通过斑点追踪超声心动图检测马拉松和超级越野跑运动员右心腔重构。
P260Right cardiac chambers remodeling in marathon and ultra-trail athletes detected by speckle-tracking echocardiography.
作者信息
Ujka K, Bruno R M, Catuzzo B, Bastiani L, Tonacci A, D'angelo G, Mrakic-Sposta S, Vezzoli A, Giardini G, Pratali L
机构信息
Institute of Clinical Physiology of CNR, Pisa, Italy.
University of Pisa, Pisa, Italy.
出版信息
Eur Heart J Cardiovasc Imaging. 2016 Dec 1;17(suppl_2):ii45-ii48. doi: 10.1093/ehjci/jew236.003.
BACKGROUND
Strenuous and chronic exercise training can have detrimental effects on cardiac morphology and function. Our aim was to evaluate the cardiac adaptation between 2 different specialties' endurance athletes: marathon runners (M) and ultra-trailers (UT).
METHODS
47 M (age 45±7, men 32; training: 18 (9-53) yearsdays/week), 41 UT (age 42±9, men 38, training: 30 (15-66) yearsdays/week) were submitted in rest condition to conventional 2D echocardiography and Speckle-Tracking echo (STE) (Beyond Diogenes 2.0, AMID) during agonistic season and compared with 15 age matched sedentary individuals (S) (age 43±6, men 10).
RESULTS
Left ventricle (LV) global longitudinal strain (GLS) and global radial strain (GRS) were increased in M and UT compared to S (see table) without differences in LV anatomy and function. Right ventricle (RV) end-diastolic area (p=0.026), fractional area changing (p=0.008) and RV GLS were increased in UT compared to M. Moreover UT showed larger right atrium (RA) volume compared to M (p=0.03) and S (p=0.003). RA GLS was reduced in UT compared to M while the RA Global Circumferential Strain was significantly increased in UT. After adjusted for age, sex and HR as covariates, UT showed a reduced RA GLS (OR 0.907; CI 0.856-0.961) and increased RV FAC (OR 1.172; CI: 1.044-1.317) compared to M; while when compared to S subjects, UT showed increased RA volume (OR 1.048; CI 1.002-1.096) and RV GLS (OR 0.667; CI 0.490-0.907).
CONCLUSION
UT showed higher RV and RA morphological and functional remodeling in comparison with M. 2D-STE is a useful tool to investigate the deformation dynamic in different sport specialties. Further studies will be necessary to clarify the long-term consequences for cardiac health due to myocardial perturbations.
UNLABELLED
MUTSpLV GLS-28.59±3.43*-27.64±4.18*-24.82±4.53<0.05LV GRS69.85±8.9466.59±11.1956.27±16.25<0.001RV GLS-25.60±10.54-30.41±4.38*-27.10±4.64<0.05RA GLS37.15±13.4931.65±9.6035.37±9.99<0.05RA GCS17.46±6.4222.28±8.9723.37±6.47<0.01.
背景
剧烈且长期的运动训练可能对心脏形态和功能产生有害影响。我们的目的是评估两种不同专业耐力运动员之间的心脏适应性：马拉松运动员（M）和超级马拉松运动员（UT）。
方法
47名马拉松运动员（年龄45±7岁，男性32名；训练时长：18（9 - 53）年天/周），41名超级马拉松运动员（年龄42±9岁，男性38名，训练时长：30（15 - 66）年天/周）在竞技赛季休息状态下接受常规二维超声心动图和斑点追踪超声心动图（STE）（Beyond Diogenes 2.0，AMID）检查，并与15名年龄匹配的久坐不动个体（S）（年龄43±6岁，男性10名）进行比较。
结果
与久坐不动个体相比，马拉松运动员和超级马拉松运动员的左心室（LV）整体纵向应变（GLS）和整体径向应变（GRS）增加（见表），左心室解剖结构和功能无差异。与马拉松运动员相比，超级马拉松运动员的右心室（RV）舒张末期面积（p = 0.026）、面积变化分数（p = 0.008）和右心室GLS增加。此外，与马拉松运动员相比，超级马拉松运动员的右心房（RA）容积更大（p = 0.03），与久坐不动个体相比也更大（p = 0.003）。与马拉松运动员相比，超级马拉松运动员的右心房GLS降低，而右心房整体圆周应变显著增加。在将年龄、性别和心率作为协变量进行调整后，与马拉松运动员相比，超级马拉松运动员的右心房GLS降低（OR 0.907；CI 0.856 - 0.961），右心室FAC增加（OR 1.172；CI：1.044 - 1.317）；与久坐不动个体相比，超级马拉松运动员的右心房容积增加（OR 1.048；CI 1.002 - 1.096），右心室GLS增加（OR 0.667；CI 0.490 - 0.907）。
结论
与马拉松运动员相比，超级马拉松运动员表现出更高程度的右心室和右心房形态及功能重塑。二维斑点追踪超声心动图是研究不同运动专业中变形动态的有用工具。有必要进一步研究以阐明心肌扰动对心脏健康的长期影响。
未标记
MUTSpLV GLS - 28.59±3.43 * - 27.64±4.18 * - 24.82±4.53 <0.05LV GRS69.85±8.94 * 66.59±11.19 * 56.27±16.25 <0.001RV GLS - 25.60±10.54 - 30.41±4.38 * - 27.10±4.64 <0.05RA GLS37.15±13.4931.65±9.60 * 35.37±9.99 <0.05RA GCS17.46±6.4222.28±8.97 * 23.37±6.47 <0.01。
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