1Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SWEDEN; 2Department of Medicine, Montefiore Medical Center, The University Hospital of Albert Einstein School of Medicine, Bronx, NY; and 3Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, SWEDEN.
Med Sci Sports Exerc. 2014 Aug;46(8):1624-30. doi: 10.1249/MSS.0000000000000270.
The objective of this study is to investigate the time course of autonomic tone changes after a first-time endurance running race participation and associations with postexertional high-sensitivity troponin (hsTnT) levels in middle-aged males.
Male (n = 42) first-time long-distance running race (Lidingöloppet 30 km) participants ≥45 yr (50.5 ± 5) were examined. HR and HR variability (HRV) in the time domain (SDANN) was measured continuously from 2 d before to 4 d after the race using a wireless cardiovascular monitor that also recorded arrhythmia episodes. In addition, subjects were assessed pre- and postrace by medical history and physical examination, 12-lead ECG, blood tests including hsTnT, and echocardiography.
Compared with corresponding prerace values, nighttime (2:00-4:00 a.m.) HR was significantly elevated (63.6 ± 9.4 vs 53.9 ± 8.3 bpm, P < 0.001) on the first night postrace, whereas HRV remained reduced for a median of 64 h (interquartile range, 51-102 h). A prolonged HR recovery period (r = 0.48, P = 0.005) and a larger reduction in postrace HRV (r = -0.49, P = 0.003) correlated with higher postrace hsTnT levels. The association between reduced HRV and higher hsTnT remained significant after multivariate analysis (β = -0.48, P = 0.01). No sustained ventricular arrhythmias were recorded, but atrial fibrillation occurred in two subjects.
Endurance running race participation caused a prolonged alteration of autonomic tone. More marked and prolonged changes were associated with higher levels of hsTnT, suggesting that the magnitude of troponin increase after strenuous exercise may reflect the magnitude of exercise-induced cardiovascular stress.
本研究旨在探讨中年男性首次参加耐力跑比赛后自主神经张力变化的时程，并探讨其与赛后高敏肌钙蛋白（hsTnT）水平的关系。
入选 42 名首次参加长距离跑步比赛（Lidingöloppet 30km）的中年男性（年龄 50.5±5 岁）。使用无线心血管监测仪连续监测 2 天前至赛后 4 天的心率（HR）和时域 HR 变异性（SDANN），该监测仪还记录心律失常发作。此外，在比赛前后对受试者进行病史和体格检查、12 导联心电图、包括 hsTnT 在内的血液检查以及超声心动图评估。
与相应的赛前值相比，赛后第一晚（凌晨 2:00-4:00）夜间 HR 显著升高（63.6±9.4 比 53.9±8.3bpm，P<0.001），而 HRV 中位数持续降低 64 小时（四分位间距，51-102 小时）。HR 恢复时间延长（r=0.48，P=0.005）和赛后 HRV 降低幅度较大（r=-0.49，P=0.003）与更高的赛后 hsTnT 水平相关。多变量分析后，HRV 降低与 hsTnT 升高之间的关联仍然显著（β=-0.48，P=0.01）。虽然没有记录到持续的室性心律失常，但有 2 名受试者发生了心房颤动。
耐力跑比赛导致自主神经张力的长期改变。更明显和持久的变化与更高的 hsTnT 水平相关，提示剧烈运动后肌钙蛋白升高的幅度可能反映运动引起的心血管应激的幅度。
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