Pluim B M, Chin J C, De Roos A, Doornbos J, Siebelink H M, Van der Laarse A, Vliegen H W, Lamerichs R M, Bruschke A V, Van der Wall E E
Department of Cardiology, University Hospital, Leiden, The Netherlands.
Eur Heart J. 1996 Aug;17(8):1271-8. doi: 10.1093/oxfordjournals.eurheartj.a015046.
We investigated whether left ventricular hypertrophy in elite cyclists is associated with functional changes or abnormal energy metabolism. Left ventricular hypertrophy is a powerful risk factor for sudden cardiac death with different prognostic significance among the various geometric forms. Cyclists may have a combination of mixed eccentric and concentric hypertrophy. Magnetic resonance imaging was used to define left ventricular mass, geometry and function. Thirteen highly trained male cyclists and 12 healthy controls were investigated. Proton-decoupled phosphorus-31 cardiac spectroscopy was performed to assess parameters of myocardial high-energy phosphate metabolism. Left ventricular mass and end-diastolic volumes normalized for body surface area were significantly higher in cyclists (124.1 +/- 9.4 g.m-2 and 106.2 +/- 11.4 ml.m-2, respectively) than in controls (85.9 +/- 9.3 g.m-2 and 79.1 +/- 11.6 ml.m-2, respectively), (both P < 0.0001). The left ventricular mass to end-diastolic volume ratio, as a parameter of left ventricular geometry, was not significantly increased in cyclists compared to controls. Resting left ventricular ejection fraction, cardiac index, and systolic wall stress in cyclists did not differ significantly from those of controls. The phosphocreatine to adenosine triphosphate ratio was not significantly different between cyclists and controls (2.2 +/- 0.34 vs 2.2 +/- 0.17, ns). Cyclists show prominent left ventricular hypertrophy with normal geometry. The finding that the hypertrophic hearts of the cyclists had normal left ventricular function and a normal phosphocreatine to adenosine triphosphate ratio suggests that sport-induced left ventricular hypertrophy is a physiological adaptation rather than a pathophysiological response.
我们研究了精英自行车运动员的左心室肥厚是否与功能变化或能量代谢异常有关。左心室肥厚是心源性猝死的一个重要危险因素，在不同的几何形态中具有不同的预后意义。自行车运动员可能同时存在混合性离心性和向心性肥厚。采用磁共振成像来确定左心室质量、几何形态和功能。对13名训练有素的男性自行车运动员和12名健康对照者进行了研究。采用质子去耦联磷-31心脏波谱法评估心肌高能磷酸代谢参数。自行车运动员经体表面积校正后的左心室质量和舒张末期容积显著高于对照组（分别为124.1±9.4 g·m-2和106.2±11.4 ml·m-2），而对照组分别为85.9±9.3 g·m-2和79.1±11.6 ml·m-2，（均P<0.0001）。作为左心室几何形态参数的左心室质量与舒张末期容积之比，自行车运动员与对照组相比没有显著增加。自行车运动员静息时的左心室射血分数、心脏指数和收缩期壁应力与对照组相比无显著差异。自行车运动员与对照组之间的磷酸肌酸与三磷酸腺苷之比无显著差异（2.2±0.34对2.2±0.17，无显著性差异）。自行车运动员表现出明显的左心室肥厚，但几何形态正常。自行车运动员肥厚的心脏左心室功能正常且磷酸肌酸与三磷酸腺苷之比正常这一发现表明，运动诱导的左心室肥厚是一种生理适应性改变而非病理生理反应。
