How native T1 and T2 mapping is influenced by sex and training load? Cardiac magnetic resonance imaging in young elite athletes and less active individuals

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): This study was financed by the Ministry of Innovation and Technology NRDI Office within the framework of the Artificial Intelligence National Laboratory Program. LS is supported by the EACVI Research Grant 2021.

Introduction

Cardiac adaptation due to regular and intense exercise is a well-known phenomenon. Cardiac magnetic resonance (CMR) imaging is a well suited, highly reproducible technique that has a vital role in differentiating physiological adaptation and pathological alterations. Native T1 and T2 mapping enable the quantitative assessment of tissue characteristics without the administration of contrast material. These techniques are increasingly used in studies aiming to consider subtle differences. However, the sex-and training-dependence of native T1 and T2 mapping values remains incompletely understood.

Purpose

We aimed to describe the differences in native T1 and T2 mapping among healthy athletes and less active individuals.

Methods

We enrolled healthy elite athletes (n=88, 56 male, 25±5 years) and healthy volunteers (n=82, 46 male, 25±3 years) to undergo CMR examinations at our Centre. Healthy elite athletes performed high sports activity levels (>10 hours/week) and competed nationally or internationally. Sex- and age-matched healthy volunteers engaged in ≤6 hours/week of sports activity. Standardized CMR protocol included short- and long-axis cine images covering the entire left (LV) and right (RV) ventricle and native T1 and T2 mapping in basal, midventricular and apical slices.

Results

Athletes had consistently higher LV and RV volumes and mass indexes compared to healthy volunteers (p<.001 for all). Native T1 mapping was lower in athletes than in the control group (T1: 954±24 ms vs 970±23 ms; p <.001). T1 mapping showed a moderately strong negative correlation to markers of cardiac adaptation, including LV mass, end-diastolic volume and stroke volume indexes (p<.001 for all). Moreover, we found a negative correlation between native T1 and training hours (Rho: -0.302; p<.001). On the other hand, native T2 mapping showed no difference between athletes and less active controls. Furthermore, T2 correlated with LV shape features but not with training hours. We found that mapping values differed between sexes, both in the athletic and control groups. Females showed slightly higher values compared to their male counterparts (T2: 46±2 vs 43±2; p<.001). Finally, native T1 mapping was associated with training hours and sex in our multiple linear regression model, adjusted for age, resting heart rate, body mass index, body surface area and LVM (p<.001). While T2 mapping was associated only with sex considering the same covariates.

Conclusion

Our study demonstrates the importance of sex-matched controls in CMR studies evaluating mapping parameters. Moreover, the consideration of exercise load seems paramount in the case of T1 mapping.

Toxic organic pollutants in Greek house dust: Implications for human exposure and health risk

Organic contaminants often documented in house dust include mainly chemicals released from construction materials and consumer products and compounds emitted from indoor combustion activities. The occurrence of major chemical classes of toxic organic pollutants, included polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs) and nitrated polycyclic aromatic hydrocarbons (NPAHs), was for the first time investigated in house dust in Greece. The mean concentrations of ∑₁₆PAHs, ∑₂₀PBDEs, ∑₇NPAHs and∑₁₅PCBs in house dust were 4650 ng g^-1, 564 ng g^-1, 7.52 ng g^-1, and 6.29 ng g^-1, respectively. Exposure to dust organic contaminants via ingestion, inhalation and dermal absorption was estimated for two age classes (adults and children) and carcinogenic and non-carcinogenic risks were assessed. The hazard index (HI) for adults and children for PBDEs, PCBs, PAHs and NPAHs in all samples was less than 1 suggesting a very low level of concern for all human age group due to exposure to those chemicals. Total carcinogenic risk via the three exposure pathways (ingestion, inhalation and dermal contact) was within the safe range of 10^-6 to 10^-4.

The diagnostic value of cardiac magnetic resonance in athletes with suspected structural myocardial diseases

Introduction

Sudden cardiac death (SCD) is the leading cause of death in athletes occurring usually during intensive training. Cardiac magnetic resonance (CMR) is a reliable technique to assess ventricular volumes and function. Furthermore, it provides tissue-specific information and has a crucial role in detecting structural myocardial diseases.

Aim

We aimed to investigate the prevalence of myocardial structural heart diseases and the etiology of sudden cardiac death in highly trained athletes and their outcome during follow-up.

Method

We examined athletes (training ≥6 hours/week) who underwent CMR due to suspected structural myocardial disease at Semmelweis University Heart and Vascular Center between 2009 and 2019. Cine movie images and late gadolinium enhanced (LGE) images were performed. Athletes with structural myocardial alterations were followed for the endpoint of all-cause-mortality.

