Hollmann W, Rost R, De Meirleir K, Liesen H, Heck H, Mader A
Acta Med Scand Suppl. 1986;711:193-203. doi: 10.1111/j.0954-6820.1986.tb08950.x.
After a short historical remark the development of athlete's heart in childhood is described. Within 2 years significant differences were observed between endurance-trained (swimming) and untrained girls and boys determined by X-ray and echocardiographical examinations. The limits of the physiological size in relation to body weight were not exceeded within 10 years of longitudinal studies. A second point deals with athlete's heart from physiological and clinical viewpoints. The largest healthy heart ever found in our examinations of athletes had a size of 1,700 ml. Sixteen years after stopping the active career it was reduced to 950 ml without a pathological finding. Questionable and pathological cases are described. A third chapter covers the blood supply of internal organs during exercise combined with air or oxygen breathing. In this connection liver, kidneys, heart, lungs, and brain have been investigated. The reduced blood supply of the liver and kidneys during intense exercise on the cycle ergometer was not influenced significantly by inspiration of oxygen. A significant blood volume increase of the lungs was noticed during incremental rates of work. Exercise augmented also blood flow of the brain in relation to the work rate (at 100 W a 27% increase in grey matter flow of the right hemisphere). A fourth chapter deals with new hormonal and neurohormonal aspects related to the cardiovascular system. Beta-endorphines remained unchanged at work rates below the anaerobic threshold but increased significantly during maximal rate of work. The opiate antagonist naloxone abolished the rise in body temperature seen during ergometer exercise. The serotonin antagonist ketanserin lowered the blood pressure and the arterial lactic acid level during an incremental exercise test, similar to the results with the dopamine agonist pergolide. The hormone cardiodilatin is produced in the atrial appendages, and it is a potent substance in the regulation of the cardiovascular system. The adaptive reaction of the sympathetic nerve fibres in the myocard revealed different directions: activation, degeneration, and regeneration. These findings correlated highly significantly with the total amount of catecholamines in the heart muscle.
在简短的历史回顾之后，描述了儿童运动员心脏的发育情况。通过X射线和超声心动图检查发现，在2年内，耐力训练（游泳）的女孩和男孩与未训练的女孩和男孩之间存在显著差异。在长达10年的纵向研究中，并未超过与体重相关的生理尺寸极限。第二点从生理和临床角度探讨运动员心脏。在我们对运动员的检查中发现的最大健康心脏大小为1700毫升。停止活跃职业生涯16年后，其大小降至950毫升，且无病理发现。文中描述了可疑和病理病例。第三章涵盖运动时结合空气或氧气呼吸的内脏血液供应情况。就此对肝脏、肾脏、心脏、肺和大脑进行了研究。在自行车测力计上进行剧烈运动时，肝脏和肾脏血液供应减少，吸氧对此并无显著影响。在工作量递增时，肺部血容量显著增加。运动还使大脑血流量相对于工作强度增加（在100瓦时，右半球灰质血流量增加27%）。第四章涉及与心血管系统相关的新的激素和神经激素方面。β - 内啡肽在低于无氧阈值的工作强度下保持不变，但在最大工作强度时显著增加。阿片拮抗剂纳洛酮消除了测力计运动期间出现的体温升高。5 - 羟色胺拮抗剂酮色林在递增运动试验中降低了血压和动脉乳酸水平，与多巴胺激动剂培高利特的结果相似。心脏扩张素在心房附件中产生，是调节心血管系统的一种强效物质。心肌中交感神经纤维的适应性反应呈现不同方向：激活、退化和再生。这些发现与心肌中儿茶酚胺的总量高度显著相关。
