二维斑点追踪技术对业余马拉松运动员左心室收缩功能的研究

目的应用二维斑点追踪技术评价业余马拉松运动员左心室收缩功能。方法选取2019年1月至2020年6月在杭州市招募的业余马拉松运动员59例,根据参加马拉松运动时限分为A组(参加马拉松运动时间>2~5年)和B组(参加马拉松运动时间>5年);另选取同期在医院体检健康志愿者31例为对照组。使用常规超声心动图结合二维斑点追踪技术测量受检者舒张末期室间隔厚度(IVSd)、舒张末期左室后壁厚度(PWd)、左室舒张末期内径(LVEDd)、相对室壁厚度(RWT)、左室舒张末期质量(LVM)、左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、每搏量(SV)、左室射血分数(LVEF)、左心室整体纵向应变(GLS)及整体圆周应变(GCS);对A组和B组受检者在完成全程马拉松运动前、运动后1 h和运动后第4 d分别行超声心动图检查。结果与对照组比较,A组IVSd、PWd、LVEDd、RWT、LVM显著增高(均P<0.05);与对照组及A组比较,B组IVSd、PWd、LVEDd、RWT、LVM、EDV、ESV、SV显著增高(均P<0.01)。三组间LVEF差异无统计学意义(P>0.05)。三组间运动前GLS比较差异有统计学意义(P<0.01),GCS差异无统计学意义(P>0.05);与A组比较,B组运动前、运动后1 h、运动后第4 d GLS及运动后1 h GCS显著降低(均P<0.05)。组内比较:A组及B组运动后1 h GLS较运动前、运动后第4 d显著降低(均P<0.05);B组运动后1 h GCS较运动前显著降低(P<0.05)。结论长期参加马拉松的业余运动员左心室纵向应变显著降低,全程马拉松运动后出现左心室收缩功能短暂下降。

Assessment of left ventricular systolic function in amateur marathoners by two-dimensional speckle tracking echocardiography

Objective To assess the left ventricular(LV)systolic function in amateur marathoners by two-dimensional speckle tracking echocardiography.Methods A total of 59 amateur marathon runners were recruited from January 2019 to June 2020 in Hangzhou and were divided into group A(>2-5 years)and group B(>5 years)based on their time of participating in marathon.Thirty-one healthy volunteers were enrolled from Affiliate Hospital of Hangzhou Normal University during the same period as a control group.Conventional echocardiography combined with two-dimensional speckle tracking imaging were applied to all the subjects to obtain interventricular septum diastolic thickness(IVSd),LV posterior wall thickness(PWd),LV end-diastolic diameter(LVEDd),relative wall thickness(RWT)and LV mass(LVM),LV end-diastolic volume(EDV),LV end-systolic volume(ESV)and stroke volume(SV),LV ejection fraction(LVEF),LV global longitudinal strain(GLS),and global circumferential strain(GCS).Pre-marathon,1 hour and 4th day post-marathon echocardiography were performed in amateur marathon runners.Results Compared with the control group,group A amateur marathon runners showed significant increases in IVSd,PWd,LVEDd,RWT and LVM(all P<0.05);In addition,the IVSd,PWd,LVEDd,RWT,LVM,EDV,ESV and SV in group B runners were further increased compared to those of group A runners(all P<0.01).The LVEF and pre-marathon GCS showed no statistically significant differences among the three groups(all P>0.05),while the pre-marathon GLS showed a statistically significant difference among the three groups(P<0.01).Compared with group A runners,the pre-marathon,1 hour and 4th day post-marathon GLS and 1 hour post-marathon GCS were significantly decreased in group B runners(all P<0.01);In intra-group comparison,1 hour post-marathon GLS was significantly decreased in relative to pre-marathon and 4th day post-marathon GLS in both group A and B(all P<0.05).One hour post-marathon GCS was significantly decreased compared with pre-marathon GCS in group B(P<0.05).Conclusions Amateur runners who have participated in long time marathon have reduced LV longitudinal strains and transient post-marathon decreases in LV systolic function.