Cardiac MRI in Young Adults with Sedentary Lifestyle-Related Risks

Western society is characterized by a sedentary lifestyle combined with an unhealthy diet resulting in growing populations with overweight, high blood pressure and type 2 diabetes. In older populations, it was demonstrated that these risk factors trigger cardiac adaptation. If cardiac adaptation already occurs at younger age, these changes could potentially overlap with findings on cardiac MRI that are suggestive of cardiomyopathy, complicating diagnosis and treatment.

In a prospectively recruited study cohort of 311 young adults (18-45 years old, 49% male), the impact of the aforementioned risk factors on cardiac MRI outcomes was investigated. It was shown that overweight, high blood pressure and type 2 diabetes cause alterations in wall mass, cardiac volumes and tissue characteristics. Therefore, reference values of cardiac outcomes have been reported for young risk populations to more reliably assess future MRI scans. Also, it was demonstrated that the body metric being used for indexation of body size has a significant impact. Furthermore, changes in ejection fraction were not found, whereas subtle wall motion abnormalities were present.

With literature, the applicability of the tissue characteristics T2 (edema) and T2*-mapping (iron) was assessed for the differentiation of cardiac diseases, risk factors and healthy individuals. Further, it was demonstrated that aortic dimensions can be measured accurately with native imaging, thereby reducing potential health risks in especially risk populations. Lastly, a short-axis cardiac MRI contour-tracing protocol was validated which can be used to accurately assess morphology and function, and also to manually adjust automated tracings in a standardized fashion.