Wilson Mathew, O'Hanlon Rory, Prasad Sanjay, Basavarajaiah Sandeep, Stephens Nigel, Senior Roxy, Shaw Anthony, Sharma Sanjay, Whyte Gregory
Research Centre for Sport and Exercise Performance, University of Wolverhampton, Gorway Road, Walsall, WS1 3BD, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.12.2008.1345. Epub 2009 Aug 17.
This study reports the cardiac structure and function of a lifelong male endurance athlete, who has run over 148 000 miles, who presented with symptoms of chest discomfort, dyspnoea and loss of competitive running performance. Importantly, the athlete documented several periods of regular intensive endurance activity while suffering with flu-like symptoms. Cardiovascular MRI demonstrated a pattern of late gadolinium enhancement, which indicated myocardial scarring as a result of previous myocarditis.Myocarditis is a non-ischaemic inflammatory disease of the myocardium associated with cardiac dysfunction and arrhythmogenic substrate. The clinical course of viral myocarditis is mostly insidious with limited cardiac inflammation and dysfunction. However, as in the present case, overwhelming inflammation may occur in a subset of patients leading to myocardial fibrosis due to recurrent inflammation.
本研究报告了一名终身从事耐力运动的男性运动员的心脏结构和功能。该运动员累计跑步里程超过148000英里，出现了胸部不适、呼吸困难和竞技跑步成绩下降等症状。重要的是，该运动员在出现类似流感症状的同时，记录了多个定期进行高强度耐力活动的时期。心血管磁共振成像显示了钆延迟强化模式，这表明既往心肌炎导致了心肌瘢痕形成。心肌炎是一种与心脏功能障碍和致心律失常基质相关的非缺血性心肌炎症性疾病。病毒性心肌炎的临床病程大多隐匿，心脏炎症和功能障碍有限。然而，如本病例所示，一部分患者可能会发生严重炎症，由于反复炎症导致心肌纤维化。
