The developing athlete's heart: a cohort study in young athletes transitioning through adolescence
The developing athlete's heart: a cohort study in young athletes transitioning through adolescence
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DOI：
10.1177/2047487319862061
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发表时间：
2019-07-08
影响因子：
8.3
通讯作者：
Sarvari, Sebastian, I
中科院分区：
文献类型：
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作者：
Bjerring, Anders W.;Landgraff, Hege E. W.;Sarvari, Sebastian, I
运动员心脏是一个用来描述运动员心脏生理变化的术语，但其早期发育尚未在纵向研究中描述。本研究旨在提高我们对耐力训练对心脏发育影响的认识。方法对48名越野滑雪运动员在12岁（12.1 ± 0.2岁）时和15岁（15.3 ± 0.3岁）时的心脏形态和功能进行了评估。所有受试者均行超声心动图检查，包括二维斑点追踪应变超声心动图和三维超声心动图。所有参与者在12岁和15岁时都进行了心肺运动测试，以评估最大摄氧量和运动能力。结果31名（65%）在15岁时仍然是积极的耐力运动员，17名（35%）不是。主动耐力运动员在随访时的最大摄氧量指数更高（62 +/- 8 vs. 57 +/- 6 mL/kg/min，P < 0.05）。基线时心脏形态无差异。随访时，主动耐力运动员的左心室舒张末期三维指数（84 +/- 11 mL/m2 vs. 79 +/- 10 mL/m2，P < 0.05）和收缩末期容积（36 +/- 6 mL/m2 vs. 32 +/- 3 mL/m2，P < 0.05）更大。主动耐力运动员的相对室壁厚度下降，但戒烟者的相对室壁厚度没有下降（-0.05 Delta mL/m2 vs. 0.00 mL/m2，P = 0.01）。四名主动耐力运动员在基线时的相对壁厚高于参考值上限;所有人在随访时均恢复正常。结论青春期前运动员在初始向心重构后，继续耐力训练的运动员出现离心改变，心腔扩张，室壁厚度变化不大。那些停止耐力训练的人保持了相当的室壁厚度，但没有发生室腔扩张。
Background Athlete's heart is a term used to describe physiological changes in the hearts of athletes, but its early development has not been described in longitudinal studies. This study aims to improve our understanding of the effects of endurance training on the developing heart. Methods Cardiac morphology and function in 48 cross-country skiers were assessed at age 12 years (12.1 +/- 0.2 years) and then again at age 15 years (15.3 +/- 0.3 years). Echocardiography was performed in all subjects including two-dimensional speckle-tracking strain echocardiography and three-dimensional echocardiography. All participants underwent cardiopulmonary exercise testing at both ages 12 and 15 years to assess maximal oxygen uptake and exercise capacity. Results Thirty-one (65%) were still active endurance athletes at age 15 years and 17 (35%) were not. The active endurance athletes had greater indexed maximal oxygen uptake (62 +/- 8 vs. 57 +/- 6 mL/kg/min, P < 0.05) at follow-up. There were no differences in cardiac morphology at baseline. At follow-up the active endurance athletes had greater three-dimensional indexed left ventricular end-diastolic (84 +/- 11 mL/m(2) vs. 79 +/- 10 mL/m(2), P < 0.05) and end-systolic volumes (36 +/- 6 mL/m(2) vs. 32 +/- 3 mL/m(2), P < 0.05). Relative wall thickness fell in the active endurance athletes, but not in those who had quit (-0.05 Delta mL/m(2) vs. 0.00 mL/m(2), P = 0.01). Four active endurance athletes had relative wall thickness above the upper reference values at baseline; all had normalised at follow-up. Conclusion After an initial concentric remodelling in the pre-adolescent athletes, those who continued their endurance training developed eccentric changes with chamber dilatation and little change in wall thickness. Those who ceased endurance training maintained a comparable wall thickness, but did not develop chamber dilatation.