Di Gioia Giuseppe, Ferrera Armando, Mango Federica, Maestrini Viviana, Monosilio Sara, Pelliccia Antonio, Squeo Maria Rosaria
Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy.
Department of Cardiology, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy.
Int J Cardiovasc Imaging. 2025 May 26. doi: 10.1007/s10554-025-03430-w.
Endurance sports disciplines largely differ in terms of specific training and event modalities, likely resulting in diverse morpho-functional cardiac changes. Our study aims to assess elite athletes engaged in different endurance disciplines and describe cardiac remodelling in each. We enrolled 282 Olympic athletes (58.5% males, mean age 26.7 ± 4.7) practising long-distance running (57, 20.2%), triathlon (18, 6.4%), canoeing/rowing (76, 26.9%), cycling (65, 23%), long-distance swimming (21, 7.4%), cross-country skiing & biathlon (45, 16%). athletes underwent ECG, echocardiogram and exercise stress-test. Eccentric LV hypertrophy (EH) was present in 73.8% of athletes, without gender differences (p = 0.847), varying greatly among disciplines (p = 0.0005). Triathlon (94.4%) and cycling (87.7%) showed the highest prevalence. The largest LV volumes were observed in triathlon-athletes and cyclists (LVEDVi: males, p = 0.009, females, p = 0.002). The lowest LV dimensions were found in rowing/canoeing (males: p < 0.0001; females: p < 0.0001). Long-distance runners and swimmer presented intermediate extent of LV remodelling. Positive correlation between hours of training and LVMi (p = 0.0004) and LVEDVi (p = 0.048) was observed among cyclists. Indeed, cyclists with the highest EH (i.e., lowest LVMi\LVEDVi ratio) achieved the highest workload at exercise stress-test (p = 0.045) and better athletic achievements. Among endurance athletes, cyclists and triathletes present the most marked extent of LV EH, while canoeists and rowers the lowest degree, with major increase in LV mass. Intra-group analysis showed an association between eccentric hypertrophy and superior exercise capacity and higher athletic performances that may be related to an increased stroke volume and cardiac output, which improve cardiovascular efficiency during endurance exercise. These findings could be useful both for clinicians in identifying potential health issues in athletes and for coaches when assessing athletes' training status.
耐力运动项目在特定训练和赛事模式方面差异很大，这可能导致不同的形态功能心脏变化。我们的研究旨在评估从事不同耐力项目的精英运动员，并描述每个项目中的心脏重塑情况。我们招募了282名奥运选手（男性占58.5%，平均年龄26.7±4.7岁），他们分别从事长跑（57人，占20.2%）、铁人三项（18人，占6.4%）、皮划艇/赛艇（76人，占26.9%）、自行车（65人，占23%）、长距离游泳（21人，占7.4%）、越野滑雪和冬季两项（45人，占16%）。运动员们接受了心电图、超声心动图和运动压力测试。73.8%的运动员存在离心性左心室肥厚（EH），无性别差异（p=0.847），但在不同项目间差异很大（p=0.0005）。铁人三项（94.4%）和自行车项目（87.7%）的患病率最高。铁人三项运动员和自行车运动员的左心室容积最大（左心室舒张末期容积指数：男性，p=0.009；女性，p=0.002）。划船/皮划艇项目的左心室尺寸最小（男性：p<0.0001；女性：p<0.0001）。长跑运动员和游泳运动员的左心室重塑程度处于中间水平。在自行车运动员中，观察到训练时长与左心室质量指数（p=0.0004）和左心室舒张末期容积指数（p=0.048）呈正相关。事实上，EH程度最高（即左心室质量指数/左心室舒张末期容积指数比值最低）的自行车运动员在运动压力测试中达到了最高工作量（p=0.045），并且运动成绩更好。在耐力运动员中，自行车运动员和铁人三项运动员的左心室EH程度最明显，而划艇运动员和赛艇运动员的程度最低，左心室质量增加最多。组内分析显示，离心性肥厚与卓越的运动能力和更高的运动成绩之间存在关联，这可能与每搏输出量和心输出量增加有关，而这在耐力运动中提高了心血管效率。这些发现对于临床医生识别运动员潜在的健康问题以及教练评估运动员的训练状态都可能有用。
