优秀耐力、力量项目运动员心脏形态功能特点

目的:探讨我国优秀耐力、力量项目运动员心脏形态功能特点。方法:运用超声心动图技术对78名优秀耐力、力量项目运动员心脏形态、功能进行分析研究。结果:(1)在心脏形态方面,耐力项目男运动员主肺动脉内径、左室舒张末期前后径、室间隔运动幅度、左室后壁运动幅度、右室内径、左房前后径各指标均显著高于力量项目男运动员(P<0.01);耐力项目女运动员的心脏形态各指标均显著高于力量项目女运动员(P<0.01)。(2)在心脏功能方面,耐力项目男运动员左室舒张末期容积、左室心输出量、左室射血分数、左室缩短分数等均显著高于力量项目男运动员(P<0.01);而耐力项目女运动员二尖瓣前向血流E峰、二尖瓣前向血流A峰、二尖瓣峰值流速E/A、主动脉瓣最大血流速度、左室舒张末期容积、左室收缩末期容积、左室心输出量、左室射血分数、左室缩短分数等均显著高于力量项目女运动员(P<0.01)。结论:(1)在心脏形态方面,相对于力量项目运动员,耐力项目运动员左室、右室和左房明显扩大。(2)在心脏功能方面,耐力项目男运动员左室收缩功能强于力量项目男运动员;而耐力项目女运动员左室舒张和收缩功能以及顺应性均好于力量项目。     

耐力运动员左室舒张期室壁多普勒频谱初步观察

目的与方法:采用用室壁多普勒频谱图,通过测定和比较普通人和耐力运动员在静息和逐级递增负荷运动时左室E波和A波峰值速度,探讨耐力运动员在静息状态和递增负荷运动时,左室后壁主动松弛和被动充盈功能的变化.结果:(1)静息状态下,耐力运动员组A波速度显著低于普通对照组(P<0.05).50W负荷和100W负荷时,耐力运动员组A波速度显著低于对照组(P<0.05);150W负荷时,两组无显著性差异(P>0.05);200W负荷时,耐力运动员组显著高于普通对照组(P<0.01).(2)静息状态下,普通对照组E波速度显著低于耐力运动员组(P<0.05).在递增负荷过程中,两组E波速度均有升高趋势,耐力组显著高于普通对照组(P<0.05).结果提示,与心力储备相似,心脏舒张功能也有一定的储备能力.心脏舒张功能在四级递增负荷中变化较静息状态更为明显,建议在评定心脏功能,特别是心脏的舒张功能时,引入运动负荷,可能更为准确、客观.     

体外反搏对少年耐力运动员心缩间期等指标的影响

提高心脏功能的传统方法是通过运动器官的锻炼间接提高心脏的泵血机能,由于训练过程受多种因素的影响,其效果往往难尽人意。为探索提高少年耐力运动员心脏功能的辅助训练手段,我们对本市１２名少年耐力运动员进行了两个疗程的体外反搏对照试验,本文通过心缩间期的变化...     

耐力锻炼对人体心脏左室舒张功能的影响

采用彩色多普勒超声技术，研究分析了耐力项目大学生运动员、普通大学生不同状态二尖瓣血流频谱，旨在了解耐力锻炼对人体心脏左室舒张功能的影响。结果表明耐力锻炼可使心脏左室舒张功能产生适应性反应；二尖瓣血流速度积分、平均压差、A峰值与心率、每搏输出量及极量负荷运动时间存在密切的相关；耐力锻炼可使二尖瓣血流速度积分明显增大，平均压差和A峰值明显减小。     

运动员心导纳图的初步研究

要培养高水平的运动员,特别是从事耐力性项目的运动员,除进行必要的形态机能测试外,对其心脏泵血功能的优劣进行鉴别、选择是十分重要的。要提高运动员的耐力成绩,必须先发展其最大有氧能力,而最大运动时氧的增加主要来自心输出量(CO)的增     

