Barczuk-Falęcka Marzena, Małek Łukasz A, Krysztofiak Hubert, Roik Danuta, Brzewski Michał
Department of Pediatric Radiology, Medical University of Warsaw, Żwirki i Wigury 63A, 02-091, Warsaw, Poland.
Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968, Warsaw, Poland.
Pediatr Cardiol. 2018 Jun;39(5):948-954. doi: 10.1007/s00246-018-1844-5. Epub 2018 Mar 8.
Physical training is associated with changes in cardiac morphology called the "athlete's heart", which has not been sufficiently studied in children. The aim of the study was to analyze cardiac adaptation to exercise in pre-adolescent soccer players. Thirty-six soccer players (mean age 10.1 ± 1.4 years) and 24 non-athlete male controls (10.4 ± 1.7 years) underwent cardiac magnetic resonance. Measurements of myocardial mass, end-diastolic and end-systolic volume, stroke volume and ejection fraction for left and right ventricle (LV, RV) were performed. Additionally, left and right atrial (LA, RA) areas and volumes were analysed. Relative wall thickness (RWT) was calculated to describe the pattern of cardiac remodeling. Interventricular wall thickness and LV mass were significantly higher in athletes, but remained within the reference (6.9 ± 0.8 vs. 6.2 ± 0.9 mm/√m, p = 0.003 and 57.1 ± 7.4 vs. 50.0 ± 7.1 g/m, p = 0.0006, respectively) with no changes in LV size and function between groups. The RWT tended to be higher among athletes (p = 0.09) indicating LV concentric remodeling geometry. Soccer players had significantly larger RV size (p < 0.04) with similar function and mass. Also, the LA volume (p = 0.01), LA area (p = 0.03) and LA diameter (p = 0.009) were significantly greater in players than in controls. Cardiac adaptations in pre-adolescent soccer players are characterized by an increased LV mass without any changes in LV size and systolic function, which is typical of resistance training with tendency to concentric remodeling. This is accompanied by increase of LA and RV size. It should be taken into account during annual pre-participation evaluation.
体育锻炼与被称为“运动员心脏”的心脏形态变化有关，而这在儿童中尚未得到充分研究。本研究的目的是分析青春期前足球运动员心脏对运动的适应性。36名足球运动员（平均年龄10.1±1.4岁）和24名非运动员男性对照组（10.4±1.7岁）接受了心脏磁共振成像检查。对左、右心室（LV、RV）的心肌质量、舒张末期和收缩末期容积、每搏输出量和射血分数进行了测量。此外，还分析了左、右心房（LA、RA）的面积和容积。计算相对壁厚度（RWT）以描述心脏重塑模式。运动员的室间隔厚度和左心室质量显著更高，但仍在参考范围内（分别为6.9±0.8 vs. 6.2±0.9mm/√m，p = 0.003和57.1±7.4 vs. 50.0±7.1g/m，p = 0.0006），两组之间左心室大小和功能无变化。运动员的RWT往往更高（p = 0.09），表明左心室呈向心性重塑几何形态。足球运动员的右心室尺寸显著更大（p < 0.04），功能和质量相似。此外，运动员的左心房容积（p = 0.01）、左心房面积（p = 0.03）和左心房直径（p = 0.009）均显著大于对照组。青春期前足球运动员的心脏适应性表现为左心室质量增加，而左心室大小和收缩功能无任何变化，这是阻力训练的典型特征，且有向心性重塑倾向。同时伴有左心房和右心室尺寸增加。在年度赛前评估时应予以考虑。
