电影磁共振图像评定运动员心脏形态与功能

本文对瑞典10名耐力运动员(耐力组,长跑7人,游泳3人),10名举重运动员(力量组)及10名健康无训练者(对照组)进行了心脏电影磁共振图像与最大吸氧量的测试。结果表明:1)从左室舒末容量、左室编末容量、心搏量、左室心肌重量、最大吸氧量、最大通气量等指标来看,无论是其绝对实测值,还是其按体表面积或体重校正计算的相对值,耐力组均非常显著地大于其它二组。力量组除了左室心肌重量及左室心肌重量/左室舒末容量比值略有增高外(P<0.05),其余各指标与对照组比较均无显著性差异。2)左室舒末容量、心搏量、左室心肌重量及最大通气量四指标均与最大吸氧量呈高度正相关关系,相关系数依次为0.88,0.85,0.81,0.76,各相关系数均有高度显著性(P<0.001)。3)本文各组的左室心肌重量的电影磁共振图像测定值低于以往多数类似研究对象的超声心动图测定值。文章指出,电影磁共振图像技术是评定左室心肌重量与左室容量十分准确可靠的无创性检查新方法。本文首先报道了运动员心脏电影磁共振部分指标正常测量值。     

运动员左室假腱索与心律失常及左心功能的关系

目的:探讨运动员左室假腱索与心律失常和左心功能的关系。方法:1、通过对广东省体育运动技术学院1743名运动员进行心脏B超检查,调查运动员左室假腱索发生情况;2、将发现左室假腱索的93例运动员(排除心肌炎、心肌病等心脏疾患)作为一组,在无左室假腱索运动员中随机选取93名作为另一组,行心电图和心脏彩色多普勒检查,对比两组运动员心律失常和左心功能。结果:1743名无器质性心脏病运动员中,检测出93例左室假腱索,检出率为5.3%;其中Ⅰ型(横型)91例,Ⅱ型(纵型)2例。男、女运动员左心室假腱索发生率无明显差异。左心室假腱索运动员室性早搏发生率为74.19%,左心室无假腱索运动员室性早搏发生率为4.30%,二组差异有统计学意义(P<0.001);有、无左心室假腱索运动员左心功能指标之间无明显差异。结论:运动员左室假腱索与室性早搏明显相关。左室假腱索对运动员左心功能无明显影响。     

优秀游泳运动员大运动量训练期间的超声心动图测定

<正> 自1967年Feignbaum首先应用超声心动图测算心搏量以来,发展迅速,目前已广泛用于心脏功能和结构的测定。Morganroth等1975年发表题为“有训练运动员运动性左室肥大”。我国白洁心等于1979年报道了运动员超声心动图的测量分析。近几年来,国内关于运动员的超声心动图已先后发表了二十多篇文章,都是属于一次性的测定,在作横向比较时,由于仪     

超声心动图在运动医学中的应用

自 196 7年Ｆｅｉｇｎｂａｕｍ[32 ] 首先应用超声心动图测定心搏量以来 ,超声心动图已被广泛用于临床实践和基础研究。作为一种无创性的检查方法 ,超声心动图也越来越多地用于运动员心脏检查。十余年来 ,与此有关的论文已发表百余篇 ,人们从安静状态到运动负荷状态 ,从普通训练到高原训练等不同方面对运动员心脏结构、心功能特点做了大量的分析、研究 ,取得了大量的数据 ,对运动员心脏的特点有了更多的认识。1　超声心动图的应用对运动员超声心动图的检查大致分两个方面 ,一是结构方面的检查 ;二是功能方面的检查。由于测试的方法 ,所用的…     

心脏附近的肺微波消融:天线定位可以减轻猪模型心脏并发症

正摘要目的研究心脏附近肺微波消融位置不引起心脏组织损伤或明显心律失常的最短距离。材料与方法该研究经机构动物保护和使用委员会批准。在CT透视引导下对12只猪模型进行微波消融。天线方向和位置被随机分配到相对平行(180°±20°)或垂直(90°±20°)于心脏表面和距离心脏0~10 mm的位置。在65 W时消融5 min或直到发生显著的心律失常(心搏停止、心脏传导阻滞、心动过缓、室上性或室性心动过速)为止。用活体染色和组织学检查评价心脏组织。用     

