通过磁共振成像和多巴酚丁胺负荷磁共振波谱对运动员心脏进行功能和代谢评估。

Functional and metabolic evaluation of the athlete's heart by magnetic resonance imaging and dobutamine stress magnetic resonance spectroscopy.

作者信息

Pluim B M, Lamb H J, Kayser H W, Leujes F, Beyerbacht H P, Zwinderman A H, van der Laarse A, Vliegen H W, de Roos A, van der Wall E E

机构信息

Interuniversity Cardiology Institute of The Netherlands, Utrecht.

出版信息

Circulation. 1998 Feb 24;97(7):666-72. doi: 10.1161/01.cir.97.7.666.

DOI:10.1161/01.cir.97.7.666

PMID:9495302

Abstract

BACKGROUND

The question of whether training-induced left ventricular hypertrophy in athletes is a physiological rather than a pathophysiological phenomenon remains unresolved. The purpose of the present study was to detect any abnormalities in cardiac function in hypertrophic hearts of elite cyclists and to examine the response of myocardial high-energy phosphate metabolism to high workloads induced by atropine-dobutamine stress.

METHODS AND RESULTS

We studied 21 elite cyclists and 12 healthy control subjects. Left ventricular mass, volume, and function were determined by cine MRI. Myocardial high-energy phosphates were examined by 31P magnetic resonance spectroscopy. There were no significant differences between cyclists and control subjects for left ventricular ejection fraction (59+/-5% versus 61+/-4%), left ventricular cardiac index (3.4+/-0.4 versus 3.4+/-0.4 L x min(-1) x m[-2]), peak early filling rate (562+/-93 versus 535+/-81 mL/s), peak atrial filling rate (315+/-93 versus 333+/-65 mL/s), ratio of early and atrial filling volumes (3.0+/-1.0 versus 2.6+/-0.6), mean acceleration gradient of early filling (5.2+/-1.4 versus 5.8+/-1.9 L/s2), mean deceleration gradient of early filling(-3.1 +/- 0.9 versus -3.2 +/- 0.7 L/s2), mean acceleration gradient of atrial filling (3.6+/-1.8 versus 4.5+/-1.7 L/s2), and atrial filling fraction (0.23+/-0.06 versus 0.26+/-0.04, respectively). Cyclists and control subjects showed similar decreases in the ratio of myocardial phosphocreatine to ATP measured with 31P magnetic resonance spectroscopy during atropine-dobutamine stress (1.41+/-0.20 versus 1.41+/-0.18 at rest to 1.21+/-0.20 versus 1.16+/-0.13 during stress, both P=NS).

CONCLUSIONS

Left ventricular hypertrophy in cyclists is not associated with significant abnormalities of cardiac function or metabolism as assessed by MRI and spectroscopy. These observations suggest that training-induced left ventricular hypertrophy in cyclists is predominantly a physiological phenomenon.

摘要

背景

运动员训练所致的左心室肥厚是一种生理现象而非病理生理现象，这一问题仍未得到解决。本研究的目的是检测精英自行车运动员肥厚心脏的心脏功能是否存在异常，并研究心肌高能磷酸代谢对阿托品 - 多巴酚丁胺负荷诱发的高负荷的反应。

方法与结果

我们研究了21名精英自行车运动员和12名健康对照者。通过电影磁共振成像测定左心室质量、容积和功能。通过磷 - 31磁共振波谱检查心肌高能磷酸盐。自行车运动员和对照者在左心室射血分数（59±5% 对 61±4%）、左心室心脏指数（3.4±0.4 对 3.4±0.4L·min⁻¹·m⁻²）、早期充盈峰值速率（562±93 对 535±81mL/s）、心房充盈峰值速率（315±93 对 333±65mL/s）、早期和心房充盈容积比（3.0±1.0 对 2.6±0.6）、早期充盈平均加速度梯度（5.2±1.4 对 5.8±1.9L/s²）、早期充盈平均减速梯度（-3.1±0.9 对 -3.2±0.7L/s²）、心房充盈平均加速度梯度（3.6±1.8 对 4.5±1.7L/s²）以及心房充盈分数（分别为 0.23±0.06 对 0.26±0.04）方面均无显著差异。在阿托品 - 多巴酚丁胺负荷期间，自行车运动员和对照者通过磷 - 31磁共振波谱测量的心肌磷酸肌酸与三磷酸腺苷的比值下降相似（静息时为 1.41±0.20 对 1.41±0.18，负荷时为 1.21±0.20 对 1.16±0.13，P 均无统计学意义）。