马拉松比赛中业余耐力运动员运动诱发的ST-T段偏移和心律失常的发生率：前瞻性观察性柏林跑步心跳研究结果
Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.
作者信息
Herm Juliane, Töpper Agnieszka, Wutzler Alexander, Kunze Claudia, Krüll Matthias, Brechtel Lars, Lock Jürgen, Fiebach Jochen B, Heuschmann Peter U, Haverkamp Wilhelm, Endres Matthias, Jungehulsing Gerhard Jan, Haeusler Karl Georg
机构信息
Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Berlin, Germany.
出版信息
BMJ Open. 2017 Aug 3;7(8):e015798. doi: 10.1136/bmjopen-2016-015798.
OBJECTIVES
While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias.
DESIGN
Prospective observational cohort study including healthy volunteers.
SETTING AND PARTICIPANTS
One hundred and nine experienced marathon runners wore a portable ECG recorder during a marathon race in Berlin, Germany. Athletes underwent blood tests 2-3 days prior, directly after and 1-2 days after the race.
RESULTS
Overall, 108 athletes (median 48 years (IQR 45-53), 24% women) completed the marathon in 249±43 min. Blinded ECG analysis revealed abnormal findings during the marathon in 18 (16.8%) athletes. Ten (9.3%) athletes had at least one episode of non-sustained ventricular tachycardia, one of whom had atrial fibrillation; eight (7.5%) individuals showed transient ST-T-segment deviations. Abnormal ECG findings were associated with advanced age (OR 1.11 per year, 95% CI 1.01 to 1.23), while sex and cardiovascular risk profile had no impact. Directly after the race, high-sensitive troponin T was elevated in 18 (16.7%) athletes and associated with ST-T-segment deviation (OR 9.9, 95% CI 1.9 to 51.5), while age, sex and cardiovascular risk profile had no impact.
CONCLUSIONS
ECG monitoring during a marathon is feasible. Abnormal ECG findings were present in every sixth athlete. Exercise-induced transient ST-T-segment deviations were associated with elevated high-sensitive troponin T (hsTnT) values.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01428778; Results.
目的
虽然规律的体育锻炼对健康有诸多益处，但剧烈体育锻炼可能会对心脏功能产生负面影响。“跑步的柏林心跳”研究聚焦于马拉松比赛期间对业余耐力运动员进行连续心电图监测的可行性及诊断价值。我们假设在一群业余耐力运动员中经常会发现心律失常，尤其是心房颤动。主要的次要假设是这些运动员的病理实验室检查结果（部分）与心律失常有关。
设计
包括健康志愿者的前瞻性观察队列研究。
地点和参与者
109名经验丰富的马拉松跑者在德国柏林的一场马拉松比赛中佩戴了便携式心电图记录仪。运动员在比赛前2 - 3天、比赛结束后立即以及比赛后1 - 2天接受了血液检查。
结果
总体而言，108名运动员（年龄中位数48岁（四分位间距45 - 53岁），24%为女性）在249±43分钟内完成了马拉松比赛。盲态心电图分析显示，18名（16.8%）运动员在马拉松比赛期间有异常发现。10名（9.3%）运动员至少有一次非持续性室性心动过速发作，其中1人有心房颤动；8名（7.5%）个体出现短暂性ST - T段偏移。心电图异常发现与高龄相关（每年的比值比为1.11，95%置信区间为1.01至1.23），而性别和心血管风险状况没有影响。比赛结束后立即，18名（16.7%）运动员的高敏肌钙蛋白T升高，且与ST - T段偏移相关（比值比为9.9，95%置信区间为1.9至51.5），而年龄、性别和心血管风险状况没有影响。
结论
马拉松比赛期间的心电图监测是可行的。每六名运动员中就有一名存在心电图异常发现。运动诱发的短暂性ST - T段偏移与高敏肌钙蛋白T（hsTnT）值升高有关。
试验注册
ClinicalTrials.gov NCT01428778；结果
Zotero 插件