Results

CMR was performed on a total of 338 athletes (280 male, 24±11 age). The indications for CMR were as follows: aborted sudden cardiac death/sustained ventricular tachycardia (SVT) (4%), ECG alterations (36%), echocardiographic alterations (32%), positive family history of SCD or cardiomyopathies (CMP) (3%), and patients' complaints, e.g. palpitation, syncope, dyspnoea, chest complaints (25%). CMR confirmed structural myocardial disease in 82 athletes with the following distribution: 20 hypertrophic (HCM), 10 arrhythmogenic (AC), 8 dilated (DCM), and 7 non-compact (NCCMP) CMP. The CMR images of three patients indicated Fabry disease. We found post-myocardial infarction scars in 7 cases, and atypical non-ischemic scars in 28 athletes. Besides pathological conditions, we identified minor alterations in 58 patients (51 male, 25±12 age) such as: increased trabeculation, nonspecific LGE in left ventricular insertion point and myocardial crypts. Among athletes examined after aborted sudden cardiac death or SVT we found structural heart disease in 11 males and one female: AC (n=7), HCM (n=1), NCCMP (n=1) and atypical non-ischemic scars (n=3, in two patients the localisation was lateral subepicardial) were diagnosed. During the median follow up of five years one patient died in whom CMR showed lateral scar formation and only mildly reduced left ventricular ejection fraction (50%).

Conclusions

The most common structural alteration was non-ischaemic scar, the most common CMP was HCM, and the leading cause of sudden cardiac death or SVT in our competitive athletes was AC and lateral subepicardial scar formation.

LGE pattern in various cardiomyopathies

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary, financed under the NVKP_16 funding scheme. This project was supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K 120277).

Characterization of dissolved organic carbon in rainwater of an urban/coastal site in Mediterranean area

Concentration and optical characteristics of dissolved organic matter were studied in rainwater in the urban/coastal city of Thessaloniki, Northern Greece for 2-yr sampling period (2014-2016). The concentration of DOC ranged from 0.33-24.5mg/L with higher values measured in spring-summer period. Higher aromaticity and fluorescence intensity was observed in winter. Chromophoric organic matter represents a significant fraction of DOC that is highly correlated with fluorescence during cold period. Three factor spectral profiles of fluorescence were elucidated, with peaks at protein-like and humic-like area at different intensities. Fluorophores at shorter wavelengths are more susceptible to changes. DOC showed negative relationship with precipitation height, particularly during autumn and spring suggesting washout effect. NMR spectra showed the dominance of aliphatic protons in rainwater. Levoglucosan, sucrose and arabitol were determined in rainwater at concentrations <0.07-2.2μg/L, <0.03-5.1μg/L and <0.03-2.1μg/L, respectively showing impact of biomass combustion and biogenic emissions.

Study of polar organic compounds in airborne particulate matter of a coastal urban city

Two classes of polar organic compounds, dicarboxylic acids (DCAs) and sugars/sugar anhydrides (S/SAs), were measured in airborne particulate matter in the area of Thessaloniki, northern Greece. The target compounds were measured simultaneously in two particle fractions PM₁₀ and PM_2.5 during cold and warm periods by employing extraction in an ultrasonic bath with a mixture of MeOH/DCM (1:2 v/v), derivatization with BSTFA-TMCS and GC-MS for analysis. At both fractions, phthalic was the predominant carboxylic acid during cold season and a-ketoglutaric acid in warm season, followed by maleic and malic. Levoglucosan was the dominant sugar anhydride during the cold and arabitol during the warm season. In total, the distribution of DCAs seemed to favor the PM_2.5 particle fraction, probably due to anthropogenic emissions and photochemical formation. The relative contribution of DCAs to PM_2.5 fraction was 0.9-3.2% in cold and 0.9-7.0% in warm period. Regarding S/SAs, levoglucosan was also predominantly distributed in fine particles, with relative contribution to this fraction 0.1-6.3% in cold and <0.65% in warm season, suggesting impact of biomass burning emissions. In contrast, arabitol, fructose, and glucose were mainly found in coarse fraction, possibly due to their biogenic origin. Negative correlation of target compounds with temperature and total solar radiation suggested the contribution of seasonal dependant local sources. Positive relationship with NO and NO₂ oxidants and relative humidity showed secondary formation of polar compounds or enhanced gas-to-particle conversion.

Toxic organic substances and marker compounds in size-segregated urban particulate matter - Implications for involvement in the in vitro bioactivity of the extractable organic matter

Toxic organic substances and polar organic marker compounds, i.e. polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), polycyclic aromatic hydrocarbons (PAHs) and their nitro-derivatives (N-PAHs), as well as dicarboxylic acids (DCAs) and sugars/sugar anhydrites (S/SAs) were analyzed in size-segregated PM samples (<0.49, 0.49-0.97, 0.97-3 and >3 μm) collected at two urban sites (urban traffic and urban background) during the cold and the warm season. The potential associations between the organic PM determinants and the adverse cellular effects (i.e. cytotoxicity, genotoxicity, DNA damage, oxidative DNA adduct formation, and inflammatory response) induced by the extractable organic matter (EOM) of PM, previously measured in Velali et al. (2016b), were investigated by bivariate correlations and Principal Component Analysis (PCA). Partial Least Square regression analysis (PLS) was also employed in order to identify the chemical classes mainly involved in the EOM-induced toxicological endpoints in the various particle size fractions. Results indicated that particle size range <0.49 μm was the major carrier of PM mass and organic compounds at both sites. All toxic organic compounds exhibited higher concentrations at the urban traffic site, except PCBs and OCPs that did not exhibit intra-urban variations. Conversely, wintertime levels of levoglucosan were significantly higher at the urban background site as a result of residential biomass burning. The PLS regression analysis allowed quite good prediction of the EOM-induced cytotoxicity and genotoxicity based on the determined organic chemical classes, particularly for the finest size fraction of PM. Nevertheless, it is expected that other chemical constituents, not determined here, also contribute to the measured toxicological responses.

