Pelliccia A, Spataro A, Caselli G, Maron B J
Department of Medicine, Italian National Olympic Committee, Rome.
Am J Cardiol. 1993 Nov 1;72(14):1048-54. doi: 10.1016/0002-9149(93)90861-6.
There is a widely held perception that power training increases left ventricular (LV) wall thickness. Consequently, in individual power-trained athletes, confusion may legitimately occur with regard to the differential diagnosis of athlete's heart and nonobstructive hypertrophic cardiomyopathy. To investigate the effects of systematic strength training on cardiac dimensions (particularly absolute LV wall thickness), 100 relatively young and highly conditioned athletes participating in weight and power lifting, wrestling, bobsledding and weight-throwing events for 3 to 24 years (mean 7) were studied by echocardiography. No athlete showed a maximal absolute LV wall thickness that exceeded the generally accepted upper limits of normal (i.e., 12 mm; range 8 to 12). When compared with 26 normal, sedentary control subjects of similar age and body surface area, maximal septal thickness was mildly but significantly greater in athletes (9.6 +/- 0.8 vs 9.0 +/- 0.5 mm; p < 0.001), as was the calculated LV mass index (96 +/- 12 vs 81 +/- 8 g/m2; p < 0.001); LV end-diastolic cavity dimension was similar in athletes and controls (55 +/- 4 and 54 +/- 3, respectively; p > 0.05). Consequently, echocardiographic data in this selected group of purely strength-trained athletes show that whereas this form of conditioning is associated with increased LV mass and a disproportionate increase in wall thickness in relation to cavity dimension, only modest alterations in absolute wall thickness occur (which do not exceed upper normal limits). Therefore, in highly conditioned, strength-trained, competitive athletes, the presence of substantial LV wall thickening (> 13 mm) should suggest alternative explanations, such as the diagnosis of pathologic hypertrophy (i.e., hypertrophic cardiomyopathy).
人们普遍认为力量训练会增加左心室（LV）壁厚度。因此，在个别进行力量训练的运动员中，对于运动员心脏与非梗阻性肥厚型心肌病的鉴别诊断可能会合理地出现混淆。为了研究系统力量训练对心脏尺寸（特别是绝对左心室壁厚度）的影响，通过超声心动图对100名相对年轻且身体状况良好的运动员进行了研究，这些运动员参加举重、力量举、摔跤、雪橇和掷重项目3至24年（平均7年）。没有运动员的最大绝对左心室壁厚度超过公认的正常上限（即12毫米；范围8至12毫米）。与26名年龄和体表面积相似的正常久坐对照者相比，运动员的最大室间隔厚度轻度但显著更大（9.6±0.8对9.0±0.5毫米；p<0.001），计算出的左心室质量指数也是如此（96±12对81±8克/平方米；p<0.001）；运动员和对照者的左心室舒张末期腔内径相似（分别为55±4和54±3；p>0.05）。因此，在这组经过单纯力量训练的运动员中，超声心动图数据表明，虽然这种训练方式与左心室质量增加以及相对于腔内径而言壁厚度不成比例增加有关，但绝对壁厚度仅发生适度改变（未超过正常上限）。因此，在身体状况良好、经过力量训练的竞技运动员中，存在大量左心室壁增厚（>13毫米）应提示其他解释，如病理性肥厚（即肥厚型心肌病）的诊断。
