斑点追踪技术评价中国优秀男子举重运动员心脏的改变

doi:10.19723/j.issn.1671-167X.2021.05.004

北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (5): 832-837. doi: 10.19723/j.issn.1671-167X.2021.05.004

斑点追踪技术评价中国优秀男子举重运动员心脏的改变

王新宇¹,崔哲²,和清源²,邓湘宁¹,郭歌²,冯新恒¹,冯杰莉^1,^△()

1.北京大学第三医院心内科, 血管医学研究所, 国家卫健委心血管分子生物学与调节肽重点实验室, 分子心血管学教育部重点实验室, 心血管受体研究北京市重点实验室, 北京 100191
2.北京大学第三医院放射科, 北京 100191

收稿日期:2021-06-04 出版日期:2021-10-18 发布日期:2021-10-11
通讯作者: 冯杰莉 E-mail:jielifeng@ymail.com
基金资助:
国家自然科学基金(81972149);国家自然科学基金(81871850);北京市自然科学基金(7212125)

Assessment of heart’s changes of elite Chinese male weightlifter by speckle tracking echocardiography

WANG Xin-yu¹,CUI Zhe²,HE Qing-yuan²,DENG Xiang-ning¹,GUO Ge²,FENG Xin-heng¹,FENG Jie-li^1,^△()

1. Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, National Health Commission of the PRC; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research; Beijing 100191, China
2. Department of Radiology, Peking University Third Hospital, Beijing 100191, China

Received:2021-06-04 Online:2021-10-18 Published:2021-10-11
Contact: Jie-li FENG E-mail:jielifeng@ymail.com
Supported by:
National Natural Science Foundation of China(81972149);National Natural Science Foundation of China(81871850);Beijing Natural Science Foundation(7212125)

摘要/Abstract

摘要：

目的: 采用斑点追踪技术评价中国优秀举重运动员心脏结构功能的变化。方法: 以中国男性优秀举重运动员(举重组n=16)和年龄匹配的健康男性(对照组n=16)为研究对象,进行经胸超声心动图检查,采用斑点追踪自动功能成像技术进行二维心肌应变测定。结果: 举重组的室间隔厚度、左心室后壁厚度和左心室心肌质量指数均大于对照组[(9.3±1.3) mm vs. (8.0±0.4) mm,(9.2±0.8) mm vs. (8.0±0.8) mm,(77.8±12.8) g/m² vs. (67.8±11.2) g/m²,均P<0.05]。举重组与对照组相比,左心室射血分数(left ventricular ejection fraction,LVEF)和左心室整体长轴应变值(left ventricular global longitudinal strain,LVGLS)差异无统计学意义,但反映左心室收缩功能的平均收缩期运动速度峰值Sm和反映左心室舒张功能的舒张早期运动速度峰值Em这两个指标,举重组均低于对照组(均P<0.05),进一步分析显示,举重组前间隔基底段及后间隔中段长轴应变绝对值均明显低于对照组[ $(- 15.1 ± 4.2) %$ vs. $(- 18.7 ± 3.0) %$ , $(- 18.8 ± 2.6) %$ vs. $(- 21.3 ± 2.8) %$ ,均P<0.05]。根据运动员在全国青年运动会上的最好成绩排名将本组运动员分成成绩优秀组与成绩良好组,两组相比,成绩优秀组的室间隔厚度更大[(10.2±1.1) mm vs. (8.5±1.0) mm,P<0.05],后间隔中段长轴应变绝对值更低[ $(- 17.1 ± 2.1) %$ vs. $(- 20.4 ± 2.1) %$ ,P<0.05]。结论: 举重运动员中,成绩优秀者的室间隔增厚更明显,伴随心肌收缩功能减低,超声心动图的斑点追踪技术能早期识别优秀运动员心脏形态的改变,有可能为运动医学监督及优秀人才选拔提供依据。

关键词: 超声心动图, 运动员, 心室, 身体耐力

Abstract:

Objective: To evaluate the changes of heart structure and function in elite Chinese weightlifters by spot tracking technique. Methods: Chinese elite male weightlifters (weightlifter group, n=16) and age-matched healthy men (control group, n=16) were included as subjects. Transthoracic echocardiography and speckle-tracking automatic functional imaging were used for two-dimensional myocardial strain measurements. Results: The thickness of septum and left ventricular (LV) posterior wall and the myocardial mass index of LV were all higher than those of the control group [(9.3±1.3) mm vs. (8.0±0.4) mm, (9.2±0.8) mm vs. (8.0±0.8) mm, (77.8±12.8) g/m² vs. (67.8±11.2) g/m², all P<0.05]. Although the LV ejection fraction (LVEF) and global long axis strain value (LVGLS) were not significantly different from those in the control group, the LV mean Sm and Em reflecting the systolic and diastolic functions of the LV were lower than those in the control group (P<0.05). Further myocardial strain analysis showed that the absolute value of the long axial strain of the basal anteroseptal and mid-inferoseptal segments of the weightlifters were significantly lower than those of the control group [ $(- 15.1 ± 4.2) %$ vs. $(- 18.7 ± 3.0) %$ , $(- 18.8 ± 2.6) %$ vs. $(- 21.3 ± 2.8) %$ , all P<0.05]. There was no significant difference in other segments. The athletes were divided into two groups according to their best performance in the National Youth Games. The athletes were divided into two sub-groups according to their performance in the National Youth Games. The thickness of the septum in the sub-group with better performance (who ranked the 1^st to 8^th) was larger [(10.2±1.1) mm vs. (8.5±1.0) mm, P<0.05], and the absolute value of the long-axis strain in the mid-inferoseptal segment was lower [ $(- 17.1 ± 2.1) %$ vs. $(- 20.4 ± 2.1) %$ , P<0.05]. Conclusion: The thickening of septum is more obvious in the excellent weightlifters, accompanied by the decrease of myocardial systolic function. The speckle-tracking technique of echocardiography can identify the changes of the heart structure and function of elite athletes at an early stage, which may provide a basis for sports medicine supervision and the selection of excellent talents.

