Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Greece.
Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece.
Eur J Prev Cardiol. 2020 Sep;27(14):1467-1477. doi: 10.1177/2047487319898782. Epub 2020 Feb 3.
The investigation of the pathophysiological determinants of cardiac changes following ultra-long duration exercise.
Twenty-seven runners who finished a 246 km running race were examined both before and after the finish of the race. Examinations included echocardiography and measurement of body weight and blood biochemical parameters.
Exercise increased left ventricular end-diastolic interventricular septum thickness (LVIVSd) ( < 0.001) and posterior wall thickness (LVPWTd) ( = 0.001) and right ventricular end-diastolic area ( = 0.005), while reduced tricuspid annular plane systolic excursion (TAPSE) ( = 0.004). A minor decrease in the peak absolute values of both left ventricular (from -20.9 ± 2.3% to -18.8 ± 2.0%, = 0.009) and right ventricular (from -22.9 ± 3.6% to -21.2 ± 3.0%, = 0.040) global longitudinal strains occurred. There was decrease in body weight ( < 0.001) and increase in both circulating high-sensitivity troponin I ( = 0.028) and amino-terminal pro-B type natriuretic peptide (NT-proBNP) ( = 0.018). The change in the sum of LVIVSd and LVPWTd correlated negatively with percentage change of body weight ( = -0.416, = 0.049). The only independent determinant of post-exercise NT-proBNP was pulmonary artery systolic pressure ( = 0.797, = 0.002). Post-exercise NT-proBNP correlated positively with percentage changes of basal (RVbas) ( = 0.582, = 0.037) and mid-cavity (RVmid) ( = 0.618, = 0.043) right ventricular diameters and negatively with percentage change of TAPSE ( = -0.720, = 0.008). Similar correlations with RVbas, RVmid and TAPSE were found for pulmonary artery systolic pressure. Post-exercise high-sensitivity troponin I correlated negatively with percentage change of body weight ( = -0.601, = 0.039), but was not associated with any cardiac parameter.
The main cardiac effects of ultra-long duration exercise were the decrease in left ventricular end-diastolic dimensions and increase in left ventricular wall thickness, as well as minimal dilatation and alteration in systolic function of right ventricle, possibly due to the altered exercise-related right ventricular afterload.
研究超长距离运动后心脏变化的病理生理决定因素。
对 27 名完成 246 公里跑步比赛的跑步者在比赛结束前后进行了检查。检查包括超声心动图以及体重和血液生化参数的测量。
运动增加了左心室舒张末期室间隔厚度（LVIVSd）（<0.001）和后壁厚度（LVPWTd）（=0.001）和右心室舒张末期面积（=0.005），同时降低了三尖瓣环平面收缩期位移（TAPSE）（=0.004）。左心室（从-20.9±2.3%降至-18.8±2.0%，=0.009）和右心室（从-22.9±3.6%降至-21.2±3.0%，=0.040）整体纵向应变的峰值绝对值均略有下降。体重下降（<0.001），循环中高敏肌钙蛋白 I（=0.028）和氨基末端 pro-B 型利钠肽（NT-proBNP）（=0.018）升高。LVIVSd 和 LVPWTd 总和的变化与体重变化的百分比呈负相关（= -0.416，=0.049）。运动后 NT-proBNP 的唯一独立决定因素是肺动脉收缩压（=0.797，=0.002）。运动后 NT-proBNP 与基础（RVbas）（=0.582，=0.037）和中腔（RVmid）（=0.618，=0.043）右心室直径的百分比变化呈正相关，与 TAPSE 的百分比变化呈负相关（= -0.720，=0.008）。肺动脉收缩压与 RVbas、RVmid 和 TAPSE 也有类似的相关性。运动后高敏肌钙蛋白 I 与体重变化的百分比呈负相关（= -0.601，=0.039），但与任何心脏参数均无关。
超长距离运动的主要心脏效应是左心室舒张末期尺寸减小，左心室壁厚度增加，以及右心室轻微扩张和收缩功能改变，这可能是由于运动相关的右心室后负荷改变所致。