优秀女子足球运动员安静、力竭运动后和恢复期心缩间期的变化

目的:探讨女子足球运动员心脏功能及耐力水平。方法:利用MCA-3C心脏功能信息综合检测仪对女子足球运动员(女足组,n=10)、体育学院体育教育专业(体教组,n=10)和普通院系(对照组,n=10)女大学生进行安静时、力竭运动后和恢复期心缩间期(STI)测试并比较相关指标。结果:女足组无论在安静状态下还是力竭运动后和恢复期,左室射血时间(LVET)、心脏机械收缩时间(MST)均显著高于体教组和对照组(P<0.01);射血前期/左室射血时间(PEP/LVET)、等容收缩期(ICT)、等容收缩期/左室射血时间(ICT/LVET)均低于体教组和对照组;达到力竭的时间和强度也高于体教组和对照组。结果表明,女子足球运动员的心脏功能和耐力素质均优于体育教育专业和普通院系大学生。     

应用直立位运动二维超声心动图评价运动员的心脏结构及功能

对２５名优秀男子耐力项目运动员及３１名男大学生正常对照组进行了直立位安静、踏车运动负荷状态下及运动后恢复过程的二维超声心动图检查。结果表明：１）只要掌握好超声探测要点，本法是可行而可靠的，且较以往超声检查方法所得的结果更接近于实际运动状态下的心脏结构和功能改变；２）运动员的心室顺应性较好，心肌收缩力较强；３）运动员的心力储备较大，只有在较大运动负荷下才能对受试者的心力储备作出正确评价；４）研究运动停止后恢复期的心脏结构和功能改变非常重要。     

马拉松赛对中老年人心脏结构、功能和血清酶的影响

为了了解中老年人马拉松赛后心脏结构、功能和血清磷酸肌酸激酶及同功酶变化的特点,对参加加拿大国家马拉松赛的10名50—73岁的马拉松运动员进行观察并与10名50岁以下的马拉松运动员作了比较,发现50岁以上有训练的马拉松运动员有较好的血管调节功能和良好的心脏代偿能力。血清磷酸肌酸激酶同功酶的变化,反映了马拉松跑对老年人心脏的影响。     

中国优秀运动员心脏瓣膜生理性返流调查分析

目的:了解中国优秀运动员心脏瓣膜生理性返流的发生情况。方法:自2000年对10个项目398名国家队运动员进行超声心动图检查,观察瓣膜运动及血流情况,测量心脏结构指标并计算其心功能指标。结果:398名运动员中,共检出各种瓣膜生理性返流90例(22.61%),其中男运动员44例(25.58%),女运动员46例(20.35%)。以三尖瓣返流最常见,检出率为14.07%,二尖瓣返流为4.52%,肺动脉瓣返流为1.76%,未检出主动脉瓣返流。联合瓣膜返流9例(2.26%),其中二尖瓣和三尖瓣联合返流6例,三尖瓣和肺动脉瓣联合返流3例。羽毛球项目心脏瓣膜生理性返流检出率最高,其次为游泳、女子垒球、举重和乒乓球,竞走运动员检出率为0。在兼具力量性和耐力性运动特点的混合型项目运动员中,与无返流者相比,检出返流者的左室舒张末期和收缩末期的内径增加、容积增大,右室和右房横径增加,射血分数下降但仍正常,其余结构和功能指标均无显著性差异。举重运动员中检出者和未检出者未见上述心脏结构和功能指标的差异。结论:中国优秀运动员瓣膜生理性返流检出率较高,以三尖瓣返流为主,性别之间无显著性差异,项目特点不明显。     

耐力锻炼对人体心脏左室收缩功能的影响

目的评价耐力锻炼对人体心脏左室收缩功能的影响.方法采用运动负荷试验,测量、分析了12名耐力项目大学生运动员和12名普通大学生安静状态、定量负荷和极量负荷运动后主动脉收缩期血流频谱.结果安静状态、定量负荷运动后,实验组Vmax、PGmax、PGm、AVm明显小,AT、ET明显大,VTI、AT/ET实验组尽管大于对照组,但无明显的统计学差异;极量负荷运动后,两组各参数无明显差异.结论耐力锻炼可使人体心脏左室收缩产生能量节省化,具备较大的功能潜力,泵血顺畅,主动脉瓣口面积增大.     

