Adler Yehuda, Fisman Enrique Z, Koren-Morag Nira, Tanne David, Shemesh Joseph, Lasry Ety, Tenenbaum Alexander
Cardiac Rehabilitation Institute, Sheba Medical Center, Tel Hashomer, Israel.
Am J Cardiol. 2008 Jul 1;102(1):97-101. doi: 10.1016/j.amjcard.2008.02.105. Epub 2008 Apr 22.
Individuals involved in intense resistance training present with increased absolute left ventricular (LV) wall thickness and mass and show good systolic responses to isometric exercise. There is no consensus regarding diastolic features and no available information regarding diastolic function in athletes during isometric exertion itself. Therefore, the main aim of this study was to assess diastolic LV function at baseline and during exercise in athletes. The population consisted of 96 men (mean age 29 +/- 7 years): 48 weight lifters who trained for 15 to 20 hours/week and 48 sedentary men. All weight lifters had been active for >6 years, including the 6 months before the study. Ultrasound was performed using a commercially available Doppler echocardiographic system. Isometric exercise was performed in the supine position using a standard 2-hand bar dynamometer. The man end-diastolic volumes at rest were 97 +/- 6 ml in sedentary subjects and 101 +/- 5 ml in weight lifters, increasing to 100 +/- 6 and 118 +/- 11 ml during exercise (p = 0.06 and p <0.01, respectively). End-systolic volumes at rest were similar in the 2 groups, showing significantly greater reductions during exercise in the weight lifters. The mean absolute LV mass was 167 +/- 30 g in sedentary subjects and 202 +/- 32 g in weight lifters (p <0.0001). The mean stroke volume increased from 65 +/- 7 to 86 +/- 7 ml in sedentary subjects and from 70 +/- 6 to 107 +/- 11 ml in weight lifters (intergroup significance p = 0.05 and p <0.01, respectively). A similar pattern of response was documented for the ejection fraction (i.e., significantly greater increases during exercise in weight lifters). Regarding diastolic indexes, in the weight lifters, the mean peak early velocity at rest was 68 +/- 7 cm/s, the mean acceleration rate was 1,242 +/- 176 cm/s/s, and the mean deceleration rate was 414 +/- 44 cm/s/s. All these values were significantly higher than in sedentary subjects, with further increases during exercise (p <0.0001). In weight lifters, the mean peak atrial velocity at rest was 37 +/- 6 cm/s, the mean acceleration time was 55 +/- 4 ms, the mean isovolumic relaxation time was 63 +/- 3 ms, and the mean deceleration time was 164 +/- 4 ms; these values were lower than in sedentary subjects (p <0.0001 for all). In conclusion, intense resistance training leads to enhanced LV diastolic function at rest and during isometric exercise despite the markedly increased LV mass.
参与高强度抗阻训练的个体表现出左心室(LV)绝对壁厚度和质量增加,并且对等长运动表现出良好的收缩反应。关于舒张期特征尚无共识,对于运动员在等长运动期间的舒张功能也没有可用信息。因此,本研究的主要目的是评估运动员在基线和运动期间的左心室舒张功能。研究对象包括96名男性(平均年龄29±7岁):48名每周训练15至20小时的举重运动员和48名久坐不动的男性。所有举重运动员的运动年限均超过6年,包括研究前的6个月。使用市售的多普勒超声心动图系统进行超声检查。使用标准的双手握力计在仰卧位进行等长运动。久坐不动的受试者静息时的舒张末期容积为97±6 ml,举重运动员为101±5 ml,运动期间分别增加到100±6和118±11 ml(p分别为0.06和p<0.01)。两组静息时的收缩末期容积相似,举重运动员在运动期间的减少幅度明显更大。久坐不动的受试者左心室平均绝对质量为167±30 g,举重运动员为202±32 g(p<0.0001)。久坐不动的受试者平均每搏输出量从65±7 ml增加到86±7 ml,举重运动员从70±6 ml增加到107±11 ml(组间差异分别为p = 0.05和p<0.01)。射血分数也记录到了类似的反应模式(即举重运动员在运动期间的增加幅度明显更大)。关于舒张期指标,在举重运动员中,静息时的平均早期峰值速度为68±7 cm/s,平均加速度为1242±176 cm/s/s,平均减速度为414±44 cm/s/s。所有这些值均显著高于久坐不动的受试者,并且在运动期间进一步增加(p<0.0001)。在举重运动员中,静息时的平均心房峰值速度为37±6 cm/s,平均加速时间为55±4 ms,平均等容舒张时间为63±3 ms,平均减速时间为164±4 ms;这些值低于久坐不动的受试者(所有p<0.0001)。总之,尽管左心室质量明显增加,但高强度抗阻训练会导致静息和等长运动期间左心室舒张功能增强。