Palazzuoli Alberto, Gennari Luigi, Calabria Paolo, Nami Renato, Martini Giuseppe, Palazzuoli Vincenzo, Nuti Ranuccio
Department of Internal Medicine and Metabolic Disease, Section of Cardiology, University of Siena.
Blood Press. 2004;13(1):14-9. doi: 10.1080/08037050310025690.
This study was executed to evaluate left ventricular (LV) geometry, diastolic and systolic function assessed by B- and M-mode and pulsed Doppler echocardiography in a group of professional sprinter runners (group I), in young patients suffering from mild hypertension (group II) and in control young adults (group III). Twenty-one male sprinter runners were checked during a period of training and compared with 19 young patients suffering from mild hypertension and 15 healthy controls matched for gender and body size.
LV septum thickness, LV posterior wall thickness, LV ejection fraction, LV shortening fraction, midwall fractional shortening and stroke volume were significantly higher in runners compared to hypertensive patients and controls (p < 0.001). A significant increase of diastolic function parameters of the early peak flow velocity, E, and the early/late diastolic wave ratio, E/A, and in the isovolumic relaxation time or in the E velocity deceleration time wave was observed in hypertensive patients when compared to runners and controls (p < 0.05). The study of the pulmonary venous flow revealed a significant increase in the early systolic flow velocity, S, in hypertensive patients compared to runners (p < 0.05); the late diastolic flow velocity, D, appeared to be similar in all groups, while atrial backward flow velocity, Ar, was higher in group I and II respect to control (p < 0.001).
Our data indicate that LV concentric hypertrophy in sportsmen is associated with improvement of systolic and diastolic performance, whereas diastolic dysfunction can occurs even in the early stages of hypertension in young patients, in whom an alteration in the LV filling appears even in absence of systolic dysfunction and evident concentric myocardial hypertrophy.
本研究旨在通过B型和M型以及脉冲多普勒超声心动图评估一组职业短跑运动员(第一组)、轻度高血压年轻患者(第二组)和健康对照年轻成年人(第三组)的左心室(LV)几何形态、舒张功能和收缩功能。在训练期间对21名男性短跑运动员进行检查,并与19名轻度高血压年轻患者和15名性别和体型匹配的健康对照者进行比较。
与高血压患者和对照组相比,跑步运动员的左心室间隔厚度、左心室后壁厚度、左心室射血分数、左心室缩短分数、室壁中层缩短分数和每搏输出量显著更高(p<0.001)。与跑步运动员和对照组相比,高血压患者的舒张功能参数早期峰值流速E、早期/晚期舒张波比值E/A、等容舒张时间或E波速度减速时间波显著增加(p<0.05)。肺静脉血流研究显示,与跑步运动员相比,高血压患者的早期收缩期流速S显著增加(p<0.05);所有组的晚期舒张期流速D似乎相似,而第一组和第二组的心房逆向流速Ar高于对照组(p<0.001)。
我们的数据表明,运动员的左心室向心性肥厚与收缩和舒张功能的改善有关,而舒张功能障碍即使在年轻高血压患者的早期阶段也可能发生,这些患者即使在没有收缩功能障碍和明显的向心性心肌肥厚的情况下,左心室充盈也会出现改变。