Left ventricular morphology and function in female athletes: a meta-analysis

The purpose of the present study was to examine the impact of physical training upon cardiac structure and function, and identify physiologic upper limits in female athletes. Meta-analytical techniques were applied to 13 published echocardiographic studies examining cardiac structure and function in female athletes. The study group included 890 athletes and 333 controls. For comparison of sporting discipline, studies were partitioned into 3 categories (endurance, strength/sprint, team). Significant (p < 0.05) effect sizes were observed for all structural measures between athletes and controls. Significant effect size differences existed between sporting groups for LVIDd and LVM only, with endurance and team game athletes demonstrating the largest effect sizes compared to strength trained athletes. No significant effect of training was observed for left ventricular diastolic or systolic function, with the exception of stroke volume where a significant effect size difference was observed between athletes and controls with no observed difference between sporting groups. Maximum reported upper limits for LV wall thickness and LVIDd in female athletes were 12 mm and 66 mm respectively. Chronic exercise training results in cardiac enlargement in female athletes. The nature of physiologic adaptation is similar to that observed in male athletes. LV wall thickness values greater than 12 mm in female athletes should be viewed with caution and indicate a more comprehensive evaluation to establish a physiological or pathological basis for the observed left ventricular enlargement.     

Atrioventricular plane displacement in untrained and trained females

PURPOSE: Female athletes often demonstrate changes in cardiac dimensions that are less prominent than in male athletes, and results from longitudinal studies are conflicting. The atrioventricular plane displacement (AVPD) in the heart is used as an index of left ventricular systolic function with the assumption that it is a more sensitive method for measuring myocardial contractility compared with left ventricular ejection fraction. The aim of the present study was to determine the effect of a short period of endurance training on cardiac dimensions in sedentary female subjects and to measure the AVPD at rest and during submaximal workload. METHODS: Twelve sedentary female subjects (21.9 +/- 1.3 yr, 168.8 +/- 3.5 cm, 64.0 +/- 6.6 kg, and 42.6 +/- 2.9 mL x kg(-1) x min(-1) in maximal oxygen uptake) were examined with echocardiography before and after a period of interval training (varying from 2 to 5 min at 90-95% of maximal heart rate, 3 d x wk(-1), 8 wk). RESULTS: Maximal oxygen uptake increased by 18% to 50.4 +/- 3.1 mL x kg(-1) x min(-1) (P < 0.001). Left ventricular mass increased from 123.9 to 139.2 g (P = 0.007). There was a significant increase in posterior wall thickness but no change in cavity size. The AVPD did not change at rest but increased significantly from 15.6 to 17.6 mm (P < 0.001) during exercise at 85-90% of maximal heart rate. CONCLUSION: This study shows that a short period of aerobic endurance training induces changes in the female heart, both in cardiac dimensions at rest and in left ventricular systolic function at submaximal workload. AVPD during submaximal exercise discriminate well between the untrained and trained healthy heart.     

Echocardiographic findings in strength- and endurance-trained athletes.

