Van Buuren Frank, Mellwig Klaus P, Faber Lothar, Prinz Christian, Fruend Andreas, Dahm Johannes B, Kottmann Tanja, Bogunovic Nikola, Horstkotte Dieter, Butz Thomas, Langer Christoph
Dept. of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany.
Acta Cardiol. 2012 Apr;67(2):213-20. doi: 10.1080/ac.67.2.2154212.
Cardiac adaptation to sports activity in endurance athletes is considerably different from that in power athletes. The effects of a high-level team sport like handball, one of the most popular sports in the world, performed at a younger age, on cardiac rhythm in individuals above the age of 50 have not been investigated to date.
Thirty-three former top-level handball players from the first German league (6 former world champions and numerous Olympians) (57.5 +/- 5.5 y) joined our screening programme for former athletes and underwent electrocardiography, echocardiography and spiroergometry. Data were compared to 24 sedentary healthy controls.
Ten of the 33 athletes suffered from atrial fibrillation (AF). Left ventricular diameter was 53.68 +/- 4.88 mm in the athletes group and 50.58 +/- 4.12 mm in the healthy controls. Analysing the subgroups of handball players ('AF group' and 'non-AF group'), spiroergometry showed oxygen consumption at the anaerobic threshold of 27.54 +/- 6.77 ml/kg/min in the AF group and 31.24 +/- 10.33 ml/kg/min in the non-AF group (P = 0.228). Absolute left atrial diameter was 44.34 +/- 4.41 mm in the AF group (non-AF group 38.94 +/- 3.77 mm, P < 0.001) (healthy controls 37.54 +/- 4.34 mm, compared with all athletes P = 0.015). In all individuals left ventricular wall thickness was within normal limits. However, myocardial walls were thicker in the AF group (11.28 +/- 1.83 mm) than in the non-AF group (9.44 +/- 1.26 mm, P = 0.002). Athletes in the AF group (187.6 +/- 6.42 cm) were significantly taller than in the non-AF group (180.91 +/- 7.31 cm, P = 0.018).
Not only endurance training, but also sports activity with a relevant static component, like team handball, might predispose for AF above the age of 50. LA size, height and myocardial wall thickness seem to affect the risk of developing AF. More data in non-endurance sports are mandatory to confirm this hypothesis.
耐力运动员心脏对体育活动的适应性与力量型运动员有很大不同。像手球这样一项世界上最受欢迎的高水平团队运动，在较年轻时参与，对50岁以上个体心脏节律的影响迄今尚未得到研究。
33名来自德国甲级联赛的前顶级手球运动员（6名前世界冠军和众多奥运选手）（57.5±5.5岁）参加了我们针对前运动员的筛查项目，并接受了心电图、超声心动图和运动心肺功能测试。数据与24名久坐不动的健康对照者进行比较。
33名运动员中有10人患有心房颤动（AF）。运动员组左心室直径为53.68±4.88毫米，健康对照组为50.58±4.12毫米。分析手球运动员亚组（“AF组”和“非AF组”），运动心肺功能测试显示AF组无氧阈值时的耗氧量为27.54±6.77毫升/千克/分钟，非AF组为31.24±10.33毫升/千克/分钟（P = 0.228）。AF组左心房绝对直径为44.34±4.41毫米（非AF组为38.94±3.77毫米，P < 0.001）（健康对照组为37.54±4.34毫米，与所有运动员相比P = 0.015）。所有个体的左心室壁厚度均在正常范围内。然而，AF组心肌壁（11.28±1.83毫米）比非AF组（9.44±1.26毫米，P = 0.002）更厚。AF组运动员（187.6±6.42厘米）明显高于非AF组（180.91±7.31厘米，P = 0.018）。
不仅耐力训练，但也包括像团队手球这种有相关静态成分的体育活动，可能使50岁以上人群易患AF。左心房大小、身高和心肌壁厚度似乎会影响发生AF的风险。需要更多非耐力运动的数据来证实这一假设。
