Christou Georgios A, Kouidi Evangelia J, Anifanti Maria A, Sotiriou Panagiota G, Koutlianos Nikolaos A, Deligiannis Asterios P
Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Int J Cardiol. 2016 Dec 1;224:20-26. doi: 10.1016/j.ijcard.2016.08.308. Epub 2016 Aug 21.
The investigation of the differences in orthostatic responses of individuals with a history of noncardiac syncope(NCS) between athletes and nonathletes.
A passive tilt test for 30min was performed in 133 athletes (54 with NCS, 79 without NCS) and 48 nonathletes (15 with NCS, 33 without NCS). We performed measurement of haemodynamic, heart rate variability and baroreflex sensitivity parameters. All comparisons were adjusted for age, gender and body mass index(BMI).
Athletes with NCS had increased heart rate(HR) (90±11 vs 81±10bpm, p=0.001) and decreased total peripheral resistance index(TPRI) (2227±408 vs 2918±733dynesm/cm, p=0.039) and baroreflex effectiveness index(BEI) [70.16(37.42-89.71) vs 72.19(48.49-91.35)%, p=0.016] compared with athletes without NCS. After applying backward stepwise logistic regression analysis to predict history of NCS in athletes, the final model included age, gender, BMI, HR and TPRI. Nonathletes with NCS had increased HR (95±24 vs 83±11bpm, p=0.024) and TPRI (3744±1606 vs 2937±880dynesm/cm, p=0.030) and decreased stroke index(SI) (25.4±7.6 vs 33.0±7.5mL/m, p=0.003) compared with nonathletes without NCS. After applying backward stepwise logistic regression analysis to predict history of NCS in nonathletes, the final model included SI and HR. Among individuals with NCS, athletes had increased SI and BEI and decreased HR and TPRI compared with nonathletes. Among individuals without NCS, a positive result of tilt test was less frequent in athletes compared with nonathletes (p=0.031).
The possible main underlying mechanism for NCS during upright standing in athletes is the decreased TPRI, while the inadequate preservation of SI in nonathletes.
调查有非心源性晕厥（NCS）病史的运动员与非运动员在直立位反应上的差异。
对133名运动员（54名有NCS，79名无NCS）和48名非运动员（15名有NCS，33名无NCS）进行30分钟的被动倾斜试验。我们测量了血流动力学、心率变异性和压力反射敏感性参数。所有比较均根据年龄、性别和体重指数（BMI）进行了调整。
与无NCS的运动员相比，有NCS的运动员心率（HR）升高（90±11对81±10次/分，p=0.001），总外周阻力指数（TPRI）降低（2227±408对2918±733达因·秒/厘米，p=0.039），压力反射有效性指数（BEI）降低[70.16（37.42 - 89.71）%对72.19（48.49 - 91.35）%，p=0.016]。在应用向后逐步逻辑回归分析预测运动员的NCS病史后，最终模型包括年龄、性别、BMI、HR和TPRI。与无NCS的非运动员相比，有NCS的非运动员HR升高（95±24对83±11次/分，p=0.024），TPRI升高（3744±1606对2937±880达因·秒/厘米，p=0.030），每搏输出量指数（SI）降低（25.4±7.6对33.0±7.5毫升/米，p=0.003）。在应用向后逐步逻辑回归分析预测非运动员的NCS病史后，最终模型包括SI和HR。在有NCS的个体中，与非运动员相比，运动员的SI和BEI升高，HR和TPRI降低。在无NCS的个体中，与非运动员相比，运动员倾斜试验阳性结果的发生率较低（p=0.031）。
运动员直立位时发生NCS的可能主要潜在机制是TPRI降低，而非运动员每搏输出量指数保存不足。
