Teske Arco J, Prakken Niek H, De Boeck Bart W, Velthuis Birgitta K, Martens Edwin P, Doevendans Pieter A, Cramer Maarten J
Department of Cardiology, HP F.02.352, University Medical Centre Utrecht, Heidelberglaan100, 3582 CX Utrecht, The Netherlands.
Eur Heart J. 2009 Apr;30(8):969-77. doi: 10.1093/eurheartj/ehp040. Epub 2009 Feb 24.
To investigate the physiological adaptation of the right ventricle (RV) in response to endurance training and to define reference values for regional deformation in the RV in endurance athletes.
Healthy controls (n = 61), athletes (n = 58), and elite athletes (n = 63) were prospectively enrolled with a training intensity of 2.2 +/- 1.6, 12.5 +/- 2.3 and 24.2 +/- 5.7 h/week, respectively (P < 0.001). Conventional echocardiographic parameters, tissue Doppler imaging (TDI), and 2D strain echo (2DSE)-derived velocity, strain, and strain rate (SR) were calculated in three RV segments. Left ventricular and RV dimensions were significantly increased (P < 0.001) in both groups of athletes compared with controls. Right ventricular systolic velocities and displacement were not different between the groups. Right ventricular strain and SR values were reduced in the RV basal and mid-segment in athletes. Athletes with marked RV dilatation showed lower strain and SR values in the basal (-20.9 +/- 4.7 vs. -24.5 +/- 4.9%, P < 0.001 and -1.23 +/- 0.31 vs. -1.50 +/- 0.33 s(-1), P < 0.001) and mid (-29.3 +/- 5.4 vs. -32.1 +/- 5.3%, P = 0.017 and -1.58 +/- 0.41 vs. -1.82 +/- 0.42 s(-1), P = 0.009) segment, whereas athletes without RV dilatation showed no significant difference compared with the controls.
Regional deformation and deformation rates (TDI and 2DSE) are reduced in the basal RV segment in athletes. This phenomenon is most pronounced in athletes with RV dilatation and should be interpreted as normal when evaluating athletes suspected for RV pathology.
研究右心室(RV)对耐力训练的生理适应性,并确定耐力运动员右心室区域变形的参考值。
前瞻性纳入健康对照组(n = 61)、运动员(n = 58)和精英运动员(n = 63),训练强度分别为2.2±1.6、12.5±2.3和24.2±5.7小时/周(P < 0.001)。在右心室三个节段计算常规超声心动图参数、组织多普勒成像(TDI)以及二维应变超声(2DSE)得出的速度、应变和应变率(SR)。与对照组相比,两组运动员的左心室和右心室尺寸均显著增加(P < 0.001)。各组之间右心室收缩速度和位移无差异。运动员右心室基底段和中间段的应变和SR值降低。右心室明显扩张的运动员基底段(-20.9±4.7 vs. -24.5±4.9%,P < 0.001和-1.23±0.31 vs. -1.50±0.33 s⁻¹,P < 0.001)和中间段(-29.3±5.4 vs. -32.1±5.3%,P = 0.017和-1.58±0.41 vs. -1.82±0.42 s⁻¹,P = 0.009)的应变和SR值较低,而右心室未扩张的运动员与对照组相比无显著差异。
运动员右心室基底段的区域变形和变形率(TDI和2DSE)降低。这种现象在右心室扩张的运动员中最为明显,在评估疑似右心室病变的运动员时应将其视为正常现象。