Trachsel Lukas D, Carlen Frederik, Brugger Nicolas, Seiler Christian, Wilhelm Matthias
University Clinic for Cardiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland *Lukas D. Trachsel and Frederik Carlen contributed equally to the writing of this article.
J Hypertens. 2015 Jun;33(6):1276-83. doi: 10.1097/HJH.0000000000000558.
Extensive endurance training and arterial hypertension are established risk factors for atrial fibrillation. We aimed to assess the proportion of masked hypertension in endurance athletes and the impact on cardiac remodeling, mechanics, and supraventricular tachycardias (SVT).
Male participants of a 10-mile race were recruited and included if office blood pressure was normal (<140/90 mmHg). Athletes were stratified into a masked hypertension and normotension group by ambulatory blood pressure. Primary endpoint was diastolic function, expressed as peak early diastolic mitral annulus velocity (E'). Left ventricular global strain, left ventricular mass/volume ratio, left atrial volume index, signal-averaged P-wave duration (SAPWD), and SVT during 24-h Holter monitoring were recorded.
From 108 runners recruited, 87 were included in the final analysis. Thirty-three (38%) had masked hypertension. The mean age was 42 ± 8 years. Groups did not differ with respect to age, body composition, cumulative training hours, and 10-mile race time. Athletes with masked hypertension had a lower E' and a higher left ventricular mass/volume ratio. Left ventricular global strain, left atrial volume index, SAPWD, and SVT showed no significant differences between the groups. In multiple linear regression analysis, masked hypertension was independently associated with E' (beta = -0.270, P = 0.004) and left ventricular mass/volume ratio (beta = 0.206, P = 0.049). Cumulative training hours was the only independent predictor for left atrial volume index (beta = 0.474, P < 0.001) and SAPWD (beta = 0.481, P < 0.001).
In our study, a relevant proportion of middle-aged athletes had masked hypertension, associated with a lower diastolic function and a higher left ventricular mass/volume ratio, but unrelated to left ventricular systolic function, atrial remodeling, or SVT.
广泛的耐力训练和动脉高血压是心房颤动已确定的危险因素。我们旨在评估耐力运动员中隐匿性高血压的比例及其对心脏重塑、力学和室上性心动过速（SVT）的影响。
招募参加10英里赛跑的男性参与者，若其诊室血压正常（<140/90 mmHg）则纳入研究。通过动态血压将运动员分为隐匿性高血压组和血压正常组。主要终点是舒张功能，用舒张早期二尖瓣环峰值速度（E'）表示。记录24小时动态心电图监测中的左心室整体应变、左心室质量/容积比、左心房容积指数、信号平均P波时限（SAPWD）和SVT。
在招募的108名跑步者中，87名纳入最终分析。33名（38%）有隐匿性高血压。平均年龄为42±8岁。两组在年龄、身体成分、累计训练时长和10英里赛跑时间方面无差异。隐匿性高血压运动员的E'较低，左心室质量/容积比更高。两组之间左心室整体应变、左心房容积指数、SAPWD和SVT无显著差异。在多元线性回归分析中，隐匿性高血压与E'（β = -0.270，P = 0.004）和左心室质量/容积比（β = 0.206，P = 0.049）独立相关。累计训练时长是左心房容积指数（β = 0.474，P < 0.001）和SAPWD（β = 0.481，P < 0.001）的唯一独立预测因素。
在我们的研究中，相当比例的中年运动员有隐匿性高血压，这与较低的舒张功能和较高的左心室质量/容积比相关，但与左心室收缩功能、心房重塑或SVT无关。
