Results: Exercise induced a decrease in myocardial microcirculation among athletes. Those athletes with cardiac remodeling (CR) and/or myocardial fibrosis (MF) exhibited decreased levels of myocardial microcirculation compared to thoes without these conditions. The first-pass perfusion parameters demonstrated a modest correlation with T2 values and 12-lead electrocardiogram. Impact: The established prediction model that combines first-pass perfusion parameters demonstrates strong predictive capabilities and may be beneficial for screening athletes with CR and/or MF.