Baldesberger Sylvette, Bauersfeld Urs, Candinas Reto, Seifert Burkhardt, Zuber Michel, Ritter Manfred, Jenni Rolf, Oechslin Erwin, Luthi Pia, Scharf Christop, Marti Bernhard, Attenhofer Jost Christine H
Cardiovascular Center Zurich, Klinik Im Park, Seestr. 220, 8027 Zurich, Switzerland.
Eur Heart J. 2008 Jan;29(1):71-8. doi: 10.1093/eurheartj/ehm555. Epub 2007 Dec 7.
Significant brady- and tachyarrhythmias may occur in active endurance athletes. It is controversial whether these arrhythmias do persist after cessation of competitive endurance training.
Among all 134 former Swiss professional cyclists [hereafter, former athletes (FAs)] participating at least once in the professional bicycle race Tour de Suisse in 1955-1975, 62 (46%) were recruited for the study. The control group consisted of 62 male golfers matched for age, weight, hypertension, and cardiac medication. All participants were screened with history, clinical and echocardiographic examination, ECG, and 24 h ECG. The time for the last bicycle race of FAs was 38 +/- 6 years. The mean age at examination was 66 +/- 6 years in controls and 66 +/- 7 years in FAs (P = 0.47). The percentage of study participants with >4 h current cardiovascular training per week was identical. QRS duration (102 +/- 20 vs. 95 +/- 13 ms, P = 0.03) and corrected QTc interval (416 +/- 27 vs. 404 +/- 18, P = 0.004) were longer in FAs. There was no significant difference in the number of isolated atrial or ventricular premature complexes, or supraventricular tachycardias in the 24 h ECG; however, ventricular tachycardias tended to occur more often in FAs than in controls (15 vs. 3%, P = 0.05). The average heart rate was lower in FAs (66 +/- 9 vs. 70 +/- 8 b.p.m.) (P = 0.004). Paroxysmal or persistent atrial fibrillation or flutter was reported more often in FAs (P = 0.028). Sinus node disease (SND), defined as bradycardia of <40 b.p.m. (10 vs. 2%), atrial flutter (6 vs. 0%), pacemaker for bradyarrhythmias (3 vs. 0%), and/or maximal RR interval of >2.5 s (6 vs. 0%), was more common in FA (16%) than in controls (2%, P = 0.006). Observed survival of all FAs was not different from the expected.
Among FAs, SND occurred significantly more often compared with age-matched controls, and there is trend towards more frequent ventricular tachycardias. Further studies have to evaluate prevention of arrhythmias with extreme endurance training, the necessity of regular follow-up of heart rhythm, and management of arrhythmias in former competitive endurance athletes.
活跃的耐力运动员可能会出现显著的缓慢性和快速性心律失常。这些心律失常在停止竞技耐力训练后是否持续存在存在争议。
在1955年至1975年间至少参加过一次瑞士职业自行车赛环瑞士自行车赛的所有134名前瑞士职业自行车手[以下简称前运动员（FAs）]中，62名（46%）被招募参加该研究。对照组由62名年龄、体重、高血压和心脏用药相匹配的男性高尔夫球手组成。所有参与者均接受病史、临床和超声心动图检查、心电图和24小时心电图筛查。FAs最后一次参加自行车比赛的时间为38±6年。对照组检查时的平均年龄为66±6岁，FAs为66±7岁（P = 0.47）。每周进行超过4小时当前心血管训练的研究参与者百分比相同。FAs的QRS时限（102±20 vs. 95±13毫秒，P = 0.03）和校正QTc间期（416±27 vs. 404±18，P = 0.004）更长。24小时心电图中孤立性房性或室性早搏或室上性心动过速的数量无显著差异；然而，FAs中室性心动过速的发生频率往往高于对照组（15% vs. 3%，P = 0.05）。FAs的平均心率较低（66±9 vs. 70±8次/分钟）（P = 0.004）。FAs中阵发性或持续性心房颤动或心房扑动的报告更为频繁（P = 0.028）。窦性心动过缓（SND）定义为心率<40次/分钟（10% vs. 2%）、心房扑动（6% vs. 0%）、缓慢性心律失常起搏器（3% vs. 0%）和/或最大RR间期>2.5秒（6% vs. 0%），在FAs（16%）中比对照组（2%）更常见（P = 0.006）。所有FAs的观察生存率与预期无差异。
与年龄匹配的对照组相比，FAs中SND的发生频率显著更高，并且室性心动过速有更频繁发生的趋势。进一步的研究必须评估极端耐力训练对心律失常的预防、心律定期随访的必要性以及前竞技耐力运动员心律失常的管理。
