Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA.
J Am Coll Cardiol. 2023 Sep 5;82(10):1030-1038. doi: 10.1016/j.jacc.2023.05.070.
Routine exercise leads to cardiovascular adaptations that differ based on sex. Use of cardiac testing to screen athletes has driven research to define how these sex-based adaptations manifest on the electrocardiogram and cardiac imaging. Importantly, sex-based differences in cardiovascular structure and outcomes in athletes often parallel findings in the general population, underscoring the importance of understanding their mechanisms. Substantial gaps exist in the understanding of why cardiovascular adaptations and outcomes related to exercise differ by sex because of underrepresentation of female participants in research. As female sports participation rates have increased dramatically over several decades, it also remains unknown if differences observed in older athletes reflect biological mechanisms vs less lifetime access to sports in females. In this review, we will assess the effect of sex on cardiovascular adaptations and outcomes related to exercise, identify the impact of sex hormones on exercise performance, and highlight key areas for future research.
常规运动导致的心血管适应因人而异。心脏测试在运动员中的应用推动了相关研究，以明确这些基于性别的适应在心电图和心脏成像上的表现。重要的是，运动员的心血管结构和结果存在基于性别的差异，这与普通人群中的发现相似，这突显了了解其机制的重要性。由于研究中女性参与者代表性不足，对为什么与运动相关的心血管适应和结果存在性别差异的理解存在很大差距。几十年来，女性参与体育运动的比例大幅增加，目前仍不清楚在老年运动员中观察到的差异是反映了生物学机制，还是女性在一生中较少有机会参与体育运动。在这篇综述中，我们将评估性别对与运动相关的心血管适应和结果的影响，确定性激素对运动表现的影响，并强调未来研究的重点领域。
