D'Andrea Antonello, Zeppilli Paolo, Caso Pio, D'Andrea Luigi, Scherillo Marino, Calabrò Raffaele
Cattedra di Cardiologia, Seconda Università degli Studi, Napoli.
Ital Heart J Suppl. 2003 Aug;4(8):635-44.
Hemodynamic overload due to long-term training usually involves both left and right ventricles, inducing changes in cardiac structure such as an increase in internal cavity diameters, wall thickness and mass. Standard Doppler echocardiography has been widely used to identify the athlete's heart and to distinguish it from left ventricular pathologies. Pulsed Doppler myocardial imaging (DMI) extends Doppler applications beyond the analysis of cardiac blood flows to the measurement of myocardial wall motion. Recent reports have documented the usefulness of DMI in the evaluation of the athlete's heart. In particular, DMI analysis of trained subjects may represent a valid noninvasive tool in the following fields of application: 1) to assess differences in myocardial function in diverse forms of both physiological and pathological left ventricular hypertrophy; 2) to predict left ventricular performance during effort; 3) to analyze the effects of different training protocols on ventricular regional function; 4) to evaluate biventricular cooperation; 5) to detect myocardial dysfunction associated with pathological genotype in cardiomyopathies.
长期训练导致的血流动力学超负荷通常累及左、右心室，引起心脏结构改变，如心腔内径、壁厚和质量增加。标准多普勒超声心动图已被广泛用于识别运动员心脏，并将其与左心室病变相区分。脉冲多普勒心肌成像（DMI）将多普勒应用从心脏血流分析扩展到心肌壁运动测量。最近的报告记录了DMI在评估运动员心脏方面的有用性。特别是，对训练有素的受试者进行DMI分析可能在以下应用领域中是一种有效的非侵入性工具：1）评估不同形式的生理性和病理性左心室肥厚中心肌功能的差异；2）预测运动时左心室功能；3）分析不同训练方案对心室局部功能的影响；4）评估双心室协作；5）检测心肌病中与病理基因型相关的心肌功能障碍。
