Jun Zhang, Xiang Kong, Li Qi, Shutian Xu, Tongyuan Liu, Jun Cai, Song Luo, Long Jiang Zhang
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Cardiac symptoms (chest pain, dyspnea, palpitations, and syncope) at follow-up were recorded using standardized questionnaires.</p><p><strong>Statistical tests: </strong>Paired sample t-test, independent sample t-test, analysis of variance, Kendall's τ-b. A p value < 0.05 was considered significant.</p><p><strong>Results: </strong>Significant improvements were observed in native T1 (1492 ± 52 ms vs. 1521 ± 57 ms), ECV (23.4% ± 1.7% vs. 24.3% ± 1.8%), T2 (45.9 ± 2.2 ms vs. 47.3 ± 2.3 ms), and 2D global longitudinal strain (-16.7% ± 1.6% vs. -15.8% ± 1.1%) at 3 months follow-up compared to baseline parameters in the EHS cohort. However, native T1 (1492 ± 52 ms vs. 1456 ± 26 ms) and ECV (23.4% ± 1.7% vs. 20.6% ± 1.6%) at follow-up were significantly higher in EHS than in HCs. At 3-month follow-up, native T1, ECV, and LGE presence were associated with cardiac symptoms (Kendall's τ-b = -0.430, -0.447, and -0.398, respectively).</p><p><strong>Data conclusion: </strong>This study demonstrated persistently elevated native T1 and ECV at 3 months following EHS, despite partial improvement. Those with residual abnormalities should not be cleared for unrestricted training.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiac Involvement After Exertional Heatstroke: Short-Term Cardiac MRI Follow-Up Study.\",\"authors\":\"Jun Zhang, Xiang Kong, Li Qi, Shutian Xu, Tongyuan Liu, Jun Cai, Song Luo, Long Jiang Zhang\",\"doi\":\"10.1002/jmri.70157\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Myocardial involvement is a major manifestation of exertional heatstroke (EHS), yet its short-term clinical outcome remains unclear.</p><p><strong>Purpose: </strong>To assess serial cardiac left ventricular structural and functional changes using baseline and 3-month cardiac MRI.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Population: </strong>A total of 41 participants (median age, 21 years; IQR, 20-23 years) hospitalized for EHS and 27 age-, sex-, and training-matched healthy controls (HCs).</p><p><strong>Field strength/sequence: </strong>Fast imaging employing steady-state acquisition (cine imaging), saturation methods using adaptive recovery times (native T1, extracellular volume [ECV]), phase-sensitive inversion-recovery gradient recalled echo (late gadolinium enhancement [LGE]), and multi-echo fast spin echo (T2) sequences at 3.0 T.</p><p><strong>Assessment: </strong>Longitudinal comparisons were performed within the EHS group (baseline vs. 3-month follow-up), and cross-sectional comparisons were performed between patients and HCs. Cardiac symptoms (chest pain, dyspnea, palpitations, and syncope) at follow-up were recorded using standardized questionnaires.</p><p><strong>Statistical tests: </strong>Paired sample t-test, independent sample t-test, analysis of variance, Kendall's τ-b. A p value < 0.05 was considered significant.</p><p><strong>Results: </strong>Significant improvements were observed in native T1 (1492 ± 52 ms vs. 1521 ± 57 ms), ECV (23.4% ± 1.7% vs. 24.3% ± 1.8%), T2 (45.9 ± 2.2 ms vs. 47.3 ± 2.3 ms), and 2D global longitudinal strain (-16.7% ± 1.6% vs. -15.8% ± 1.1%) at 3 months follow-up compared to baseline parameters in the EHS cohort. However, native T1 (1492 ± 52 ms vs. 1456 ± 26 ms) and ECV (23.4% ± 1.7% vs. 20.6% ± 1.6%) at follow-up were significantly higher in EHS than in HCs. 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引用次数: 0
