Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Colorado State University, 1582 Campus Delivery, Fort Collins, CO, 80523, USA.
Human Performance Clinical Research Laboratory, Department of Health and Exercise Science, Colorado State University, 1582 Campus Delivery, Fort Collins, CO, 80523, USA.
Atherosclerosis. 2021 Mar;320:105-111. doi: 10.1016/j.atherosclerosis.2020.11.030. Epub 2020 Dec 1.
Recent studies suggest that long-term endurance training may be damaging to the heart, thus increasing cardiovascular disease (CVD) risk. However, studies utilizing cardiac imaging are conflicting and lack measures of central and peripheral vascular structure and function, which are also independently predictive of CVD events.
We performed a comprehensive assessment of cardiovascular structure and function in long-term (≥ 10 years) ultra-endurance athletes (ATH, 14 M/11 F, 50 ± 1 y) and physically active controls (CON, 9 M/9 F, 49 ± 2 y).
As expected, left ventricular mass and end-diastolic volume (echocardiography) were greater in ATH vs CON, whereas there was no difference in cardiac function at rest. Coronary artery calcium scores (computed tomography) were not statistically different between groups. There was no evidence of myocardial fibrosis (contrast magnetic resonance imaging) in any subject. Aortic stiffness (carotid-femoral pulse wave velocity) was lower in ATH vs CON (6.2 ± 0.2 vs 6.9 ± 0.2 m/s, p < 0.05), whereas carotid intima-media thickness (ultrasound) was not different between groups. Peripheral vascular endothelial function (flow-mediated vasodilation of the brachial artery) and microvascular function (peak blood velocity) in response to 5 min of forearm ischemia were not different between groups. Furthermore, there was no difference in 10-year coronary heart disease risk (ATH; 2.3 ± 0.5 vs CON; 1.6 ± 0.2%, p > 0.05).
Our data indicate that middle-aged ultra-endurance ATH do not have marked signs of widespread cardiovascular dysfunction or elevated CHD risk compared to CON meeting physical activity guidelines.
最近的研究表明，长期的耐力训练可能对心脏有害，从而增加心血管疾病（CVD）的风险。然而，利用心脏成像的研究结果存在冲突，并且缺乏对心血管结构和功能的中心和外周血管的测量，这些测量也是 CVD 事件的独立预测因素。
我们对长期（≥ 10 年）超耐力运动员（ATH，14 名男性/11 名女性，50 ± 1 岁）和有体力活动的对照组（CON，9 名男性/9 名女性，49 ± 2 岁）进行了心血管结构和功能的综合评估。
正如预期的那样，与 CON 相比，ATH 的左心室质量和舒张末期容积（超声心动图）更大，但静息时心脏功能没有差异。冠状动脉钙评分（计算机断层扫描）在两组之间没有统计学差异。在任何受试者中均没有心肌纤维化的证据（对比磁共振成像）。与 CON 相比，ATH 的主动脉僵硬度（颈动脉-股动脉脉搏波速度）较低（6.2 ± 0.2 对 6.9 ± 0.2 m/s，p < 0.05），而颈动脉内膜-中层厚度（超声）在两组之间没有差异。外周血管内皮功能（肱动脉血流介导的血管扩张）和微血管功能（前臂缺血 5 分钟后的峰值血流速度）在两组之间没有差异。此外，10 年冠心病风险也没有差异（ATH；2.3 ± 0.5 对 CON；1.6 ± 0.2%，p > 0.05）。
与符合体力活动指南的 CON 相比，我们的数据表明，中年超耐力 ATH 没有明显的广泛心血管功能障碍或升高的 CHD 风险迹象。
