Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
Cardiology Clinical Academic Group, St. George's, University of London, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.
JACC Cardiovasc Imaging. 2017 Sep;10(9):965-972. doi: 10.1016/j.jcmg.2016.08.011. Epub 2016 Nov 16.
This study sought to investigate the effect of different types of exercise on left ventricular (LV) geometry in a large group of female and male athletes.
Studies assessing cardiac adaptation in female and male athletes indicate that female athletes reveal smaller increases in LV wall thickness and cavity size compared with male athletes. However, data on sex-specific changes in LV geometry in athletes are scarce.
A total of 1,083 healthy, elite, white athletes (41% female; mean age 21.8 ± 5.7 years) assessed with electrocardiogram and echocardiogram were considered. LV geometry was classified into 4 groups according to relative wall thickness (RWT) and left ventricular mass (LVM) as per European and American Society of Echocardiography guidelines: normal (normal LVM/normal RWT), concentric hypertrophy (increased LVM/increased RWT), eccentric hypertrophy (increased LVM/normal RWT), and concentric remodeling (normal LVM/increased RWT).
Athletes were engaged in 40 different sporting disciplines with similar participation rates with respect to the type of exercise between females and males. Females exhibited lower LVM (83 ± 17 g/m vs. 101 ± 21 g/m; p < 0.001) and RWT (0.35 ± 0.05 vs. 0.36 ± 0.05; p < 0.001) compared with male athletes. Females also demonstrated lower absolute LV dimensions (49 ± 4 mm vs. 54 ± 5 mm; p < 0.001) but following correction for body surface area, the indexed LV dimensions were greater in females (28.6 ± 2.7 mm/m vs. 27.2 ± 2.7 mm/m; p < 0.001). Most athletes showed normal LV geometry. A greater proportion of females competing in dynamic sport exhibited eccentric hypertrophy compared with males (22% vs. 14%; p < 0.001). In this subgroup only 4% of females compared with 15% of males demonstrated concentric hypertrophy/remodeling (p < 0.001).
Highly trained athletes generally show normal LV geometry; however, female athletes participating in dynamic sport often exhibit eccentric hypertrophy. Although concentric remodeling or hypertrophy in male athletes engaged in dynamic sport is relatively common, it is rare in female athletes and may be a marker of disease in a symptomatic athlete.
本研究旨在探讨不同类型的运动对大量女性和男性运动员左心室（LV）几何形状的影响。
评估女性和男性运动员心脏适应性的研究表明，与男性运动员相比，女性运动员的 LV 壁厚度和腔室大小增加幅度较小。然而，关于运动员 LV 几何形状的性别特异性变化的数据很少。
共纳入 1083 名健康的精英白人运动员（女性占 41%；平均年龄 21.8±5.7 岁），进行心电图和超声心动图检查。根据欧洲和美国超声心动图协会指南，根据相对壁厚度（RWT）和左心室质量（LVM）将 LV 几何形状分为 4 组：正常（正常 LVM/正常 RWT）、向心性肥厚（增加的 LVM/增加的 RWT）、离心性肥厚（增加的 LVM/正常 RWT）和向心性重构（正常的 LVM/增加的 RWT）。
运动员从事 40 种不同的运动项目，女性和男性运动员的运动类型参与率相似。女性的 LVM（83±17 g/m 与 101±21 g/m；p<0.001）和 RWT（0.35±0.05 与 0.36±0.05；p<0.001）均低于男性运动员。女性的 LV 绝对尺寸也较小（49±4 mm 与 54±5 mm；p<0.001），但校正体表面积后，女性的 LV 指数尺寸较大（28.6±2.7 mm/m 与 27.2±2.7 mm/m；p<0.001）。大多数运动员的 LV 几何形状正常。与男性相比，从事动力性运动的女性中离心性肥厚的比例更大（22%比 14%；p<0.001）。在这个亚组中，只有 4%的女性表现出向心性肥厚/重构，而男性为 15%（p<0.001）。
经过高强度训练的运动员通常表现出正常的 LV 几何形状；然而，从事动力性运动的女性运动员常表现出离心性肥厚。尽管男性运动员中常见动力性运动引起的向心性重构或肥厚，但在女性运动员中很少见，这可能是症状性运动员疾病的标志物。
