Manier G, Wickers F, Lomenech A M, Cazorla G, Roudaut R
Laboratoire de Physiologie, Université de Bordeaux II, France.
Eur Heart J. 1991 Nov;12(11):1183-8. doi: 10.1093/eurheartj/12.11.1183.
To determine the effect of strenuous prolonged exercise on systolic and diastolic left ventricular function, 11 non-elite marathon runners aged 37 +/- 7 years (mean +/- SD) were studied before and during early recovery from a marathon race. Cavity dimensions, wall thickness, and fractional shortening were computed from two-dimensionally guided M-mode echocardiograms. Doppler left ventricular inflow tract recordings were analysed for peak early and late velocities and their ratio. In seven subjects, heart frequency was recorded throughout the race. These subjects ran the marathon at 87 +/- 4% of their maximal heart rate. Left ventricular diastolic dimension was slightly reduced at the end of the race (49.4 +/- 4.2 mm to 47.3 +/- 5.1 mm; P less than 0.05). Fractional shortening remained unchanged, although blood pressure (P less than 0.001) and systolic wall stress (P less than 0.01) were decreased. The left ventricular filling pattern was unchanged, and the ratio of early to late velocities remained constant. These results suggest that the fractional shortening was a result of the opposing effects of changes in preload and afterload. However, the absence of a change in the end systolic dimension, despite a marked reduction in afterload and the occurrence of septal akinesia in one subject after the race could only suggest that strenuous prolonged exercise may alter myocardial performance.
为了确定剧烈长时间运动对左心室收缩和舒张功能的影响，我们对11名年龄在37±7岁（平均±标准差）的非精英马拉松运动员在马拉松比赛前及早期恢复期间进行了研究。通过二维引导的M型超声心动图计算腔室尺寸、壁厚和缩短分数。对多普勒左心室流入道记录进行分析，以获取早期和晚期峰值速度及其比值。在7名受试者中，在整个比赛过程中记录心率。这些受试者以其最大心率的87±4%跑完马拉松。比赛结束时左心室舒张末期内径略有减小（从49.4±4.2mm降至47.3±5.1mm；P<0.05）。尽管血压（P<0.001）和收缩期壁应力（P<0.01）降低，但缩短分数保持不变。左心室充盈模式未改变，早期与晚期速度比值保持恒定。这些结果表明，缩短分数是前负荷和后负荷变化的相反作用的结果。然而，尽管后负荷明显降低且一名受试者在比赛后出现室间隔运动不能，但收缩末期内径没有变化，这仅表明剧烈长时间运动可能会改变心肌性能。
