Pelliccia A, Maron B J, Culasso F, Spataro A, Caselli G
Institute of Sports Science, Department of Medicine, Rome, Italy.
JAMA. 1996 Jul 17;276(3):211-5. doi: 10.1001/jama.276.3.211.
OBJECTIVES; To define the expression of "athlete's heart" in women by determining the alterations in cardiac dimensions associated with long-term intense conditioning in elite female athletes. DESIGN; Prospective cardiovascular assessment conducted from 1986 through 1993. Subjects were evaluated using 2-dimensional, M-mode, and Doppler echo-cardiographic studies.
Institute of Sports Science, Italian National Olympic Committee, Rome, Italy.
A total of 600 elite female athletes (mean age, 21 years; range, 12-49 years) who had participated in vigorous training (mean duration, 9 years; range, 2-32 years) and had competed in 27 sports, including 211 athletes at the international level and 389 at the national level. A control group consisted of 65 sedentary volunteer women (mean age, 23.7 years; range, 14-41 years) who were free of cardiovascular disease and who did not participate in regular athletic training.
Left ventricular end-diastolic cavity dimension and wall thickness.
Athletes demonstrated larger left ventricular end-diastolic cavity dimension (mean +/- SD) (49 +/- 4 mm) and greater maximal wall thickness (8.2 +/- 0.9 mm) than controls (46 +/- 3 mm and 7.2 +/- 0.6 mm; P < .001). These dimensions were 6% and 14% larger in athletes. Among athletes, left ventricular cavity dimension was 40 mm to 66 mm, exceeded normal limits ( > 54 mm) in 47 women (8%), and was within the range consistent with primary dilated cardiomyopathy ( > or = 60 mm) in 4 athletes (1%). Training for endurance sports, such as cycling, cross-country skiing, and rowing had the greatest effect on cavity dimension. Left ventricular wall thickness was 6 mm to 12 mm in athletes and did not exceed normal limits or extend into the borderline gray zone with hypertrophic cardiomyopathy in any subject. Compared with data from 738 previously studied male athletes, female athletes showed significantly smaller left ventricular cavity dimension (11% less; P < .001) and wall thickness (23% less; P < .001).
Highly trained women athletes frequently demonstrate cardiac dimensional changes as an adaptation to physical training, although absolute left ventricular cavity size exceeding normal limits was evident in a minority (8%) of women athletes and was rarely (1% of athletes) within the range of dilated cardiomyopathy. Athletic training was not a stimulus for substantial increases in absolute left ventricular wall thickness, which was within normal limits for all women athletes. These findings suggest that the clinical differentiation of athlete's heart and hypertrophic cardiomyopathy appears to be a diagnostic dilemma that is limited to male athletes.
通过确定精英女性运动员长期高强度训练相关的心脏维度变化，来定义女性“运动员心脏”的表现。
1986年至1993年进行的前瞻性心血管评估。使用二维、M型和多普勒超声心动图研究对受试者进行评估。
意大利罗马意大利国家奥委会运动科学研究所。
共有600名精英女性运动员（平均年龄21岁；范围12 - 49岁），她们参加了高强度训练（平均时长9年；范围2 - 32年），并参加了27项运动，其中包括211名国际水平运动员和389名国家水平运动员。一个对照组由65名久坐的志愿女性组成（平均年龄23.7岁；范围14 - 41岁），她们无心血管疾病且未参加常规体育训练。
左心室舒张末期腔径和室壁厚度。
与对照组（46±3mm和7.2±0.6mm；P <.001）相比，运动员的左心室舒张末期腔径更大（平均±标准差）（49±4mm），最大室壁厚度更厚（8.2±0.9mm）。这些维度在运动员中分别大6%和14%。在运动员中，左心室腔径为40mm至66mm，47名女性（8%）超过正常范围（>54mm），4名运动员（1%）在与原发性扩张型心肌病一致的范围内（≥60mm）。耐力运动训练，如骑自行车、越野滑雪和划船，对腔径的影响最大。运动员的左心室壁厚度为6mm至12mm，在任何受试者中均未超过正常范围或延伸至肥厚型心肌病的临界灰色区域。与738名先前研究的男性运动员的数据相比，女性运动员的左心室腔径明显更小（小11%；P <.001），室壁厚度更小（小23%；P <.001）。
训练有素的女性运动员经常表现出心脏维度变化以适应体育训练，尽管少数（8%）女性运动员的左心室腔绝对大小超过正常范围，且很少（运动员的1%）在扩张型心肌病范围内。体育训练不是绝对左心室壁厚度大幅增加的刺激因素，所有女性运动员的左心室壁厚度均在正常范围内。这些发现表明，运动员心脏与肥厚型心肌病的临床鉴别似乎是一个仅限于男性运动员的诊断难题。
