Utility of Native T1 mapping to differentiate between athlete's heart and non-ischemic dilated cardiomyopathy

Background CMR has become an increasingly valuable tool in the diagnosis and risk stratification of patients with nonischaemic dilated cardiomyopathy (DCM) due to its assessment of left ventricular systolic function and tissue characterization ability and may have a role in early identification of cardiomyopathy. Some of the changes associated with early DCM (left ventricular dilatation and mild reduction in LV ejection fraction) can also occur in patients with a history of significant aerobic exercise, known as “athlete’s heart”. Using standard echocardiographic and CMR parameters it may be difficult to differentiate between DCM and normal physiological athletic adaptation, which may have significant implications for the patient. We hypothesized that use of CMR tagging and T1 and T2 mapping might be useful to differentiate between patients with left ventricular dilatation due to DCM and athlete’s heart.