足球运动参与与心血管重构的时变关联。
Temporal Changes in Cardiovascular Remodeling Associated with Football Participation.
机构信息
Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Atlanta, GA.
Sports Medicine, Georgia Institute of Technology, Atlanta, GA.
出版信息
Med Sci Sports Exerc. 2018 Sep;50(9):1892-1898. doi: 10.1249/MSS.0000000000001631.
PURPOSE
American-style football (ASF) participation rates in the United States are highest among high school (HS) athletes. This study sought to compare the cardiovascular response to HS versus collegiate ASF participation.
METHODS
The ASF participants (HS, n = 61; collegiate, n = 87) were studied at preseason and postseason time points with echocardiography and applanation tonometry. Primary outcome variables included: left ventricular (LV) mass index, LV diastolic function (early relaxation velocity [E']), and arterial stiffness (pulse wave velocity [PWV]).
RESULTS
High school (17.1 ± 0.4 yr) and collegiate ASF participants (18 ± 0.4 yr) experienced similar LV hypertrophy (ΔLV mass HS = 10.5 ± 10 vs collegiate = 11.2 ± 13.6 g·m, P = 0.97). Among HS participants, increases in LV mass were associated with stable diastolic tissue velocities (ΔE' = -0.3 ± 2.9 cm·s, P = 0.40) and vascular function (ΔPWV = -0.1 ± 0.6 m·s, P = 0.13). In contrast, collegiate participants demonstrated a higher burden of concentric LV hypertrophy (21/87, 24% vs 7/61, 11%, P = 0.026) with concomitant reductions in diastolic tissue velocities (ΔE': -2.0 ± 2.7 cm·s, P < 0.001) and increased arterial stiffness (ΔPWV: Δ0.2 ± 0.6 m·s, P = 0.003), changes that were influenced by linemen who had the highest post-season weight (124 ± 10 kg) and systolic blood pressure ([SBP], 138.8 ± 11 mm Hg). In multivariable analyses adjusting for age and ethnicity, body mass was an independent predictor of post-season PWV (β estimate = 0.01, P = 0.04) and E' (β estimate = -0.04, P = 0.05), whereas SBP was an independent predictor of postseason LV mass index (β estimate = 0.18, P = 0.01) and PWV (β estimate = 0.01, P = 0.007).
CONCLUSIONS
The transition from HS to college represents an important physiologic temporal data point after which differential ASF cardiovascular phenotypes manifest. Future work aimed to clarify underlying mechanisms, and the long-term clinical implications of these findings is warranted.
目的
在美国，美式足球（ASF）的参与率在高中生（HS）运动员中最高。本研究旨在比较 HS 和大学 ASF 参与的心血管反应。
方法
在 preseason 和 postseason 时间点，使用超声心动图和平面张力测量法对 ASF 参与者（HS，n=61；大学，n=87）进行研究。主要结局变量包括：左心室（LV）质量指数、LV 舒张功能（早期松弛速度 [E']）和动脉僵硬（脉搏波速度 [PWV]）。
结果
高中（17.1±0.4 岁）和大学 ASF 参与者（18±0.4 岁）经历了类似的 LV 肥大（ΔLV 质量 HS=10.5±10 与大学=11.2±13.6g·m，P=0.97）。在 HS 参与者中，LV 质量的增加与稳定的舒张组织速度（ΔE'=-0.3±2.9cm·s，P=0.40）和血管功能（ΔPWV=-0.1±0.6m·s，P=0.13）相关。相比之下，大学参与者表现出更高的向心性 LV 肥大负担（21/87，24%与 7/61，11%，P=0.026），同时舒张组织速度（ΔE'：-2.0±2.7cm·s，P<0.001）和动脉僵硬（ΔPWV：Δ0.2±0.6m·s，P=0.003）降低，这些变化受到 linemen 的影响，他们的季后体重（124±10kg）和收缩压（[SBP]，138.8±11mmHg）最高。在调整年龄和种族的多变量分析中，体重是季后 PWV（β估计值=0.01，P=0.04）和 E'（β估计值=-0.04，P=0.05）的独立预测因素，而 SBP 是季后 LV 质量指数（β估计值=0.18，P=0.01）和 PWV（β估计值=0.01，P=0.007）的独立预测因素。
结论
从高中到大学的过渡代表了一个重要的生理时间点，在此之后，ASF 的心血管表型表现出差异。未来的工作旨在阐明潜在机制，并明确这些发现的长期临床意义。
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