Comparison of Pro-Atrial Natriuretic Peptide and Atrial Remodeling in Marathon Versus Non-Marathon Runners
Comparison of Pro-Atrial Natriuretic Peptide and Atrial Remodeling in Marathon Versus Non-Marathon Runners
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DOI：
10.1016/j.amjcard.2011.11.039
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发表时间：
2012-04-01
影响因子：
2.8
通讯作者：
Saner, Hugo
中科院分区：
文献类型：
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作者：
Wilhelm, Matthias;Nuoffer, Jean-Marc;Saner, Hugo
长期耐力运动与心房重塑以及心房颤动 (AF) 和心房扑动的风险增加有关。心房钠尿肽原 (pro-ANP) 是心房壁张力的标志物，在 AF 患者中升高。本研究的目的是检验这样的假设：剧烈比赛期间心房拉伸的重复发作会导致心房重塑持续存在，这反映在 pro-ANP 水平升高上。对计划参加 2010 年伯尔尼大奖赛（10 英里比赛）的非精英跑步者进行了一项横断面研究。 492名马拉松和非马拉松选手报名参赛，随机抽取70名，56名进入最终分析。根据以前的马拉松参与情况对受试者进行分层：对照组（非马拉松运动员，n = 22）、第 1 组（1 至 4 场马拉松比赛，n = 16）和第 2 组（≥ 5 场马拉松比赛，n = 18）。结果根据年龄、训练年限和平均每周耐力训练时间进行了调整。平均年龄为 42 +/- 7 岁。与对照组相比，第 1 组和第 2 组的马拉松运动员左心房较大（25 6 vs 30 6 vs 34 +/- 7 ml/m(2)，p = 0.002），右心房较大（27 +/- 7 vs 31 +/- 8 vs 35 +/- 5 ml/m(2)，p = 0.024）。马拉松运动员基线时的 ANP 前体水平较高（1.04 +/- 0.38 vs 1.42 +/- 0.74 vs 1.67 +/- 0.69 nmol/L，p = 0.006）。赛后，所有组中的 Pro-ANP 均显着增加。在多元线性回归分析中，参加马拉松是左心房的独立预测因素（β = 0.427，p
Long-term endurance sports are associated with atrial remodeling and an increased risk for atrial fibrillation (AF) and atrial flutter. Pro-atrial natriuretic peptide (pro-ANP) is a marker of atrial wall tension and elevated in patients with AF. The aim of this study was to test the hypothesis that atrial remodeling would be perpetuated by repetitive episodes of atrial stretching during strenuous competitions, reflected by elevated levels of pro-ANP. A cross-sectional study was performed on nonelite runners scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race. Four hundred ninety-two marathon and nonmarathon runners applied for participation, 70 were randomly selected, and 56 entered the final analysis. Subjects were stratified according to former marathon participations: a control group (nonmarathon runners, n = 22), group 1 (1 to 4 marathons, n = 16), and group 2 (>= 5 marathons, n = 18). Results were adjusted for age, training years, and average weekly endurance training hours. The mean age was 42 +/- 7 years. Compared to the control group, marathon runners in groups 1 and 2 had larger left atria (25 6 vs 30 6 vs 34 +/- 7 ml/m(2), p = 0.002) and larger right atria (27 +/- 7 vs 31 +/- 8 vs 35 +/- 5 ml/m(2), p = 0.024). Pro-ANP levels at baseline were higher in marathon runners (1.04 +/- 0.38 vs 1.42 +/- 0.74 vs 1.67 +/- 0.69 nmol/L, p = 0.006). Pro-ANP increased significantly in all groups after the race. In multiple linear regression analysis, marathon participation was an independent predictor of left atrial (beta = 0.427, p