Schoenfeld Julia, Schindler Michael Johannes, Haller Bernhard, Holdenrieder Stefan, Nieman David Christopher, Halle Martin, La Gerche André, Scherr Johannes
Preventive Sports Medicine and Sports Cardiology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Bavaria, Germany.
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Bavaria, Germany.
BMJ Open Sport Exerc Med. 2020 Jul 19;6(1):e000786. doi: 10.1136/bmjsem-2020-000786. eCollection 2020.
Prolonged strenuous exercise training may result in structural, functional and electrical cardiac remodelling, as well as vascular and myocardial injuries. However, the extent to which high-volume, intense exercise is associated with arrhythmias, myocardial fibrosis, coronary heart disease and pathological alterations of the vasculature remains unknown. In addition, there is no clear consensus on the clinical significance of these exercise-induced changes. Previous studies typically used cross-sectional designs and examined exercise-induced cardiovascular changes in small cohorts of athletes for up to 3-7 days of recovery. Long-term longitudinal studies investigating cardiovascular changes induced by prolonged strenuous exercise in large cohorts of athletes are needed to improve scientific understanding in this area.
In this prospective observational monocenter study, 277 participants of the Beer, Marathon, Genetics, Inflammation and the Cardiovascular System (Be-MaGIC) study (ClinicalTrials.gov: NCT00933218) will be invited to participate in this 10-year follow-up study. A minimum target sample size of 130 participants will be included in the study. Participating athletes will be examined via the following: anthropometry, resting electrocardiography and echocardiography, blood sampling, retinal vessel diameters, carotid sonography and cardiopulmonary exercise testing, including exercise electrocardiography.
This longitudinal study will provide comprehensive data on physiological changes in the cardiovascular system and the development of pathologies after a 10-year period of prolonged and strenuous endurance exercise. Since the participants will have engaged in a wide range of training loads and competitive race events, this study will provide useful risk factor determinants and training load cut-off values. The primary endpoint is the association between the exercise-induced increase in cardiac troponin during the Munich marathon 2009 and the decline in right ventricular ejection fraction over the next 10 years.
NCT04166903.
长时间剧烈运动训练可能导致心脏结构、功能和电活动重塑，以及血管和心肌损伤。然而，高强度大量运动与心律失常、心肌纤维化、冠心病和血管病理改变之间的关联程度仍不清楚。此外，对于这些运动诱导变化的临床意义尚无明确共识。以往研究通常采用横断面设计，在小群体运动员中检查运动诱导的心血管变化，恢复期长达3 - 7天。需要开展长期纵向研究，调查大量运动员群体中长时间剧烈运动引起的心血管变化，以增进该领域的科学认识。
在这项前瞻性观察性单中心研究中，将邀请啤酒、马拉松、遗传学、炎症与心血管系统（Be-MaGIC）研究（ClinicalTrials.gov：NCT00933218）的277名参与者参加这项为期10年的随访研究。研究将纳入至少130名参与者的最小目标样本量。参与研究的运动员将接受以下检查：人体测量、静息心电图和超声心动图、血液采样、视网膜血管直径、颈动脉超声检查以及心肺运动测试，包括运动心电图。
这项纵向研究将提供关于心血管系统生理变化以及长达10年的长时间剧烈耐力运动后病理发展的综合数据。由于参与者将经历广泛的训练负荷和竞技赛事，本研究将提供有用的风险因素决定因素和训练负荷临界值。主要终点是2009年慕尼黑马拉松期间运动诱导的心肌肌钙蛋白增加与未来10年右心室射血分数下降之间的关联。
NCT04166903。
