Department of Emergency Medicine, University of California, San Diego, CA 92103-8925, USA.
Am J Emerg Med. 2011 Nov;29(9):1182-7. doi: 10.1016/j.ajem.2010.06.035. Epub 2010 Oct 8.
The purpose of this study was to prospectively evaluate electrocardiograms (ECGs) before and after running a half marathon to characterize the changes that occur after exertion. Echocardiograms were also done postrace on selected runners.
Volunteer runners older than 18 years completed a questionnaire detailing demographic and medical history. Prerace ECGs were performed at a prerace symposium and postrace ECGs were performed within 15 minutes of the participants' completion of the race. Echocardiograms were performed on a random sampling of runners who were judged to have abnormal or changed postrace ECGs.
Eighty-seven runners were enrolled and completed the study. There were 46 males (53%) and 41 females (47%). Fifty-four (62%) runners had changes noted in their ECGs. The most common changes noted were atrial enlargement (37 runners). Other abnormalities seen on the ECGs included new conduction abnormalities, new Q waves, nonspecific ST/T-wave changes, and resolution of previous abnormalities that were seen on initial ECG. There was no statistically significant difference between runners with ECG changes and runners without ECG changes when comparing sex, age, previous marathon experience, exercise, history of exercise-induced chest pain, medical history, and family history of heart disease. Twenty runners with changed or abnormal postrace ECGs had postrace echocardiograms, and 8 were abnormal. Of the abnormal echocardiograms, 2 runners had normal but changed postrace ECGs and 4 runners had abnormalities that were inconsistent with what was seen on ECG.
Our study suggests that ECG abnormalities and changes can occur in distance runners, but their significance is unclear.
本研究旨在前瞻性评估半程马拉松赛后的心电图(ECG),以描述运动后发生的变化。还对部分跑步者进行了赛后超声心动图检查。
年龄大于 18 岁的志愿者跑步者填写详细的人口统计学和病史问卷。在赛前研讨会进行赛前心电图检查,在参赛者完成比赛后 15 分钟内进行赛后心电图检查。对赛后心电图异常或改变的跑步者进行随机抽样进行超声心动图检查。
87 名跑步者完成了研究。其中 46 名男性(53%),41 名女性(47%)。54 名(62%)跑步者的心电图有变化。最常见的变化是心房扩大(37 名跑步者)。心电图上还可见其他异常,包括新的传导异常、新的 Q 波、非特异性 ST/T 波改变以及初始心电图上先前异常的消失。比较心电图有变化和无变化的跑步者的性别、年龄、以前的马拉松经验、运动、运动诱发胸痛史、病史和心脏病家族史时,无统计学差异。20 名心电图改变或异常的跑步者进行了赛后超声心动图检查,其中 8 名异常。在异常超声心动图中,2 名跑步者的心电图正常但改变,4 名跑步者的异常与心电图不一致。
我们的研究表明,心电图异常和改变可能发生在长跑运动员中,但它们的意义尚不清楚。