Guo Chenzan, Zhang Hebin, Yang Cunxin, Hu Peipei, Ma Hui, Ma Ying, Gao Feng
Department of Ultrasonography, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
School of Medicine, Hangzhou Normal University, Hangzhou, China.
BMC Cardiovasc Disord. 2025 Jan 6;25(1):6. doi: 10.1186/s12872-024-04455-0.
Long-term endurance training is associated with structural, functional, and biochemical markers of cardiac dysfunction in highly trained athletes. Many studies have focused on structural changes in the right ventricle (RV) and few have examined functional adaptation of the right ventricle. This meta-analysis aims to compare the changes in right ventricular systolic function between endurance athletes and controls before and after exercise using speckle tracking echocardiography (STE).
A comprehensive search of relevant studies published before March 19, 2024 that examined RV systolic function using speckle tracking technology was conducted. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used as pooled statistics. Meta regression was employed to identify sources of heterogeneity and publication bias was evaluated by Egger's test and funnel plots. Sensitivity analysis was performed by removing sources of significant change from the results of a single publication to evaluate the stability of the results.
Twenty studies were included with 1186 participants. A fixed effect meta-analysis revealed RV global longitudinal strain (GLS) WMD = 0.40, 95% CI (-0.08 ~ 0.89), p = 0.102 and free wall longitudinal strain (FWLS) WMD = 0.62, 95% CI (0.28 ~ 0.96), p < 0.001, random effect models of RV basal strain WMD = 2.94, 95% CI (2.00 ~ 3.88), p < 0.001 and RV apical strain WMD = -0.79, 95% CI (-1.95, 0.37), p = 0.245 between endurance athletes and controls. In addition, a random-effects meta-analysis revealed significant impairments in RV function when assessed by comparing RV GLS pre-endurance versus post endurance exercise WMD = 2.51, 95% CI (1.634 ~ 3.40), p < 0. 001.
The evidence obtained thus far suggests that reporting only global right ventricular strain data may obscure segment-specific adaptation changes, and the use of global and segmental strain analysis may help to identify potential functional changes in the right ventricle while differentiating between normal endurance athletes and non-active controls.
长期耐力训练与高水平运动员心脏功能障碍的结构、功能和生化标志物有关。许多研究关注右心室（RV）的结构变化，而很少有研究探讨右心室的功能适应性。本荟萃分析旨在使用斑点追踪超声心动图（STE）比较耐力运动员和对照组在运动前后右心室收缩功能的变化。
对2024年3月19日前发表的使用斑点追踪技术检查RV收缩功能的相关研究进行全面检索。加权平均差（WMDs）和95%置信区间（CIs）用作合并统计量。采用Meta回归识别异质性来源，并通过Egger检验和漏斗图评估发表偏倚。通过从单个出版物的结果中去除显著变化的来源进行敏感性分析，以评估结果的稳定性。
纳入20项研究，共1186名参与者。固定效应荟萃分析显示，耐力运动员与对照组之间，RV整体纵向应变（GLS）的WMD = 0.40，95% CI（-0.08至0.89），p = 0.102；游离壁纵向应变（FWLS）的WMD = 0.62，95% CI（0.28至0.96），p < 0.001；RV基底段应变的随机效应模型WMD = 2.94，95% CI（2.00至3.88），p < 0.0需01；RV心尖段应变的WMD = -0.79，95% CI（-1.95，0.37），p = 0.245。此外，随机效应荟萃分析显示，通过比较耐力运动前与运动后RV GLS评估RV功能时存在显著损害，WMD = 2.51，95% CI（1.634至3.40），p < 0.001。
迄今为止获得的证据表明，仅报告右心室整体应变数据可能会掩盖节段特异性适应性变化，使用整体和节段应变分析可能有助于识别右心室潜在的功能变化，同时区分正常耐力运动员和非运动对照组。