现代运动心脏病学的关键问题—心律失常

近年来运动员中心律失常的发生率增加了40%,约比20年前增加了一倍。文献上有关运动员心律失常的发生率报告不完全一致,其中一个原因是心电图记录心律失常(特别是早跳)的持续时间不够。作者对6000份运动员心律失常的心电图记录时间研究结果表明,为了获得明显的心律失常,心电图描记不应少于3分钟,少于这一时间就观察不到心律失常。     

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。     

耐力运动联合NAD合成酶基因CG9940过表达对中老龄果蝇心脏功能、运动能力和寿命的影响

目的:探讨耐力运动、NAD合成酶相关基因CG9940以及耐力运动联合CG9940基因过表达对中老龄果蝇心脏功能、运动能力和寿命的影响。方法:y[1]w[67c23]P{y[+m8]=Mae-UAS.6.11}CG9940[GG01267]雌性果蝇分别与W1118雄性果蝇、arm-Gal4雄性果蝇杂交取F1代分为对照组、运动组、过表达对照组和过表达运动组,4组均收集400只处女蝇,饲养至30天龄开始训练,连续训练5天,次日取材。实时荧光定量PCR测定CG9940基因m RNA表达量,M-mode心动图检测心管收缩时间、收缩直径、舒张直径、舒张功能不全指数、射血分数和心律失常指数,测量攀爬指数,统计生命周期。结果:(1)过表达对照组CG9940 m RNA过表达率为155.2%,过表达运动组的过表达率为152.0%。(2)与对照组相比,运动组心率降低(P<0.01),射血分数增大(P<0.01),舒张功能不全指数降低(P<0.05);过表达对照组心率降低(P<0.05),射血分数增大(P<0.01);过表达运动组心率降低(P<0.01),心脏平均收缩速度增大(P<0.05),射血分数增大(P<0.01),舒张功能不全指数减小(P<0.01),心律失常指数降低(P<0.05)。与运动组相比,过表达运动组心率降低(P<0.05),射血分数增大(P<0.01),舒张功能不全指数减小(P<0.05)。与过表达对照组相比,过表达运动组心率降低(P<0.05),射血分数增大(P<0.05),舒张功能不全指数减小(P<0.01)。(3)运动组攀爬指数高于对照组(P<0.05);过表达运动组攀爬指数高于对照组(P<0.01)和过表达对照组(P<0.05)。(4)运动组寿命高于对照组(P<0.05);过表达对照组寿命高于对照组(P<0.01);过表达运动组寿命高于对照组(P<0.01)、运动组(P<0.01)和过表达对照组(P<0.05)。结论:耐力运动能够提高中老年果蝇运动能力并且能延缓心脏功能性衰退和延长生命周期;NAD合成酶基因CG9940过表达能够延缓果蝇心脏衰老,显著延长果蝇寿命;耐力运动联合CG9940基因过表达能降低中老龄果蝇心律失常和舒张功能不全,同时能增强中老龄果蝇逆重力攀爬特征,提高活动能力,并且延寿效果更好,表明二者对中老龄果蝇抗衰老产生叠了加效应。     

二维超声心动图测定运动员左室功能的初步观察

受试者取平卧位,观察运动员、常人及冠心病患者二维超声心动图,结果表明:运动员心搏量、心肌厚度和心缩效率较常人和冠心病患者增高,冠心病患者收缩末期容积远远高于运动员。     

糖尿病时心脏自主神经功能的紊乱

糖尿病常伴有自主神经功能紊乱。测定心搏间距及血压变化可反映心脏自主神经功能状态。本文观察了74例无明显临床心脏病表现的糖尿病患者心脏自主神经功能受损情况。 临床资料 一、病人情况 诊断标准按全国糖尿病研究协作会议规定。本组男41例,女33例。年龄17～72岁,平均52岁。病程1～32年,平均6.5年。患者分为两组进行对照观察:(1)具有腹泻、阳萎、尿潴留、出汗异常、体位性低血压等症状者,为糖尿病自主神经病变组(糖神),共46例;(2)无明显上述症状者为普通糖尿病组(普糖),共28例。另设正常对照组132例作     

Are heart rate monitors valuable tools for diagnosing arrhythmias in endurance athletes?

