Jouffroy Romain, Hergault Hélène, Antero Juliana, Vieillard Baron Antoine, Mansencal Nicolas
Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.
IRMES - Institute for Research in Medicine and Epidemiology of Sport, INSEP, Paris, France.
Front Cardiovasc Med. 2022 Aug 16;9:954032. doi: 10.3389/fcvm.2022.954032. eCollection 2022.
Even if the beneficial cardiovascular effects of moderate exercise are recognized, effects of prolonged and intense exercise are still debated. This study aims to detect cardiovascular changes associated with long endurance running by assessing the relationship between echocardiographic parameters and cardiac biomarkers during long-distance trail running.
We performed a prospective observational study that included 20 participants who were all amateur runners (median age of 41 years old, still alive after a 7-year clinical follow-up) from 80-km trail running. All the participants underwent an echocardiographic examination and venous blood sampling before the race, at the intermediate refreshment checkpoints of the race (21st and 53rd km), and within 10 min after arrival.
Mitral E/A velocity ratio and mitral TDI e' wave were significantly decreased at the 21st km to arrival ( < 0.05). Mitral S wave and global longitudinal strain (GLS) were significantly decreased from the 53rd km to arrival ( < 0.05 for 53rd and 80th km). As compared to baseline, T-troponin and NT-proBNP were significantly increased at the 21st km in all the participants, but T-troponin values were systematically increased above the significative threshold. Diastolic echocardiographic abnormalities were mainly observed among participants with highest NT-proBNP (> 77 ng.l) values at the 21st km. As compared to baseline, mitral e' wave was significantly decreased (-35%) in participants with highest values of NT-proBNP. Similarly, GLS was also depressed among participants with highest troponin values at the 53rd km ( = 0.01 for 53rd km and = 0.04 for arrival).
During the long-distance trail running, the early LV decrease in diastolic echocardiographic parameters is associated with increase in NT pro-BNP blood levels, and the decrease in LV systolic echocardiographic parameters later is associated with increase in T-troponin blood levels.
即使适度运动对心血管有益的作用已得到认可，但长时间剧烈运动的影响仍存在争议。本研究旨在通过评估长距离越野跑期间超声心动图参数与心脏生物标志物之间的关系，检测与长时间耐力跑相关的心血管变化。
我们进行了一项前瞻性观察性研究，纳入了20名参与者，他们均为来自80公里越野跑的业余跑步者（中位年龄41岁，经过7年临床随访后仍存活）。所有参与者在比赛前、比赛的中间补给点（21公里和53公里处）以及到达后10分钟内接受了超声心动图检查和静脉血采样。
二尖瓣E/A速度比值和二尖瓣组织多普勒成像e'波在21公里处至到达时显著降低（P<0.05）。二尖瓣S波和整体纵向应变（GLS）从53公里处至到达时显著降低（53公里和80公里处P<0.05）。与基线相比，所有参与者在21公里处T肌钙蛋白和N末端脑钠肽前体（NT-proBNP）显著升高，但T肌钙蛋白值系统性升高至高于显著阈值。舒张期超声心动图异常主要在21公里处NT-proBNP值最高（>77 ng/L）的参与者中观察到。与基线相比，NT-proBNP值最高的参与者二尖瓣e'波显著降低（-35%）。同样，在53公里处肌钙蛋白值最高的参与者中GLS也降低（53公里处P = 0.01，到达时P = 0.04）。
在长距离越野跑期间，早期左心室舒张期超声心动图参数降低与NT-proBNP血水平升高相关，后期左心室收缩期超声心动图参数降低与T肌钙蛋白血水平升高相关。
