Azevedo L F, Perlingeiro P S, Hachul D T, Gomes-Santos I L, Brum P C, Allison T G, Negrão C E, De Matos L D N J
Heart Institute (InCor), Medical School of University of São Paulo, Cardiovascular Rehabilitation and Exercise Physiology Unit, São Paulo, Brazil.
Heart Institute (InCor), Medical School of University of São Paulo, Clinical -Arrhythmia Unit, São Paulo, Brazil.
Int J Sports Med. 2014 Oct;35(11):954-9. doi: 10.1055/s-0033-1364024. Epub 2014 Jun 2.
We investigated the influence of sport modalities in resting bradycardia and its mechanisms of control in highly trained athletes. In addition, the relationships between bradycardia mechanisms and cardiac structural adaptations were tested. Professional male athletes (13 runners, 11 cyclists) were evaluated. Heart rate (HR) was recorded at rest on beat-to-beat basis (ECG). Selective pharmacological blockade was performed with atropine and esmolol. Vagal effect, intrinsic heart rate (IHR), parasympathetic (n) and sympathetic (m) modulations, autonomic influence (AI) and autonomic balance (Abal) were calculated. Plasmatic norepinephrine (high-pressure liquid chromatography) and cardiac structural adaptations (echocardiography) were evaluated. Runners presented lower resting HR, higher vagal effect, parasympathetic modulation (n), AI and IHR than cyclists (P<0.05). Abal, sympathetic modulation (m) and norepinephrine level were similar within athletes regardless of modality. The cardiac chambers were also similar between runners and cyclists (P=0.30). However, cyclists displayed higher septum and posterior wall thickness than runners (P=0.04). Further analysis showed a trend towards inverse correlation between IHR with septum wall thickness and posterior wall thickness (P=0.056). Type of sport influences the resting bradycardia level and its mechanisms of control in professional athletes. Resting bradycardia in runners is mainly dependent on an autonomic mechanism. In contrast, a cyclist's resting bradycardia relies on a non-autonomic mechanism probably associated with combined eccentric and concentric hypertrophy.
我们研究了运动方式对训练有素的运动员静息性心动过缓的影响及其控制机制。此外,还测试了心动过缓机制与心脏结构适应性之间的关系。对职业男性运动员(13名跑步运动员、11名自行车运动员)进行了评估。通过逐搏记录心率(HR)(心电图)。使用阿托品和艾司洛尔进行选择性药理学阻断。计算迷走神经效应、固有心率(IHR)、副交感神经(n)和交感神经(m)调节、自主神经影响(AI)和自主神经平衡(Abal)。评估血浆去甲肾上腺素(高压液相色谱法)和心脏结构适应性(超声心动图)。与自行车运动员相比,跑步运动员的静息心率更低,迷走神经效应、副交感神经调节(n)、AI和IHR更高(P<0.05)。无论运动方式如何,运动员体内的Abal、交感神经调节(m)和去甲肾上腺素水平相似。跑步运动员和自行车运动员的心脏腔室也相似(P=0.30)。然而,自行车运动员的室间隔和后壁厚度比跑步运动员更高(P=0.04)。进一步分析显示,IHR与室间隔壁厚度和后壁厚度之间存在负相关趋势(P=0.056)。运动类型会影响职业运动员的静息心动过缓水平及其控制机制。跑步运动员的静息心动过缓主要依赖于自主神经机制。相比之下,自行车运动员的静息心动过缓依赖于一种可能与离心性和向心性肥厚相结合的非自主神经机制。