Simsek Ziya, Hakan Tas M, Degirmenci Husnu, Gokhan Yazıcı A, Ipek Emrah, Duman Hakan, Gundogdu Fuat, Karakelleoglu Sule, Senocak Huseyin
Department of Cardiology, Ataturk University, Erzurum, Turkey.
Echocardiography. 2013 Nov;30(10):1202-8. doi: 10.1111/echo.12263. Epub 2013 Jun 25.
In individuals who exercise regularly and for extended periods of time, some structural alterations in the heart, called the athlete's heart, develop in time. These alterations vary in type, can be eccentric or concentric, depending on the nature of exercise. Speckle tracking echocardiography (STE) is a novel, angle-independent method that accurately and reliably measures systolic and diastolic functions of the left ventricle (LV) with considerably lower inter-operator variability.
Twenty-two marathon runners, 24 wrestlers, and 20 healthy sedentary individuals were included in the study. The average age of subjects is 17.5 ± 2.2 in marathon runners, 16.8 ± 1.9 in wrestlers, and 16.4 ± 1.8 in control group. The parameters of LV longitudinal strain (S), LV longitudinal strain rate systolic (SRS), LV longitudinal strain rate diastolic early filling (SRE), and longitudinal strain rate diastolic late filling (SRA) were evaluated by apical two-, three-, and four-chamber grayscale imaging using the global longitudinal strain (GLS) and GLS rate (GLSR). Conventional echocardiographic parameters demonstrated increased LV diameters and wall thickness in the marathon runners and increased wall thickness without increased LV diameters in the wrestlers. Systolic and diastolic functions were comparable between the marathon runners and wrestlers with conventional echocardiography. Analysis with STE, however, yielded higher systolic strain and strain rates in the athletes. Normalized GLS parameters and end-diastolic volume (EDV) were shown to be correlated.
Overall, conventional echocardiography can detect some differences between young athletes with eccentric and concentric type of athlete's heart but it is incapable of revealing differences in intrinsic myocardial functions. However, analysis using STE demonstrated increased systolic functions in athletes commensurate with increased load, with unaltered diastolic functions.
在经常长期锻炼的个体中，心脏会出现一些结构改变，即运动员心脏，且会随时间发展。这些改变类型各异，可呈离心性或向心性，取决于运动性质。斑点追踪超声心动图（STE）是一种新型的、角度无关的方法，能准确可靠地测量左心室（LV）的收缩和舒张功能，且操作者间变异性显著更低。
本研究纳入了22名马拉松运动员、24名摔跤运动员和20名健康久坐个体。马拉松运动员的平均年龄为17.5±2.2岁，摔跤运动员为16.8±1.9岁，对照组为16.4±1.8岁。通过心尖二腔、三腔和四腔灰阶成像，使用整体纵向应变（GLS）和GLS率（GLSR）评估左心室纵向应变（S）、左心室收缩期纵向应变率（SRS）、左心室舒张早期充盈纵向应变率（SRE）和左心室舒张晚期充盈纵向应变率（SRA）参数。传统超声心动图参数显示，马拉松运动员的左心室直径和壁厚增加，摔跤运动员的壁厚增加但左心室直径未增加。马拉松运动员和摔跤运动员的收缩和舒张功能在传统超声心动图检查中相当。然而，STE分析显示运动员的收缩应变和应变率更高。标准化的GLS参数与舒张末期容积（EDV）相关。
总体而言，传统超声心动图可检测出具有离心性和向心性运动员心脏的年轻运动员之间的一些差异，但无法揭示心肌内在功能的差异。然而，使用STE分析表明，运动员的收缩功能随负荷增加而增强，舒张功能未改变。