Assessment of echocardiographic measurements in athletes should take into account the specific sport and the quantity and quality of training. In addition, values corrected for body dimensions, especially the active body mass, should be used rather than absolute values. All parts of the athlete's heart are enlarged and its performance increases. Highly trained endurance athletes show the most enlarged hearts. Athlete's heart can be observed in athletes of all ages including the young. However, it is rarer than generally assumed. To differentiate between physiological and pathological myocardial changes, the relationship between heart size and ergometric performance as well as the echocardiographically measured ratio between left ventricular (LV) myocardial thickness and volume are useful; the latter remains unchanged, on the whole, in endurance- and strength-trained athletes. Concentric hypertrophy cannot be induced by strength training alone; additional factors, such as hypertension, aortic stenosis, cardiomyopathy or anabolic steroid use can play an important role. When corrected for body dimensions, non-endurance-trained, e.g. strength-trained, athletes have standard heart sizes even if considerable time is devoted to training. Findings in healthy untrained persons with large body dimensions also indicate no significant difference between the increase of echocardiographic measures caused by training and that caused by growth. An LV myocardial thickness of 13mm is seldom exceeded even in the highly endurance-trained or anabolic drug-free strength trained athletes under physiological conditions. However, the echocardiographic differentiation of cardiomyopathy can be difficult if an individual is highly trained and has large body dimensions. In such cases, LV end-diastolic diameter may be up to 66 to 70mm. The upper normal value of LV muscle mass is 170 g/m2 for a physiological heart enlargement. Future areas of investigation should include: adaptative changes; of the right ventricle; differences in the regression of the athlete's heart after cessation of training; the differentiation between echocardiographic changes; in highly endurance-trained or combined strength-endurance-trained persons and pathological changes; the importance of heart size and endurance sports performance; and finally the influence of genetic factors.     

Left ventricular size following endurance, sprint, and strength training

Left ventricular size following endurance, sprint, and strength training. Med. Sci. Sports Exercise, Vol. 14, No. 5, pp. 344-347, 1982. Left ventricular dimensions in adolescent boys were determined before and after three types of training regimens: endurance (END), N = 8, means = 16.8 yr; sprint (SPR), N = 8, means = 16.3 yr; strength (STR), N = 12, means = 18.7 yr. With training the END group significantly increased VO2max in 1 X min-1 (3.71 +/- 0.27 to 4.16 +/- 0.57, P less than 0.05) and in ml X min-1 X kg-1 (58.4 +/- 5.6 to 64.2 +/- 5.5, P less than 0.05). The SPR group increased VO2max in 1 X min-1 (3.63 +/- 0.63 to 3.98 +/- 0.78, P less than 0.05) but not in ml X min-1 X kg-1 (59.5 +/- 4.1 to 63.2 +/- 5.4) because body weight increased from 61.2 +/- 10.5 to 63.1 +/- 10.7 kg (P less than 0.05) with no change in percent body fat. The STR training group significantly improved upper body strength. Despite these specific training adaptations no significant modifications were found for interventricular and left ventricular posterior wall thickness or for left ventricular internal diameter in either training group. However, calculated left ventricular mass was slightly but significantly higher by 10% and 4% in the END and STR training groups, respectively. These small increases in calculated left ventricular mass with short-term training are probably caused by small but insignificant increases in left ventricular internal diameter secondary to a training bradycardia (END group: 76 +/- 8 to 64 +/- 1 beats X min-1) and to increased diastolic filling time rather than to true cardiac hypertrophy. Significant increases in aerobic capacity and in strength can occur without modification of left ventricular dimensions.     

A pilot study on left ventricular dimensions and wall stress before and after submaximal exercise.

Left ventricle dimensions and wall stress were measured echocardiographically before and immediately after exercise in 14 athletes and 7 control subjects. Our findings suggest that afterload is an important determinant of cardiac performance and wall hypertrophy in athletes. In spite of major changes in heart rate and blood pressure, left ventricular wall stress remains unchanged following submaximal exercise, in trained and untrained hearts. It would appear that the changes in heart size during exercise are to a large extent limited in untrained ventricles, as smaller left ventricular dimensions are required, to "normalise" wall stress. This results in a lower stroke volume for a given stroke dimensional change. Consequently cardiac output is a function of heart rate rather than stroke volume in untrained subjects. The effect of increased muscle mass in athletes, is to permit larger left ventricular dimensions for a given afterload, thus stroke volume can be augmented. The increase h/R ratio suggests that afterload is more important than preload in the development of left ventricular hypertrophy in rowers and swimmers.     

