Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County, Taiwan.
Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Medicine (Baltimore). 2024 Jul 5;103(27):e38756. doi: 10.1097/MD.0000000000038756.
Physical exercise requires integrated autonomic and cardiovascular adjustments to maintain homeostasis. We aimed to observe acute posture-related changes in blood pressure, and apply a portable noninvasive monitor to measure the heart index for detecting arrhythmia among elite participants of a 246-km mountain ultra-marathon. Nine experienced ultra-marathoners (8 males and 1 female) participating in the Run Across Taiwan Ultra-marathon in 2018 were enrolled. The runners' Heart Spectrum Blood Pressure Monitor measurements were obtained in the standing and supine positions before and immediately after the race. Their high-sensitivity troponin T and N-terminal proB-type natriuretic peptide levels were analyzed 1 week before and immediately after the event. Heart rate was differed significantly in the immediate postrace assessment compared to the prerace assessment, in both the standing (P = .011; d = 1.19) and supine positions (P = .008; d = 1.35). Postural hypotension occurred in 4 (44.4%) individuals immediately postrace. In 3 out of 9 (33.3%) recruited finishers, the occurrence of premature ventricular complex signals in the standing position was detected; premature ventricular complex signal effect was observed in the supine position postrace in only 1 participant (11.1%). Premature ventricular complex signal was positively correlated with running speed (P = .037). Of the 6 individuals who completed the biochemical tests postrace, 2 (33.3%) had high-sensitivity troponin T and 6 (100%) had N-terminal proB-type natriuretic peptide values above the reference interval. A statistically significant increase was observed in both the high-sensitivity troponin T (P = .028; d = 1.97), and N-terminal proB-type natriuretic peptide (P = .028; d = 2.91) levels postrace compared to prerace. In conclusion, significant alterations in blood pressure and heart rate were observed in the standing position, and postexercise (postural) hypotension occurred among ultra-marathoners. The incidence of premature ventricular complexes was higher after the race than before.
身体活动需要整合自主和心血管调节以维持体内平衡。我们旨在观察与姿势相关的急性血压变化，并应用便携式非侵入性监测仪测量心指数，以检测 246 公里山地超级马拉松精英参与者中的心律失常。2018 年参加台湾环岛超级马拉松的 9 名经验丰富的超级马拉松运动员（8 名男性和 1 名女性）入选。在比赛前后，使用跑步者心率血压监测仪测量运动员的直立和仰卧位血压。在比赛前后一周分析了他们的高敏肌钙蛋白 T 和 N 端脑利钠肽前体水平。与比赛前相比，比赛后即刻评估的心率差异有统计学意义，无论是直立位（P =.011；d = 1.19）还是仰卧位（P =.008；d = 1.35）。4 名（44.4%）参与者在比赛后即刻出现体位性低血压。在 9 名入选的完赛者中，有 3 名（33.3%）在直立位时检测到室性期前收缩信号；仅 1 名参与者（11.1%）在仰卧位时出现室性期前收缩信号效应。室性期前收缩信号与跑步速度呈正相关（P =.037）。在完成赛后生化检查的 6 名参与者中，有 2 名（33.3%）高敏肌钙蛋白 T 值和 6 名（100%）N 端脑利钠肽前体值高于参考区间。与比赛前相比，赛后高敏肌钙蛋白 T（P =.028；d = 1.97）和 N 端脑利钠肽前体（P =.028；d = 2.91）水平均有统计学显著升高。总之，直立位时血压和心率有明显变化，超级马拉松运动员出现运动后（体位性）低血压。赛后室性期前收缩的发生率高于赛前。
