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绝经后业余马拉松跑者运动诱导的左心室舒张功能变化:超声心动图和心脏生物标志物评估

Exercise-induced changes of left ventricular diastolic function in postmenopausal amateur marathon runners: assessment by echocardiography and cardiac biomarkers.

作者信息

Knebel Fabian, Spethmann Sebastian, Schattke Sebastian, Dreger Henryk, Schroeckh Sabrina, Schimke Ingolf, Hättasch Robert, Makauskiene Rita, Kleczka Josephine, Sanad Wasiem, Lock Jürgen, Brechtel Lars, Baumann Gert, Borges Adrian Constantin

机构信息

Universitätsmedizin Berlin, Berlin, Germany.

Universitätsmedizin Berlin, Berlin, Germany Bundeswehrkrankenhaus Berlin, Berlin, Germany.

出版信息

Eur J Prev Cardiol. 2014 Jun;21(6):782-90. doi: 10.1177/2047487312462799. Epub 2012 Sep 24.

DOI:10.1177/2047487312462799
PMID:23008137
Abstract

PURPOSE

Diastolic dysfunction is common among elderly women. Recently, concerns regarding marathon-induced myocardial damage were raised among young male runners. The goal of our study was to assess the impact of marathon running on systolic and diastolic ventricular function before and immediately after completing a marathon among postmenopausal well-trained amateur women.

METHODS

A total of 89 female runners of the Berlin Marathon were included (35 postmenopausal and 54 premenopausal female controls) and examined before, immediately, and 2 weeks after the race by echocardiography (including tissue Doppler- and 2D strain speckle tracking) and underwent blood tests.

RESULTS

After the marathon, there was a significant increase in E/E' (postmenopausal 8.5 ± 2.3 vs. 10.9 ± 3.2 post race; control: 8.1 ± 1.8 vs. 9.9 ± 2.9 post race, p < 0.001) and a decrease in E/A in both groups (postmenopausal 1.3 ± 0.36 vs. 0.9 ± 0.21 post race; control 1.7 ± 0.6 vs. 1.1 ± 0.3; p < 0.001). In contrast, regardless of the hormonal status the atrial contraction increased significantly. Left and right ventricular systolic contractility, as assessed by speckle tracking and pulsed-wave tissue Doppler velocities, showed a significant increase in both groups. Of all runners, 55 (61.8%) experienced increases in troponin T and/or N-terminal-B-type natriuretic peptide after the race. All echocardiographic and laboratory parameters returned to normal within 2 weeks.

CONCLUSIONS

2D strain analysis of the left and right ventricles showed an acute improvement of the systolic function after marathon running in pre- and postmenopausal well-trained women. There were no long lasting detrimental effects on the diastolic function.

摘要

目的

舒张功能障碍在老年女性中很常见。最近,年轻男性跑步者中出现了对马拉松运动引起心肌损伤的担忧。我们研究的目的是评估绝经后训练有素的业余女性在完成马拉松比赛之前和之后即刻,马拉松跑步对心室收缩和舒张功能的影响。

方法

共纳入89名柏林马拉松女性跑步者(35名绝经后女性和54名绝经前女性对照),在比赛前、赛后即刻和赛后2周通过超声心动图(包括组织多普勒和二维应变斑点追踪)进行检查,并进行血液检测。

结果

马拉松赛后,两组的E/E'均显著升高(绝经后组赛前8.5±2.3,赛后10.9±3.2;对照组赛前8.1±1.8,赛后9.9±2.9,p<0.001),且两组的E/A均降低(绝经后组赛前1.3±0.36,赛后0.9±0.21;对照组赛前1.7±0.6,赛后1.1±0.3;p<0.001)。相比之下,无论激素状态如何,心房收缩均显著增加。通过斑点追踪和脉冲波组织多普勒速度评估的左、右心室收缩力在两组中均显著增加。在所有跑步者中,55名(61.8%)在赛后肌钙蛋白T和/或N末端B型利钠肽升高。所有超声心动图和实验室参数在2周内恢复正常。

结论

对绝经前和绝经后训练有素的女性进行二维应变分析显示,马拉松赛后左、右心室收缩功能急性改善。对舒张功能没有长期的有害影响。

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