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妊娠和长期运动对孕产妇心脏结构和功能的影响。

Effects of pregnancy and chronic exercise on maternal cardiac structure and function.

作者信息

Wolfe L A, Preston R J, Burggraf G W, McGrath M J

机构信息

School of Physical and Health Education, Department of Obstetrics and Gynaecology, Queen's University, Kingston, ON, Canada.

出版信息

Can J Physiol Pharmacol. 1999 Nov;77(11):909-17.

Abstract

This study examined the interactive effects of pregnancy and aerobic conditioning on maternal cardiac structure and function. Effects of closely monitored cycle ergometer conditioning were studied during the second (TM2) and third trimesters (TM3) in 22 previously sedentary pregnant women (exercised group, EG) and a nonexercising pregnant control group with similar characteristics (CG, n = 19). Subjects were studied in the resting state by two-dimensional echocardiography and during cycle ergometer exercise at three steady-state power outputs at the start of TM2 (ENTRY), at the end of TM2 and TM3 (postconditioning), and 3-4 months postpartum (NPR, nonpregnant reference, CG only). Aerobic conditioning did not increase left ventricular dimensions beyond those attributable to pregnancy itself. In addition, in contrast with previous studies of nonpregnant women, physical conditioning during pregnancy did not reduce heart rate (HR) in the resting state. During exercise, the slope of the HR versus oxygen uptake (VO2) regression decreased significantly between preconditioning and the end of TM3 in the EG, suggesting that training-induced reductions in HR become more evident with increasing exercise intensity. Also, significant reductions in oxygen pulse (VO2/HR) were observed at all three work rates in the CG, but not in the EG. These findings support the hypothesis that the cardiovascular effects of aerobic conditioning are obscured by more powerful effects of pregnancy in the resting state but become "unmasked" during strenuous exercise.

摘要

本研究探讨了妊娠与有氧训练对孕妇心脏结构和功能的交互作用。对22名既往久坐的孕妇(运动组,EG)和19名具有相似特征的非运动孕妇对照组(CG)在妊娠中期(TM2)和晚期(TM3)进行密切监测的周期测力计训练,并研究其效果。通过二维超声心动图在静息状态下对受试者进行研究,并在TM2开始时(ENTRY)、TM2和TM3结束时(训练后)以及产后3 - 4个月(NPR,非妊娠参照,仅针对CG),在三个稳态功率输出下进行周期测力计运动时对受试者进行研究。有氧训练并未使左心室尺寸增加超过妊娠本身所导致的增加幅度。此外,与既往对非孕妇女性的研究不同,孕期的体能训练并未降低静息状态下的心率(HR)。在运动过程中,EG组在训练前至TM3结束期间,HR与摄氧量(VO2)回归曲线的斜率显著降低,这表明随着运动强度增加,训练导致的HR降低变得更加明显。而且,在CG组的所有三个工作负荷下均观察到氧脉搏(VO2/HR)显著降低,但EG组未观察到。这些发现支持了以下假设:在静息状态下,妊娠的更强效应掩盖了有氧训练对心血管系统的影响,但在剧烈运动期间这种影响会“显现出来”。

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