Millions of physically active individuals worldwide use heart rate monitors (HRM s) to control their exercise intensity. In many cases, the HRM indicates an unusually high heart rate (HR ) or even arrhythmias during training. Unfortunately, studies assessing the reliability of these devices to help control HR disturbances during exercise do not exist. We examined 142 regularly training endurance runners and cyclists, aged 18‐51 years, with unexplained HR abnormalities indicated by various HRM s to assess the utility of HRM s in diagnosing exertion‐induced arrhythmias. Each athlete simultaneously wore a Holter electrocardiogram (ECG ) recorder and an HRM during typical endurance training in which they had previously detected “arrhythmias” to verify the diagnosis. Average HR s during exercise were precisely recorded by all types of HRM s. No signs of arrhythmia were detected during exercise in approximately 39% of athletes, and concordant HR s were recorded by the HRM s and Holter ECG . HRM s indicated surprisingly high short‐term HR s in 45% of athletes that were not detected by the Holter ECG and were artifacts. In 15% of athletes, single ventricular/supraventricular beats were detected by the Holter ECG but not by the HRM . We detected a serious tachyarrhythmia in the HRM and Holter ECG data with concomitant clinical symptoms in only one athlete, who was forced to cease exercising. We conclude that the HRM is not a suitable tool for monitoring heart arrhythmias in athletes and propose an algorithm to exclude the suspicion of exercise‐induced arrhythmia detected by HRM s in asymptomatic, physically active individuals.     

Peripheral and systemic circulation after local dynamic exercise and recovery using passive foot movement and electrostimulation

AIM: This study analyzed the effect of additional means of recovery (passive foot movements [PFM] and electrical stimulation [ES]), on peripheral and systemic circulation. METHODS: The subjects were 16 endurance athletes. A period of passive rest (PR), ES and PFM were applied in 3 trials during which arterial blood flow in calf muscles, stroke volume (SV), heart rate (HR) and cardiac output (CO) were recorded. Repetitive exercise loading at 75% of maximum voluntary contraction to exhaustion was performed. RESULTS: A 15-min period of PR did not appreciably decrease residual fatigue of the exercised muscles, and working capacity during the second physical loading decreased by 84.9+/-28.3 Nm (P<0.05). After ES and PFM, muscle working capacity decreased insignificantly versus the values after the first loadings. After PR, SV (78+/-4.5 mL, P<0.05) and CO (5+/-0.3 L/min, P<0.05) decreased versus baseline values (95+/-6.6 mL and 5.8+/-0.3 L/min, respectively). After additional ES and PFM, SV and CO decreased insignificantly versus baseline values. CONCLUSION: ES and PFM improve blood return to the heart. After dynamic exercise, ES and PFM, applied as additional means of recovery, can enhance recovery and restore muscle working capacity.     

Postexercise hypotension and hemodynamics: the role of exercise intensity

AIM: Although postexercise hypotension (PEH) has already been extensively demonstrated, the influence of exercise intensity on its magnitude and mechanisms is still controversial. METHODS: Twenty-three normotensive subjects were submitted to a control (45 minutes of rest) and 3 exercise sessions (cycle ergometer, 45 minutes at 30%, 50% and 75% of .VO(2peak)) to investigate the role of exercise intensity on PEH. Blood pressure (BP - auscultatory), heart rate (HR - ECG), and cardiac output (CO - CO2 rebreathing) were measured before and after the control and exercise sessions. RESULTS: Systolic BP decreased significantly after exercise at 50% and 75% of .VO(2peak). Diastolic BP increased significantly during the control session, did not change after exercise at 30% of .VO(2peak), and decreased significantly after exercise at 50% and 75% of .VO(2peak). This fall was greater and longer after more intense exercise. CO and systemic vascular resistance (SVR) responses were similar between sessions, CO increased whereas SVR decreased significantly. Stroke volume (SV) increased and heart rate (HR) decreased following control and exercise at 30% of .VO(2peak) whereas SV decreased and HR increased after exercise at 50% and 75% of .VO(2peak). CONCLUSION: PEH is greater and longer after more intense exercise. BP profile is followed by a decrease in SVR and an increase in CO, what was not influenced by previous exercise. The increase in CO is caused by an increase in SV after rest and low intensity exercise and by an increase in HR after moderate and more intense aerobic exercise.     

