BHF Centre for Research Excellence, School of Cardiovascular Medicine and Science, King's College London, London, UK.
Guys and St Thomas' NHS Trust, St Thomas' Hospital, London, UK.
Exp Physiol. 2019 Feb;104(2):174-179. doi: 10.1113/EP087341. Epub 2019 Jan 6.
What is the main observation in this case? Ultra-endurance cycle racing is known to lead to suppressed heart rates as a product of time spent racing. This case report identifies a racer who experienced this phenomenon initially, but then uniquely experienced an overall increase in heart rate late in the race. What insight does it reveal? In this case, unique chronotropic disturbances to heart rate occurred as a result of the many extreme demands of ultra-endurance racing. Work should now focus on identifying the frequency of this response in other racers and whether the main causes are physiological, environmental or genetic in nature.
Participation in ultra-endurance cycling events, such as the Transcontinental Race, is increasing. These extremely demanding races provide a unique opportunity for field observation of the limits of human endurance physiology and, importantly, when these limits might be exceeded and cross over into pathology. The heart is of special interest in this field, and previous data suggest that 'reverse drift' of heart rate occurs as a product of time and load in races of 24-48 h, whereas transient structural abnormalities have been observed upon completion of running ultramarathons. Here, we report a unique case of a male cyclist racing in the Transcontinental Race over an extended period of 14 days characterized by extreme workloads and a low quantity and quality of sleep. The heart rate response was dynamic over the course of the race and defined by a U-shaped quadratic relationship. A larger scale study is required to determine the relevance of this information to the ultra-endurance cycling community.
本病例的主要观察结果是什么?众所周知,超长耐力自行车比赛会导致心率降低,这是比赛时间造成的结果。本病例报告确定了一位车手最初经历了这种现象,但随后在比赛后期心率却出现了整体升高。它揭示了什么见解?在这种情况下,心率的独特变时性紊乱是由于超长耐力比赛的许多极端要求造成的。现在应集中精力确定其他车手出现这种反应的频率,以及主要原因是生理性、环境性还是遗传性。
参加超长耐力自行车比赛(如 Transcontinental Race)的人数正在增加。这些极具挑战性的比赛为观察人类耐力生理学极限提供了一个独特的机会,而且重要的是,当这些极限可能被超越并进入病理状态时,我们可以观察到这一点。在这个领域,心脏是特别受关注的,先前的数据表明,在 24-48 小时的比赛中,心率会出现“反向漂移”,这是时间和负荷的产物,而在完成超长距离跑步比赛后,已经观察到短暂的结构异常。在这里,我们报告了一个独特的男性自行车手参加 Transcontinental Race 的病例,他的比赛时间长达 14 天,比赛期间的工作量极大,且睡眠的数量和质量都很低。在整个比赛过程中,心率反应具有动态性,呈 U 形二次关系。需要进行更大规模的研究,以确定这些信息对超长耐力自行车运动界的相关性。