Sanz de la Garza María, Grazioli Gonzalo, Bijnens Bart H, Pajuelo Carolina, Brotons Daniel, Subirats Enric, Brugada Ramon, Roca Emma, Sitges Marta
Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Spain
Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Spain.
Eur J Prev Cardiol. 2016 Jul;23(10):1114-24. doi: 10.1177/2047487315622298. Epub 2015 Dec 10.
Right ventricle (RV) dysfunction has been described in athletes after endurance races. We aimed to understand and characterize the RV response to endurance exercise, the impact of individual variability and the effects of the amount of exercise.
Echocardiography was performed in 55 healthy adults at baseline and after a three-stage trail race: short (14 km; n = 17); medium (35 km; n = 21); and long (56 km; n = 17). Standard and speckle tracking echocardiographic assessment of the RV was performed with global and separate analysis of the RV basal (inflow) and apical regions. Although no change was observed in the short distance runners, the RV systolic deformation decreased significantly (p < 0.05) after both the medium length and long races (Δ% RV global strain -7.6 ± 20.1 and -8.7 ± 21.8, respectively) with significant RV dilatation (Δ% RV volume +10.6 ± 9.9 and +15.3 ± 12.8, respectively). The RV basal segment made a major contribution to stroke volume during exercise, showing larger increases in size and strain compared with the apex. Various patterns of RV adaptation to exercise, ranging from increases in both RV segmental strains and sizes to an insufficient increase in size and a decrease in strain, were identified; this individual variability was not correlated with prior training.
An acute RV impairment was demonstrated after a trail-running race and was related to the amount of exercise. A high inter-individual variability was observed. Differences in RV adaptation patterns were independent of prior training, suggesting the influence was due to other individual factors.
耐力赛后运动员右心室(RV)功能障碍已有相关描述。我们旨在了解并描述右心室对耐力运动的反应、个体差异的影响以及运动量的作用。
对55名健康成年人在基线时以及进行三段越野赛后进行超声心动图检查:短距离(14公里;n = 17);中距离(35公里;n = 21);长距离(56公里;n = 17)。采用标准和斑点追踪超声心动图对右心室进行评估,并对右心室基底部(流入道)和心尖区域进行整体及单独分析。虽然短距离跑步者未观察到变化,但中距离和长距离赛后右心室收缩变形均显著降低(p < 0.05)(右心室整体应变分别降低7.6±20.1%和8.7±21.8%),同时右心室明显扩张(右心室容积分别增加10.6±9.9%和15.3±12.8%)。运动期间右心室基底部节段对每搏输出量贡献较大,与心尖相比,其大小和应变增加幅度更大。识别出右心室对运动的多种适应模式,从右心室节段应变和大小均增加到大小增加不足及应变降低;这种个体差异与既往训练无关。
越野赛后证实存在急性右心室损伤,且与运动量有关。观察到较高的个体间差异。右心室适应模式的差异与既往训练无关,提示其影响因素为其他个体因素。