The long-term involution of physiological cardiomegaly and cardiac hypertrophy

The long-term involution of physiological cardiomegaly and cardiac hypertrophy. Med. Sci. Sports Exerc., Vol. 21, No. 3, pp. 244-249, 1989. Forty-five former athletes in endurance disciplines, primarily Olympic medalists and World Cup, European Cup, and German champions, for whom results of an exercise ECG and radiological heart volume measurement were available from their active competitive phase, were examined. The study protocol included clinical examination, laboratory controls, resting and exercise ECG, determination of cardiac volume, and one- and two-dimensional echocardiographic examination. Of the 45 former athletes contacted, 38 appeared for examination. Of these, four presented with heart disease (two with infarction, one with aortic stenosis, and one with arrhythmia). The remaining 34 were divided into groups of still active (more than 300 kcal.wk-1) and inactive (less than 300 kcal.wk-1) athletes. The interval between the first and second examination averaged 23 yr. The active former athletes showed a weight increase of 5.2% (P less than 0.01) and a reduction of 14% in ergometric performance (P less than 0.02). The inactive group had a marked weight increase of 17.4% (P less than 0.001); the ergometric performance was lowered by 20% (P less than 0.001). The absolute heart size had decreased in the active group by 6.1% (NS) and the relative heart size by 10.7% (P less than 0.005); the corresponding values in the inactive group were 4.5% (NS) and 18% (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

Hypokinetic circulation in persons with paraplegia

INTRODUCTION: It is well established that hemodynamic dysfunction, resulting in diminished upper-extremity work capacity, occurs in persons with spinal cord injury (SCI) as compared with those who are nondisabled (ND). Although it has been shown that persons with paraplegia display higher values of heart rate (HR) with lower values of stroke volume (SV) during exercise, it is not resolved whether there is adequate compensation to produce similar values of cardiac output (.Q) as in ND. PURPOSE: This study examined central cardiovascular responses (HR, SV, and .Q) of 20 subjects with complete thoracic level SCI (T(4)-T(11)) and 20 sedentary ND subjects during matched levels of arm-crank (AC) exercise. METHODS: All subjects performed an incremental peak AC test to volitional exhaustion with continuous metabolic analysis and HR measurement via open circuit spirometry and 12-lead electrocardiography, respectively. Stroke volume was assessed using transthoracic impedance. RESULTS: Heart rate was higher for SCI (P< 0.05) with significantly lower values for SV and .Q at rest (approximately 25%). Peak responses were significantly higher for ND in all factors except HR. Although subpeak HRs at matched absolute workloads were significantly higher for SCI (12-20 beats.min (-1) ), SV and .Q were significantly lower (P< 0.05). CONCLUSIONS: The results of this study indicate that .Q is significantly lower in SCI than in ND during AC, despite significantly greater values of HR. These findings also suggest that the disparity in exercise values of .Q is related to differences exhibited at rest.     

小剂量美托洛尔治疗扩张型心肌病心衰的疗效观察

目的　观察用小剂量美托洛尔治疗扩张型心肌病的效果。方法　应用美托洛尔小剂量和逐渐加量的方法 ,治疗了6 4例DCM的CHF患者 ;用超声心动图检测心脏功能的参数 ,分析用药治疗前、后的疗效。结果　在用小剂量美托洛尔治疗 1月～ 2年前后对比心率明显下降 ,房性与室性过早搏动明显减少 ,S T段下降减轻 ,Q Td与Q Tdc均出现缩短 ,左室收缩期与舒张末期腔径缩小 ,左室射血分数 (EF)显著提高。结论　美托洛尔小剂量应用 ,能保护 β 受体不受减敏和出现受体上调 ,减轻患者症状 ,使体力耐量增加 ,明显改善心脏收缩功能 ,减少过早搏动的发生。     

