Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland.
First Department of Cardiology, Medical University of Gdansk, Poland.
Cardiol J. 2021;28(5):707-715. doi: 10.5603/CJ.a2019.0110. Epub 2020 Jan 7.
Training on a professional level can lead to cardiac structural adaptations called the "athlete's heart". As marathon participation requires intense physical preparation, the question arises whether the features of "athlete's heart" can also develop in recreational runners.
The study included 34 males (mean age 40 ± 8 years) who underwent physical examination, a cardiopulmonary exercise test and echocardiographic examination (ECHO) before a marathon. ECHO results were compared with the sedentary control group, reference values for an adult male population and those for highly-trained athletes. Runners with abnormalities revealed by ECHO were referred for cardiac magnetic resonance imaging (CMR).
The mean training distance was 56.5 ± 19.7 km/week, peak oxygen uptake was 53.7 ± 6.9 mL/kg/min and the marathon finishing time was 3.7 ± 0.4 h. Compared to sedentary controls, amateur athletes presented larger atria, increased left ventricular (LV) wall thickness, larger LV mass and basal right ventricular (RV) inflow diameter (p < 0.05). When compared with ranges for the general adult population, 56% of participants showed increased left atrial volume, indexed to body surface area (LAVI), 56% right atrial area and interventricular septum thickness, while 47% had enlarged RV proximal outflow tract diameter. In 50% of cases, LAVI exceeded values reported for highly-trained athletes. Due to ECHO abnormalities, CMR was performed in 6 participants, which revealed hypertrophic cardiomyopathy in 1 runner.
"Athlete's heart" features occur in amateur marathon runners. In this group, ECHO reference values for highly-trained elite athletes should be considered, rather than those for the general population and even then LAVI can exceed the upper normal value.
专业水平的训练可导致心脏结构适应性改变，即“运动员心脏”。由于马拉松比赛需要高强度的身体准备，因此出现了这样的问题，即“运动员心脏”的特征是否也能在业余跑者身上发展。
这项研究纳入了 34 名男性（平均年龄 40 ± 8 岁），他们在参加马拉松比赛前接受了体格检查、心肺运动试验和超声心动图检查（ECHO）。将 ECHO 结果与久坐对照组、成年男性人群的参考值以及训练有素的运动员的参考值进行比较。ECHO 显示异常的跑步者被转介进行心脏磁共振成像（CMR）检查。
平均训练距离为 56.5 ± 19.7 公里/周，峰值摄氧量为 53.7 ± 6.9 mL/kg/min，马拉松完赛时间为 3.7 ± 0.4 小时。与久坐对照组相比，业余运动员的心房更大，左心室（LV）壁厚度增加，LV 质量和基底右心室（RV）流入道直径更大（p < 0.05）。与一般成年人群的范围相比，56%的参与者的左心房容积指数（LAVI）、右心房面积和室间隔厚度增加，而 47%的人 RV 近端流出道直径增大。在 50%的情况下，LAVI 超过了训练有素的运动员的报告值。由于 ECHO 异常，有 6 名参与者进行了 CMR，其中 1 名跑步者被诊断为肥厚型心肌病。
“运动员心脏”特征出现在业余马拉松跑者中。在这个群体中，应考虑针对训练有素的精英运动员的 ECHO 参考值，而不是针对普通人群的参考值，即使如此，LAVI 也可能超过正常值上限。
