COUREUR Study Myocardial Inflammation in Cyclist Part 2
Condition: Myocardial Inflammation
MeSH terms: Myocarditis; Inflammation
Study type: Interventional

Summary: 
      The study will evaluate myocardial inflammation in cyclists after high intense and sustained
      exercise. Our hypothesis is that strenuous exercise in recreational cyclists may be
      associated with myocardial inflammation. Myocardial fibrosis in asymptomatic athletes is
      associated with life-threatening arrhythmic events and sudden death. Although myocarditis
      seems to be the most likely underlying cause, it remains unclear if strenuous and sustained
      physical exercise can cause myocardial inflammation with development of myocyte necrosis and
      possibly myocardial fibrosis in athletes.

      Nineteen recreational cyclists performing "L'ETAPE DU TOUR (EDT) de France" a cycling ride
      (175 km, 3600 m of positive altitude difference) on July 4 2021 will be included in this
      study. Each participant will complete a detailed questionnaire detailing their training
      history. All participants will have exercise testing approximately 1 week before the EDT
      stage to set aerobic and anaerobic gas exchange thresholds, as well as VO2max.

      In part 2 of the study cardiac MRI will be performed at rest before the EDT cycling ride
      completion. An ECG registration using a RootiRx will be realized during and up to 6 hours
      after the cycling ride. An echocardiography and cardiac MRI will be repeated in each cyclist
      between 3 and 6 hours after EDT cycling ride completion. A blood sample will be obtained at
      that time after the ride. This time point is chosen based on the highest troponin release
      that 3 to 6 hours post-exercise would allow a sufficient amount of time for inflammation to
      develop and be detectable, corresponding with the time when cardiac Troponin T is typically
      detectable and representing the liberation of enzymes from damaged myocytes.

      Finally, a third cardiac MRI will be repeated 24 hours after start of the cycling ride to
      verify the evolution of possible inflammation over this time period.
    


Intervention name(s): cardiac MRI; Echocardiography; RootiRx for the ECG monitoring during the cycling ride; Blood sample
Intervention type(s): Diagnostic Test; Diagnostic Test; Diagnostic Test; Diagnostic Test
Intervention description(s): T1 and T2 relaxation times will be evaluated on basal and mid-cavity SA maps; a single ROI measurement in the septum will be manually drawn sufficiently far from tissue interfaces to avoid the impact of susceptibility artifacts from adjacent tissues. The differences in T1 and T2 relaxation times between rest and post-exercise will be analyzed.
Cardiac ventricular volumes, function and LV mass will also be quantified.; Measurements of mass, volumes and function will be obtained of both the left and right ventricles enabling comparisons with cardiac MRI and traditional echo measures.; The final report will include the amount of recorded beats, the average heart rate, the maximum and minimum heart rate, the amount of cardiac pauses defined as an interruption in the ventricular rate > 2 seconds. Reported atrial events include atrial ectopic beats and supraventricular tachycardia and ventricular events include ventricular ectopic beats, doublets, triplets, bigeminy, trigeminy and ventricular tachycardia.; Blood sample will be performed 3 to 6 hours after the stage to analyze high-sensitivity cardiac Troponin T (high-sensitivity) levels, Creatine Phosphokinase (CPK) to eliminate the hypothesis of Troponin elevation induced by rhabdomyolysis and C-reactive Protein to corroborate the inflammatory aspect if there is any.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic