Effect of Sex and Sporting Discipline on LV Adaptation to Exercise
Effect of Sex and Sporting Discipline on LV Adaptation to Exercise
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DOI：
10.1016/j.jcmg.2016.08.011
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发表时间：
2017-09-01
影响因子：
14
通讯作者：
Sharma, Sanjay
中科院分区：
文献类型：
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作者：
Finocchiaro, Gherardo;Dhutia, Harshil;Sharma, Sanjay
目的探讨不同类型运动对男女运动员左心室几何构型的影响。背景与研究背景：评价男女运动员心脏适应性的研究表明，与男运动员相比，女运动员左心室壁厚度和腔大小的增加较小。方法1,083名健康、精英、白人运动员(41%为女性，平均年龄21.8+/-5.7岁)通过心电图和超声心动图进行评估。根据欧美超声心动图学会的诊断标准，根据相对室壁厚度(RWT)和左心室质量(LVm)，将LV几何构型分为4组：正常(LVm/正常RWT)、向心性肥厚(LVm/RWT增加)、离心性肥厚(LVm/RWT增加)和向心性重构(LVm/RWT正常)。与男运动员相比，女运动员的LVM(83+/-17g/m(2)vs.101+/-21g/m(2)；p<；0.001)和RWT(0.35+/-0.05vs.0.36+/-0.05；p<；0.001)较低。女性的绝对LV内径也较低(49+/-4 mm vs.54+/-5 mm；p<；0.001)，但在校正身体表面积后，女性的指数LV内径较大(28.6+/-2.7 mm/m(2)vs.27.2+/-2.7 mm/m(2)；p<；0.001)。大多数运动员表现出正常的左心室构型。与男性相比，参加动态运动的女性表现出偏心性肥厚的比例更高(22%比14%；p<；0.001)。在这一亚组中，只有4%的女性和15%的男性表现出向心性肥厚/重构(p<；0.001)。结论高水平训练的运动员一般表现出正常的左心室几何形状；然而，参加动态运动的女运动员往往表现出偏心性肥厚。尽管从事动态运动的男性运动员的向心性重构或肥大相对常见，但在女性运动员中很少见，可能是有症状的运动员的疾病标志。(C)2017年，由美国心脏病学院基金会提供。
OBJECTIVES This study sought to investigate the effect of different types of exercise on left ventricular (LV) geometry in a large group of female and male athletes.BACKGROUND Studies assessing cardiac adaptation in female and male athletes indicate that female athletes reveal smaller increases in LV wall thickness and cavity size compared with male athletes. However, data on sex-specific changes in LV geometry in athletes are scarce.METHODS A total of 1,083 healthy, elite, white athletes (41% female; mean age 21.8 +/- 5.7 years) assessed with electrocardiogram and echocardiogram were considered. LV geometry was classified into 4 groups according to relative wall thickness (RWT) and left ventricular mass (LVM) as per European and American Society of Echocardiography guidelines: normal (normal LVM/normal RWT), concentric hypertrophy (increased LVM/increased RWT), eccentric hypertrophy (increased LVM/normal RWT), and concentric remodeling (normal LVM/increased RWT).RESULTS Athletes were engaged in 40 different sporting disciplines with similar participation rates with respect to the type of exercise between females and males. Females exhibited lower LVM (83 +/- 17 g/m(2) vs. 101 +/- 21 g/m(2); p < 0.001) and RWT (0.35 +/- 0.05 vs. 0.36 +/- 0.05; p < 0.001) compared with male athletes. Females also demonstrated lower absolute LV dimensions (49 +/- 4 mm vs. 54 +/- 5 mm; p < 0.001) but following correction for body surface area, the indexed LV dimensions were greater in females (28.6 +/- 2.7 mm/m(2) vs. 27.2 +/- 2.7 mm/m(2); p < 0.001). Most athletes showed normal LV geometry. A greater proportion of females competing in dynamic sport exhibited eccentric hypertrophy compared with males (22% vs. 14%; p < 0.001). In this subgroup only 4% of females compared with 15% of males demonstrated concentric hypertrophy/remodeling (p < 0.001).CONCLUSIONS Highly trained athletes generally show normal LV geometry; however, female athletes participating in dynamic sport often exhibit eccentric hypertrophy. Although concentric remodeling or hypertrophy in male athletes engaged in dynamic sport is relatively common, it is rare in female athletes and may be a marker of disease in a symptomatic athlete. (C) 2017 by the American College of Cardiology Foundation.