Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5, bld 1, 80131 Naples, Italy.
Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
Eur Heart J Cardiovasc Imaging. 2017 May 1;18(5):549-555. doi: 10.1093/ehjci/jew122.
The determinants of systolic function in the performing heart are not completely understood. Aim of the study was to assess the contributors of left ventricular (LV) strain components, using 3D speckle tracking echocardiography (STE) in endurance athletes.
A total of 36 top-level male endurance athletes (AT) and 36 age-matched sedentary normal controls (NC) underwent standard and real-time 3D echocardiography. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were assessed using 3D STE. AT had significantly higher GLS (-22.1 ± 4.4 vs. -18.4 ± 3.5%; P < 0.0001), GCS (-17.9 ± 2.4 vs. -16.0 ± 3.2; P = 0.006), and GAS (-35.5 ± 6.7 vs. -30.2 ± 4.9; P < 0.0001), while GRS did not differ significantly with NC. At separate multiple linear regression analyses, heart rate emerged as independent predictor of GLS (β = -0.37, P < 0.002), GCS (β = -0.32, P = 0.007), GAS (β = -0.37, P < 0.001), and GRS (β = -0.29, P = 0.019); LV mass was independently associated with GLS (β = 0.34, P = 0.009) and GAS (β = 0.41, P < 0.001) but not with GCS and GRS, while diastolic blood pressure predicted GCS (β = -0.46, P < 0.0001), GAS (β = -0.28; P = 0.006), and GRS (β = -0.42, P < 0.001). No independent correlation emerged for body surface area and stroke volume. By replacing LV mass with end-diastolic volume, the latter showed independent association with GCS (β = -0.65, P = 0.028) and with GRS (β = -0.60, P < 0.05).
AT have an increased myocardial function at rest when compared with NC, this being elicited mainly by subendocardial and mid-wall fibres. Sinus bradycardia, LV mass, and afterload are independent determinants of supernormal myocardial deformation at rest.
人们对运动心脏收缩功能的决定因素尚不完全了解。本研究旨在使用三维斑点追踪超声心动图（STE）评估耐力运动员左心室（LV）应变分量的贡献者。
总共纳入 36 名顶级男性耐力运动员（AT）和 36 名年龄匹配的久坐正常对照组（NC）进行标准和实时 3D 超声心动图检查。使用 3D STE 评估整体纵向应变（GLS）、整体周向应变（GCS）、整体面积应变（GAS）和整体径向应变（GRS）。AT 的 GLS（-22.1 ± 4.4 比-18.4 ± 3.5%；P < 0.0001）、GCS（-17.9 ± 2.4 比-16.0 ± 3.2；P = 0.006）和 GAS（-35.5 ± 6.7 比-30.2 ± 4.9；P < 0.0001）明显更高，而 GRS 与 NC 无显著差异。在单独的多元线性回归分析中，心率是 GLS（β = -0.37，P < 0.002）、GCS（β = -0.32，P = 0.007）、GAS（β = -0.37，P < 0.001）和 GRS（β = -0.29，P = 0.019）的独立预测因子；LV 质量与 GLS（β = 0.34，P = 0.009）和 GAS（β = 0.41，P < 0.001）独立相关，但与 GCS 和 GRS 不相关，而舒张压预测 GCS（β = -0.46，P < 0.0001）、GAS（β = -0.28；P = 0.006）和 GRS（β = -0.42，P < 0.001）。体表面积和每搏量与无独立相关性。用舒张末期容积代替 LV 质量后，后者与 GCS（β = -0.65，P = 0.028）和 GRS（β = -0.60，P < 0.05）呈独立相关。
与 NC 相比，AT 在休息时具有更高的心肌功能，这主要是由心内膜下和中层纤维引起的。窦性心动过缓、LV 质量和后负荷是休息时超正常心肌变形的独立决定因素。
