Clinic of Angiology, HELIOS Clinic Krefeld, Krefeld, Germany.
Med Sci Sports Exerc. 2011 Jul;43(7):1142-7. doi: 10.1249/MSS.0b013e3182098a51.
We measured extracoronary atherosclerotic plaque burden and its association with cardiovascular risk factors and with coronary atherosclerosis in male marathon runners.
We studied 100 male presumably healthy runners, aged 50-75 yr, who completed at least five marathons during the preceding 3 yr. Presence of plaque in the carotid, abdominal, and lower limb arteries was imaged using B-mode ultrasound. In all runners, traditional cardiovascular risk factors and the electron beam computed tomography-based coronary artery calcium (CAC) score were determined.
Ten runners were free from any plaque in the carotid or peripheral arteries. Runners with plaque were older (58±6 vs 54±5 yr, P=0.04), had a higher 10-yr Framingham risk score (7.2±3.8 vs 5.0±1.9, P=0.026), and tended to have a higher prevalence of CAC (76.7% vs 50.0%, P=0.07) compared with those without. Runners with CAC≥100 had larger peripheral artery diameters (aorta and iliac and common femoral arteries) but smaller lumen than runners with CAC<100, indicating atherosclerotic remodeling. A stepwise model selection process to predict CAC on the basis of age and peripheral atherosclerosis yielded a model as follows: log2(CAC+1)=0.181 age (yr)+0.435 maximum carotid plaque thickness (mm)-6.487, with a coefficient of determination of 22.8%. However, positive and negative predictive values were too low to predict CAC≥100 with sufficient accuracy.
The prevalence of carotid and peripheral atherosclerosis in marathon runners is high and is related to cardiovascular risk factors and the coronary atherosclerotic burden. Remodeling of peripheral arteries is greatest in runners with the most evidence of atherosclerosis. These data support an increased awareness of atherosclerosis prevalence and cardiovascular risk factors in marathon runners.
我们测量了冠状动脉外动脉粥样硬化斑块负担及其与心血管危险因素以及男性马拉松运动员冠状动脉粥样硬化的关系。
我们研究了 100 名年龄在 50-75 岁之间的男性马拉松运动员，他们在过去 3 年中至少完成了 5 次马拉松比赛。使用 B 型超声成像技术对颈动脉、腹部和下肢动脉中的斑块进行成像。在所有运动员中，均确定了传统心血管危险因素和基于电子束计算机断层扫描的冠状动脉钙（CAC）评分。
10 名跑步者的颈动脉或外周动脉均无任何斑块。有斑块的跑步者年龄较大（58±6 岁比 54±5 岁，P=0.04），10 年Framingham 风险评分较高（7.2±3.8 比 5.0±1.9，P=0.026），并且 CAC 阳性的比例较高（76.7%比 50.0%，P=0.07）。与 CAC<100 的跑步者相比，CAC≥100 的跑步者的外周动脉直径（主动脉、髂总动脉和股总动脉）更大，但管腔更小，表明存在动脉粥样硬化重塑。逐步模型选择过程基于年龄和外周动脉粥样硬化来预测 CAC，得到如下模型：log2（CAC+1）=0.181 年龄（岁）+0.435 最大颈动脉斑块厚度（mm）-6.487，决定系数为 22.8%。然而，阳性和阴性预测值太低，无法准确预测 CAC≥100。
马拉松运动员颈动脉和外周动脉粥样硬化的患病率较高，与心血管危险因素和冠状动脉粥样硬化负担有关。在最有动脉粥样硬化证据的跑步者中，外周动脉的重塑最大。这些数据支持提高对马拉松运动员动脉粥样硬化患病率和心血管危险因素的认识。
