Stewart Glenn M, Chan Jonathan, Yamada Akira, Kavanagh Justin J, Haseler Luke J, Shiino Kenji, Sabapathy Surendran
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Eur Heart J Cardiovasc Imaging. 2017 Jun 1;18(6):688-696. doi: 10.1093/ehjci/jew128.
Strenuous endurance exercise acutely increases myocardial wall stress and evokes transient functional cardiac perturbations. However, it is unclear whether exercise-induced functional cardiac disturbances are ubiquitous throughout the myocardium or are segment specific. The aim of this study was to examine the influence of high-intensity endurance exercise on global and segmental left (LV) and right (RV) ventricular tissue deformation (strain).
Echocardiography was used to measure strain in 23 active men (age: 28 ± 2 years; VO2 peak: 4.5 ± 0.7 L min-1) at rest and during a standardized low-intensity exercise challenge, before and after a 90-min high-intensity endurance cycling intervention. Following the cycling intervention, LV and RV global strain decreased at rest (LV: -18.4 ± 0.4% vs. -17.7 ± 0.4%, P < 0.05; RV: -27.6 ± 0.7% vs. -26.4 ± 0.6%, P < 0.05) and by a greater extent during the low-intensity exercise challenge (LV: -21.3 ± 0.4% vs. -19.2 ± 0.5%, P < 0.01; RV: -28.4 ± 0.8% vs. -23.5 ± 0.9%, P < 0.01). Reductions in LV strain were unique to regions of RV attachment (e.g. LV septum: -24.4 ± 0.5% vs. -21.4 ± 0.6%, P < 0.01) with lateral (-18.9 ± 0.4% vs. -18.4 ± 0.5%) and posterior segments (-19.5 ± 0.4% vs. -18.8 ± 0.7%) unaffected. Similarly, augmentation of strain from rest to exercise was abolished in the RV free wall (-1.1 ± 1.0% vs. 2.9 ± 1.2%, P < 0.01), reduced in the septum (-4.6 ± 0.4% vs. -2.4 ± 0.5%, P < 0.01), and unchanged in the lateral (-1.2 ± 0.6% vs. -0.9 ± 0.6%) and posterior walls (-1.7 ± 0.6% vs. -1.3 ± 0.7%).
Changes in ventricular strain following high-intensity exercise are more profound in the right ventricle than in the left ventricle. Reductions in LV strain were unique to the septal myocardium and may reflect ventricular interactions secondary to exercise-induced RV dysfunction.
剧烈耐力运动可急性增加心肌壁应力并引发短暂的心脏功能紊乱。然而,尚不清楚运动诱发的心脏功能紊乱在整个心肌中是否普遍存在还是具有节段特异性。本研究的目的是探讨高强度耐力运动对左心室(LV)和右心室(RV)整体及节段性组织变形(应变)的影响。
对23名活跃男性(年龄:28±2岁;峰值摄氧量:4.5±0.7L/min)在静息状态下、标准化低强度运动挑战期间、90分钟高强度耐力骑行干预前后进行超声心动图检查以测量应变。骑行干预后,静息时左心室和右心室整体应变降低(左心室:-18.4±0.4%对-17.7±0.4%,P<0.05;右心室:-27.6±0.7%对-26.4±0.6%,P<0.05),在低强度运动挑战期间降低幅度更大(左心室:-21.3±0.4%对-19.2±0.5%,P<0.01;右心室:-28.4±0.8%对-23.5±0.9%,P<0.01)。左心室应变降低仅见于右心室附着区域(如左心室间隔:-24.4±0.5%对-2