Carbonyl compounds and dissolved organic carbon in rainwater of an urban atmosphere

This study investigates the occurrence of carbonyl compounds in rainwater at the city of Thessaloniki, Northern Greece. The concentrations of carbonyl compounds (as sum of 14 compounds) ranged from 21.8 to 592 μg/L, mean concentration 119 μg/L. Formaldehyde, acetaldehyde, hexanal, glyoxal, and methylglyoxal were the dominant compounds. DOC concentrations in rainwater ranged from 0.46 to 21.3 mg/L. UV-Vis and fluorescence spectra characteristics showed variation among rain events. Carbonyl compounds were negatively correlated with temperature exhibited relatively higher concentrations in cold season. They also influenced by storm origin with higher concentrations under terrestrial air masses. Calm conditions enhance the concentrations of DOC. Wash out is an effective removal mechanism of DOC.

Sink or source? - The effect of hydrology on phosphorus release in the cultivated riverine wetland Spreewald (Germany)

The cultivated riverine wetland region Spreewald faces detrimental changes in the hydrological conditions due to a significant discharge reduction. With its dense network of impounded waterways and a forced tendency of sedimentation of soluble reactive phosphorus adsorbed to large amounts of FeOH/FeOOH available from mining water and groundwater discharges the 320 km2 region is favoured to accumulate large amounts of total phosphorus (TR) and thus act as an effective phosphorus sink. The change of conditions strongly challenges this function hereafter. This is especially important because eutrophication of lakes downstream the Spreewald region is controlled by phosphorus. Phosphorus balances at a testfield situated in a polder area typical for the central Spreewald region point out that hydrological and consequently hydraulic conditions are the key factors for the phosphorus sink or source behaviour. This is true for the main processes determine P retention and release at the sediment-surface water transition zone as well as for the dominant phosphorus release and retention pathways: groundwater emissions and sedimentation. In the context of hydrological changes in the Spree river catchment results from point scale and river reach scale point out the need for an adapted water management in the Spreewald region to prevent risk of extended eutrophication tendencies downstream due to forced SRP emissions.

Effects of types of institutionalization on responsiveness to social reinforcement, wariness, and outerdirectedness among low-MA residents

The ways in which institutional factors and psychological characteristics of residents interact to determine the behavioral effects of institutionalization were investigated. Two large and five small institutions were rated on resident management practices, aide attitudes, and demographic variables, such as size and cost per resident. Resident variables included preinstitutional deprivation, CA, MA, IQ, and length of institutionalization. The institution and resident variables were used in an attempt to predict three aspects of behavior: responsiveness to social reinforcement, wariness, and outerdirectedness. Of the predictor variables, only MA was related to all three. As in earlier research, institutional variables were not predictive of the behaviors examined.

On the definition and classification of mental retardation

A classification system of mental retardation was proposed based on etiology and IQs at least 2 SDs below the population mean. Social competence and performance capabilities of individuals with subaverage IQs were removed from definitional status and given prominence as correlates of class membership. The reliance on IQs to define mental retardation was predicated on the view that the behavioral sciences currently have no better measure of intellectual functioning, although promising efforts continue. The proclivity to avoid using the label "mentally retarded" was seen as ill-conducive to the betterment of knowledge in the field and detrimental to unlabeled individuals who are denied access to beneficial services.

Role-taking, self-image, and imitativeness of mentally retarded and nonretarded individuals

Retarded and nonretarded individuals matched on MA and CA were tested on role-taking, self-image, and imitation. Higher IQ, MA, real self-image, and ideal self-image were associated with less imitation. Higher IQ and MA were related to more positive ideal self-image, and higher MA was related to more positive real self-image. Retarded individuals had less positive real and ideal self-images compared to the nonretarded groups but were equal to the MA-matched nonretarded group on role-taking ability. The findings were interpreted as supporting the view that role-taking ability is a function of cognitive level and that self-image and imitation are determined by both cognitive and experiential factors.

The treatment of adopted versus neglected delinquent children in the court: a problem of reciprocal attachment?

The authors investigated the discrepant treatment by a juvenile court of adopted versus neglected delinquents. Adopted delinquents received harsher dispositions in spite of the fact that neglected delinquents often faced more serious charges. The two groups are compared in terms of family structure and the criminal and psychiartic histories of their parents; none of these seems to account for the adoptees' harsher treatment. The authors hypothesize that an interplay of late adoption intrinsic vulnerabilities in the children, and weakness of parental bonds accounts for the differential outcomes.