儿童在连续运动负荷过程中心率与心搏量的关系

<正> 心泵功能的强弱对运动成绩的重要影响早已确认,在运动中如何充分利用与发展心泵功能也就成为教练与运动员所关心的问题。德国心脏学家赖因德尔和教练员格希勒的早期研究曾提出了一个“间歇训练的格希勒——赖因德尔定律”:在负荷时心率达170——180次/1′,间歇恢复时至100～125     

应用彩色多普勒时实显象评价高原训练对滑雪运动员左室功能的影响

中国国家集训队12名越野滑雪运动员于长白山进行为期三周高原训练。本文报道了应用彩色多普勒测试和观察高原训练对运动员左室功能的影响。分析比较高原训练前后测试结果显示,运动员安静时心搏量(SV)、心输出量(CO)、左室射血分值(EF)、短轴缩短率(ES)以及左室容积(EDV、ESV)均有显著变化,但组间差异较大。其特点是:男子组以增强左室收缩为主,呈力量型改变。文章指出,高原训练高度和训练手段对于左心功能改变有密切关系。认为在海拔2300—2500米高度、突出强度训练可能趋向力量型改变;在1600—1800米高度、突出耐力训练可能趋向容积型改变。     

The role of the right ventricle during hypobaric hypoxic exercise: insights from patients after the Fontan operation

OBJECTIVES: The principal objective of this study was to examine the importance of the right ventricle for maximal systemic oxygen transport during exercise at high altitude by studying patients after the Fontan operation. BACKGROUND: High-altitude-induced hypoxia causes a reduction in maximal oxygen uptake. Normal right ventricular pump function may be critical to sustain cardiac output in the face of hypoxic pulmonary vasoconstriction. We hypothesized that patients after the Fontan operation, who lack a functional subpulmonary ventricle, would have a limited exercise capacity at altitude, with an inability to increase cardiac output. METHODS: We measured oxygen uptake (VO2, Douglas bag), cardiac output (Qc, C2H2 rebreathing), heart rate (HR) (ECG), blood pressure (BP) (cuff), and O2 Sat (pulse oximetry) in 11 patients aged 14.5+/-5.2 yr (mean +/- SD) at 4.7+/-1.6 yr after surgery. Data were obtained at rest, at three submaximal steady state workrates, and at peak exercise on a cycle ergometer. All tests were performed at sea level (SL) and at simulated altitude (ALT) of 3048 m (10,000 ft, 522 torr) in a hypobaric chamber. RESULTS: At SL, resting O2 sat was 92.6+/-4%. At ALT, O2 sat decreased to 88.2+/-4.6% (P < 0.05) at rest and decreased further to 80+/-6.3% (P < 0.05) with peak exercise. At SL, VO2 increased from 5.1+/-0.9 mL x kg(-1) x min(-1) at rest to 23.5+/-5.3 mL x kg(-1) x min(-1) at peak exercise and CI (Qc x m(-2)) increased from 3.3+/-0.7 L x m(-2) to 6.2+/-1.2 L x m(-2). VO2 peak, 17.8+/-4 mL x kg(-1) x min(-1) (P < 0.05), and CI peak, 5.0+/-1.5 L x m(-2) (P < 0.05), were both decreased at ALT. Remarkably, the relationship between Qc and VO2 was normal during submaximal exercise at both SL and ALT. However at ALT, stroke volume index (SVI, SV x m(-2)) decreased from 37.7+/-8.6 mL x min(-1) x m2 at rest, to 31.3+/-8.6 mL x min(-1) x m2 at peak exercise (P < 0.05), whereas it did not fall during sea level exercise. CONCLUSIONS: During submaximal exercise at altitude, right ventricular contractile function is not necessary to increase cardiac output appropriately for oxygen uptake. However, normal right ventricular pump function may be necessary to achieve maximal cardiac output during exercise with acute high altitude exposure.