Baumgartner Lisa, Schulz Thorsten, Oberhoffer Renate, Weberruß Heidi
Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany.
Front Cardiovasc Med. 2019 Oct 9;6:148. doi: 10.3389/fcvm.2019.00148. eCollection 2019.
Moderate physical activity (PA) is associated with a reduced risk to develop cardiovascular disease. However, junior athletes exercise between 10 and 20 h a week with intensities exceeding moderate levels by far. In this regard, the cardiovascular system has to increase its work five to six times compared to moderate intensities. This may result in potentially pathological adaptations of the cardiovascular system. The underlying process of vascular adaptations to exercise is yet not fully understood and hardly investigated in junior athletes. An increased blood pressure and pulse wave velocity, ventricular hypertrophy, arrhythmia, and even sudden cardiac death (SCD) has been reported in adult athletes. Studies, examining the cardiovascular system in children, its association to intensity and type of exercise, are rare. Therefore, we present the study protocol of a prospective cross-sectional study that investigates the influence of PA on the cardiovascular system in young athletes. Children and adolescents, 7-18 years, presenting for their annual pre-participation screening at the Institute of Preventive Pediatrics, Faculty of Sports and Health Sciences, Technical University of Munich (TUM), are examined in this prospective cross-sectional study. Vascular parameters measured by ultrasound are carotid intima-media thickness (cIMT), vascular stiffness (AC, Ep, β, PWV β), and the vascular diameter (D) to calculate the IMT:Diameter-Ratio (IDR). Cardiac function is evaluated by a 12-lead ECG, and echocardiographic parameters (end-diastolic left ventricular diameter, left ventricular diastolic posterior wall thickness, diastolic septal thickness, left ventricular mass and relative wall thickness, ejection fraction, and shortening fraction). A cardiopulmonary exercise test is performed on a bicycle ergometer, muscular strength is assessed with the handgrip test, and physical activity with the MoMo questionnaire. It is essential to follow young athletes over the course of their career in order to detect pathophysiological changes in the myocardium as soon as possible. If these changes are preceded or followed by changes in vascular structure and function is not known yet. Therefore, we present the study protocol of the Munich Cardiovascular adaptations in young athletes study (MuCAYA-Study) which investigates the association between vascular and cardiac adaptation to intensive exercise in junior athletes.
适度身体活动（PA）与患心血管疾病风险降低相关。然而，青少年运动员每周训练10至20小时，强度远超适度水平。就此而言，与适度强度相比，心血管系统的工作量必须增加五到六倍。这可能导致心血管系统出现潜在的病理性适应。血管对运动的适应性潜在机制尚未完全明了，在青少年运动员中也鲜有研究。成年运动员中已报告有血压升高、脉搏波速度加快、心室肥厚、心律失常，甚至心源性猝死（SCD）。针对儿童心血管系统及其与运动强度和类型之间关系的研究很少。因此，我们展示一项前瞻性横断面研究的研究方案，该研究旨在调查PA对年轻运动员心血管系统的影响。在这项前瞻性横断面研究中，对7至18岁在慕尼黑工业大学（TUM）体育与健康科学学院预防儿科学研究所进行年度参赛前筛查的儿童和青少年进行检查。通过超声测量的血管参数包括颈动脉内膜中层厚度（cIMT）、血管僵硬度（AC、Ep、β、PWVβ）以及血管直径（D），以计算内膜中层厚度与直径比值（IDR）。通过12导联心电图和超声心动图参数（舒张末期左心室直径、左心室舒张后壁厚度、舒张期室间隔厚度、左心室质量和相对壁厚度、射血分数和缩短分数）评估心脏功能。在自行车测力计上进行心肺运动测试，通过握力测试评估肌肉力量，并通过MoMo问卷评估身体活动。在年轻运动员的职业生涯中持续跟踪他们至关重要，以便尽快发现心肌的病理生理变化。目前尚不清楚这些变化之前或之后血管结构和功能是否会发生变化。因此，我们展示了慕尼黑年轻运动员心血管适应性研究（MuCAYA研究）的研究方案，该研究旨在调查青少年运动员血管和心脏对高强度运动的适应性之间的关联。
