Giannattasio C, Failla M, Grappiolo A, Calchera I, Grieco N, Carugo S, Bigoni M, Randelli P, Peretti G, Mancia G
Clinica Medica, Università di Milano-Bicocca and Ospedale S Gerardo, Monza, Milano, Italy.
J Hypertens. 2001 Jan;19(1):71-7. doi: 10.1097/00004872-200101000-00010.
Exercise training induces cardiovascular changes that are both generalized and restricted to the microcirculation of the tissues more actively involved in the exercise itself. Whether the local effect of exercise extends to larger arteries is unknown, however.
In the right and left upper limb of 17 right-handed subjects performing an asymmetric training of the upper limbs (hammer throwers and baseball players) and 16 age-matched sedentary controls, we continuously measured radial artery diameter, distensibility and wall thickness by an echotracking and a beat-to-beat finger blood pressure device. Arterial distensibility was calculated by the arctangent model of Langewouters and expressed as continuous values from diastolic to systolic blood pressure. Measurements were made: (1) in baseline conditions; (2) after release from prolonged proximal ischaemia; and (3) after an increase in radial artery blood flow caused by a short (4 min) distal ischaemia to determine the endothelial involvement in the training-induced change in arterial distensibility.
In athletes the radial artery distensibility was markedly greater in the right than in the left arm, the latter showing values slightly greater than those seen in the two arms of sedentary subjects. In both arms and groups radial artery distensibility increased markedly after prolonged ischaemia, the between arm and group differences being preserved, however. The radial artery response to distal short ischaemia was, on the other hand, similar in the two arms of the athletes, although greater in these subjects than in the sedentary ones. Radial artery wall thickness was greater in the trained than in the untrained arm of athletes, both values being greater than in sedentary subjects.
Asymmetrical training of the upper limbs is accompanied by a greater distensibility of the middle-sized arteries of the more trained side. This is not associated with asymmetrical changes in endothelial structure or function. It is associated with a greater wall thickness in the trained side, suggesting that, at least in part, a training-induced asymmetrical change in wall structure (possibly with a predominance of more distensible tissues such as elastine and smooth muscle) is responsible.
运动训练会引发心血管变化，这些变化既具有全身性，又局限于运动中更活跃参与的组织的微循环。然而，运动的局部效应是否会扩展到较大动脉尚不清楚。
在17名进行上肢不对称训练的右利手受试者（链球运动员和棒球运动员）以及16名年龄匹配的久坐对照者的左右上肢，我们通过回声跟踪和逐搏手指血压装置连续测量桡动脉直径、扩张性和管壁厚度。动脉扩张性通过朗格沃特的反正切模型计算，并表示为从舒张压到收缩压的连续值。测量在以下情况下进行：（1）基线条件下；（2）长时间近端缺血解除后；（3）由短暂（4分钟）远端缺血引起桡动脉血流增加后，以确定内皮在训练诱导的动脉扩张性变化中的作用。
在运动员中，右上肢桡动脉扩张性明显大于左上肢，左上肢的值略高于久坐受试者双臂的值。在所有手臂和组中，长时间缺血后桡动脉扩张性均显著增加，但手臂和组间差异仍然存在。另一方面，运动员双臂对远端短暂缺血的桡动脉反应相似，尽管这些受试者的反应比久坐受试者更大。运动员训练侧的桡动脉壁厚度大于未训练侧，两者的值均大于久坐受试者。
上肢不对称训练伴随着训练较多一侧的中动脉更大的扩张性。这与内皮结构或功能的不对称变化无关。它与训练侧更大的管壁厚度有关，表明至少部分原因是训练诱导的壁结构不对称变化（可能以弹性蛋白和平滑肌等更具扩张性的组织为主）。
