Pelliccia A, Culasso F, Di Paolo F M, Maron B J
Institute of Sports Science, Italian National Olympic Committee, and University La Sapienza, Rome.
Ann Intern Med. 1999 Jan 5;130(1):23-31. doi: 10.7326/0003-4819-130-1-199901050-00005.
Absolute left ventricular cavity dimension may be substantially increased in some highly trained athletes. This raises questions about the differential diagnosis between athlete's heart and dilated cardiomyopathy as well as possible disqualification from competitive sports.
To evaluate the morphologic characteristics and physiologic limits of left ventricular cavity enlargement associated with intensive, long-term athletic conditioning.
Evaluation of left ventricular cavity dimension in a large sample of highly trained athletes.
Institute of Sports Science, Rome, Italy.
1309 elite Italian athletes (957 men and 352 women), 13 to 59 years of age (mean, 24 years), participating in 38 different sports.
Echocardiographic assessment of left ventricular cavity dimension and multivariate statistical analysis of the determinants.
Left ventricular end-diastolic cavity dimensions varied widely (38 to 66 mm [mean, 48 mm] in women and 43 to 70 mm [mean, 55 mm] in men) and was within generally accepted normal limits for most participants (< or = 54 mm in 725 athletes [55%]). According to an arbitrary clinical cut-point of 60 mm, the left ventricular cavity was substantially enlarged in 185 participants (14%). These athletes had global left ventricular systolic function within normal limits and no regional wall-motion abnormalities; participants remained free of cardiac symptoms and impaired performance over 1 to 12 years (mean, 4.7 years). The major determinants of cavity dimension were greater body surface area and participation in certain endurance sports (cycling, cross-country skiing, and canoeing).
In a sample of highly trained athletes, left ventricular cavity dimension varied widely but was strikingly increased to a degree compatible with primary dilated cardiomyopathy in almost 15% of participants. In the absence of systolic dysfunction, this cavity dilatation is most likely an extreme physiologic adaptation to intensive athletic conditioning. The long-term consequences and significance of this marked left ventricular remodeling of the athlete's heart is not known.
在一些训练有素的运动员中，左心室腔绝对尺寸可能会大幅增加。这引发了关于运动员心脏与扩张型心肌病鉴别诊断的问题，以及可能被取消竞技体育资格的问题。
评估与长期高强度运动训练相关的左心室腔扩大的形态学特征和生理限度。
对大量训练有素的运动员的左心室腔尺寸进行评估。
意大利罗马运动科学研究所。
1309名意大利精英运动员（957名男性和352名女性），年龄在13至59岁之间（平均24岁），参加38项不同运动。
超声心动图评估左心室腔尺寸，并对决定因素进行多变量统计分析。
左心室舒张末期腔尺寸差异很大（女性为38至66毫米[平均48毫米]，男性为43至70毫米[平均55毫米]），大多数参与者（725名运动员[55%]）的该尺寸在普遍接受的正常范围内（≤54毫米）。根据60毫米这一任意设定的临床切点，185名参与者（14%）的左心室腔明显扩大。这些运动员的左心室整体收缩功能在正常范围内，且无局部室壁运动异常；参与者在1至12年（平均4.7年）内无心脏症状且运动表现未受损。腔尺寸的主要决定因素是更大的体表面积以及参与某些耐力运动（自行车、越野滑雪和皮划艇）。
在一组训练有素的运动员样本中，左心室腔尺寸差异很大，但近15%的参与者的左心室腔尺寸显著增加至与原发性扩张型心肌病相符的程度。在没有收缩功能障碍的情况下，这种腔扩张很可能是对高强度运动训练的一种极端生理适应。运动员心脏这种明显的左心室重塑的长期后果和意义尚不清楚。