摘要
背景：心肌受累是劳累性中暑（EHS）的主要表现，但其短期临床结果尚不清楚。目的：通过基线和3个月心脏MRI评估左心室结构和功能的变化。研究类型：前瞻性。人群：共有41名参与者（中位年龄21岁；IQR为20-23岁）因EHS住院，27名年龄、性别和训练匹配的健康对照（hc）。场强/序列：采用稳态采集（电影成像）的快速成像，采用自适应恢复时间（原生T1，细胞外体积[ECV]）的饱和方法，相敏反转恢复梯度回忆回波（晚期钆增强[LGE]），以及3.0 T的多回声快速自旋回波（T2）序列。评估：在EHS组内进行纵向比较（基线与3个月随访），并在患者和hc之间进行横断面比较。使用标准化问卷记录随访时的心脏症状（胸痛、呼吸困难、心悸和晕厥）。统计检验：配对样本t检验、独立样本t检验、方差分析、肯德尔τ-b。结果：与EHS队列的基线参数相比，3个月随访时，原生T1（1492±52 ms vs 1521±57 ms）、ECV（23.4%±1.7% vs 24.3%±1.8%）、T2（45.9±2.2 ms vs 47.3±2.3 ms）和2D全局纵向应变（-16.7%±1.6% vs -15.8%±1.1%）均有显著改善。然而，随访时EHS患者的原生T1（1492±52 ms vs 1456±26 ms）和ECV（23.4%±1.7% vs 20.6%±1.6%）明显高于hc患者。在3个月的随访中，原生T1、ECV和LGE的存在与心脏症状相关（Kendall τ-b分别= -0.430、-0.447和-0.398）。数据结论：本研究显示，尽管局部改善，但在EHS后3个月，原生T1和ECV持续升高。有残留异常的不应清除无限制训练。证据等级：2。技术功效：第二阶段。
Cardiac Involvement After Exertional Heatstroke: Short-Term Cardiac MRI Follow-Up Study.
Background: Myocardial involvement is a major manifestation of exertional heatstroke (EHS), yet its short-term clinical outcome remains unclear.
Purpose: To assess serial cardiac left ventricular structural and functional changes using baseline and 3-month cardiac MRI.
Study type: Prospective.
Population: A total of 41 participants (median age, 21 years; IQR, 20-23 years) hospitalized for EHS and 27 age-, sex-, and training-matched healthy controls (HCs).
Field strength/sequence: Fast imaging employing steady-state acquisition (cine imaging), saturation methods using adaptive recovery times (native T1, extracellular volume [ECV]), phase-sensitive inversion-recovery gradient recalled echo (late gadolinium enhancement [LGE]), and multi-echo fast spin echo (T2) sequences at 3.0 T.
Assessment: Longitudinal comparisons were performed within the EHS group (baseline vs. 3-month follow-up), and cross-sectional comparisons were performed between patients and HCs. Cardiac symptoms (chest pain, dyspnea, palpitations, and syncope) at follow-up were recorded using standardized questionnaires.
Statistical tests: Paired sample t-test, independent sample t-test, analysis of variance, Kendall's τ-b. A p value < 0.05 was considered significant.
Results: Significant improvements were observed in native T1 (1492 ± 52 ms vs. 1521 ± 57 ms), ECV (23.4% ± 1.7% vs. 24.3% ± 1.8%), T2 (45.9 ± 2.2 ms vs. 47.3 ± 2.3 ms), and 2D global longitudinal strain (-16.7% ± 1.6% vs. -15.8% ± 1.1%) at 3 months follow-up compared to baseline parameters in the EHS cohort. However, native T1 (1492 ± 52 ms vs. 1456 ± 26 ms) and ECV (23.4% ± 1.7% vs. 20.6% ± 1.6%) at follow-up were significantly higher in EHS than in HCs. At 3-month follow-up, native T1, ECV, and LGE presence were associated with cardiac symptoms (Kendall's τ-b = -0.430, -0.447, and -0.398, respectively).
Data conclusion: This study demonstrated persistently elevated native T1 and ECV at 3 months following EHS, despite partial improvement. Those with residual abnormalities should not be cleared for unrestricted training.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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