Enlargement of the right heart in the endurance athlete: a two-dimensional echocardiographic study

M-mode echocardiographic studies of endurance-trained athletes have provided conflicting data for right ventricular (RV) dimensions and no data for right atrial (RA) size. Since two-dimensional echocardiography provides a more accurate measurement of the RV and RA, it was employed together with M-mode echocardiography to evaluate 12 male endurance athletes and 12 sedentary controls matched for body size and age. All subjects were screened by history, physical examination, ECG, and maximal exercise testing. RV and RA areas were planimetered in the apical four-chamber view while displaying maximal chamber sizes. Athletes had significantly greater left ventricular (LV) wall thickness (P less than 0.01), LV area (P less than 0.001), and left atrial (LA) area (P less than 0.01). They also had greater RV area (P less than 0.01), RV wall thickness (P less than or equal to 0.05), and RA area (P less than or equal to 0.01). Maintained proportionality of the cardiac chamber dimensions in the athletes was shown by similar ratios of right-to-left ventricular areas, right-to-left atrial areas, and right-to-left ventricular wall thicknesses in both groups. The symmetry of the greater athlete's heart differs from most pathological conditions which have heterogeneous effects on specific cardiac chambers.     

Form, size and function of the sports heart--differentiation from pathological findings

Dependent on the nature, intensity and scope of muscular exercise, regular athletic training can result in changes in the size and form of the heart, which can be recorded by radiologic and echocardiographic techniques. Brief anaerobic exercise and purely static forms of training (sprint, strength sports) do not produce substantial increases in the size of the heart, but a rotund heart shape with rounding of the cardiac tip and in some cases a discrete increase in the wall thickness of the ventricular myocardium is frequently observed. Dependent on the scope of the training and the intensity, aerobic, endurance-oriented training (endurance sports) can induce considerable enlargement of all cardiac chambers with a change in the cardiac configuration, which is most nearly comparable to combination mitral vitium. Comparison of physiological hypertrophy of the athletic heart with pathological forms of cardiac hypertrophy (such as cardiomyopathies) is in many cases not unequivocally possible with plain X-ray films, but it is usually successful with echocardiographic examination methods.     

Effects of resistive training on left ventricular function

Although several studies have evaluated the effects of endurance training on left ventricular (LV) function, few studies have looked at resistive training effects. Acute isometric exercise increases blood pressure and has little effect on LV function, causing only mild increases in ejection fraction and stroke volume index. However, acute isometric exercise does increase LV diastolic diameter to a lesser extent than dynamic exercise. Most studies of resistive training on LV function have been cross-sectional or short term (10 to 12 wk) training studies on athletes and suggest that increases in LV wall thickness and mass are dependent upon the intensity and duration of training. Most resistive training studies show no increase in left ventricular volume, as can be seen in endurance trained athletes. Despite the increase in LV mass with resistive training, indices of LV systolic and diastolic function do not change. In hypertensive and cardiac patients with normal LV function at rest, resistive training increases LV mass index without deleterious effects on LV systolic and diastolic function. However, in patients with abnormal resting LV function, resistive training can have adverse effects on LV systolic function. Overall, moderate levels of resistive training can be a useful adjunct to cardiac rehabilitation programs, with the caveat that it be used with caution in patients with abnormal LV function at rest.     

Left ventricular mass, geometry and filling in elite female and male endurance athletes

We compared echocardiographic findings in female (n=30) and male (n=30) endurance athletes to age-matched female (n=15) and male (n=15) sedentary controls. The differences between athletes and controls were similar in both sexes; only left ventricular (LV) mass and septum thickness differed slightly more in men than in women (67% vs 55%, P=0.004, and 36% vs 30%, P=0.03, respectively). LV wall thicknesses were in the normal range in all women, while four (13%) male athletes exceeded 13 mm. In conclusion, the effects of endurance training on echocardiographic findings appear to be quite similar in women and men. However, in female athletes with an abnormally thick left ventricular wall a thorough cardiac evaluation is indicated. This contrasts with male athletes, in whom LV wall thicknesses of over 13 mm are a not uncommon finding.