Key words: Echocardiography, Athletes, Heart ventricles, Physical endurance

中图分类号:

R540.45

王新宇,崔哲,和清源,邓湘宁,郭歌,冯新恒,冯杰莉. 斑点追踪技术评价中国优秀男子举重运动员心脏的改变[J]. 北京大学学报（医学版）, 2021, 53(5): 832-837.

Xin-yu WANG,Zhe CUI,Qing-yuan HE,Xiang-ning DENG,Ge GUO,Xin-heng FENG,Jie-li FENG. Assessment of heart’s changes of elite Chinese male weightlifter by speckle tracking echocardiography[J]. Journal of Peking University (Health Sciences), 2021, 53(5): 832-837.

图/表 4

表1

受试者基本资料"

Items Weightlifters group, $x ?$ ±s Control group, $x ?$ ±s P value
Age/years 21±3 22±3 0.401
Height/cm 171.3±7.6 175.6±4.9 0.073
Weight/kg 91.0±20.8 70.0±10.4 0.002
BSA/m² 2.1±0.3 1.8±0.2 0.010
Training time/years 9±4
HR/(beat/min) 70±11 79±15 0.081

表1

表2

受试者超声心动图结果"

Items Weightlifters group, $x ?$ ±s Control group, $x ?$ ±s P value
LVEDV/mL 115.6±23.7 96.9±22.7 0.033
LVEDVI/(mL/m²) 56.4±11.4 52.4±10.7 0.317
LVESV/mL 38.9±9.8 30.0±8.3 0.011
LVESVI/(mL/m²) 19.0±5.0 16.3±4.4 0.118
LVEF/% 66.4±3.8 68.8±5.3 0.166
LAESV/mL 54.6±11.4 49.8±12.1 0.269
LAESVI/(mL/m²) 26.2±5.3 26.9±6.2 0.739
SV/mL 76.7±15.3 66.9±16.9 0.103
CO/(L/min) 5.3±0.9 5.1±0.9 0.496
IVS/mm 9.3±1.3 8.0±0.4 0.001
LVPW/mm 9.2±0.8 8.0±0.8 0.001
RWT 0.38±0.05 0.34±0.03 0.018
LVM/g 159.8±27.8 125.2±25.0 0.001
LVMI/(g/m²) 77.8±12.8 67.8±11.2 0.029
LV average Sm/(cm/s) 10.7±1.9 13.0±1.6 0.001
LV average Em/(cm/s) 13.8±2.7 17.7±2.9 0.001
LV average Am/(cm/s) 8.2±2.5 9.2±1.4 0.211
Average E/Em 6.3±1.7 5.3±0.9 0.057
RV lateral Sm/(cm/s) 14.2±1.7 15.5±2.0 0.069
RV lateral Em/(cm/s) 13.4±2.8 16.0±3.7 0.043
RV lateral Am/(cm/s) 10.9±2.4 11.9±1.9 0.202

表2

表3

受试者左心室长轴心肌应变结果"

Segments Weightlifters group, $x ?$ ±s Control group, $x ?$ ±s P value
Basal anterior/% -13.9±8.9 -18.2±4.3 0.169
Mid-anterior/% -18.4±3.5 -20.3±3.6 0.216
Apical anterior/% -22.9±6.1 -23.9±5.6 0.693
Basal lateral/% -15.3±3.9 -16.1±2.9 0.584
Mid-lateral/% -17.5±2.7 -18.7±3.6 0.360
Apical lateral/% -22.4±4.6 -23.4±4.9 0.626
Basal inferior/% -18.7±2.9 -20.0±3.5 0.338
Mid-inferior/% -21.0±2.8 -22.4±4.3 0.344
Apical inferior/% -24.1±4.5 -25.2±5.1 0.596
Basal inferoseptal/% -16.1±2.6 -16.7±1.7 0.514
Mid-inferoseptal/% -18.8±2.6 -21.3±2.8 0.034
Apical septal/% -23.7±5.1 -26.1±4.8 0.261
Basal anteroseptal/% -15.1±4.2 -18.7±3.0 0.033
Mid-anteroseptal/% -19.2±4.8 -22.4±3.9 0.100
Basal posterior/% -15.4±4.6 -17.4±2.3 0.226
Mid-posterior/% -17.9±3.0 -19.7±2.3 0.121
Apical cap/% -23.2±4.5 -24.6±4.8 0.474
LVGLS/% -19.3±2.9 -20.8±3.1 0.234

表3

表4

不同成绩的举重运动员超声心动图结果"

Ranking 9 to 16, $x ?$ ±s Ranking 1 to 8, $x ?$ ±s P value
IVS/mm 8.5±1.0 10.2±1.1 0.012
LVPW/mm 9.1±0.7 9.2±0.9 0.767
LV average Sm/(cm/s) 10.9±1.8 10.4±2.4 0.661
LV average Em/(cm/s) 14.1±2.3 12.9±3.1 0.396
RV Em/(cm/s) 13.2±3.3 14.0±2.9 0.637
LVMI/(g/m²) 79.3±14.1 71.4±7.8 0.218
Mid-inferoseptal/% -20.4±2.1 -17.1±2.1 0.012
Basal anteroseptal/% -16.9±4.0 -13.4±4.0 0.133

表4

参考文献 14

[1]	Augustine DX, Howard L. Left ventricular hypertrophy in athletes: Differentiating physiology from pathology [J]. Curr Treat Options Cardiovasc Med, 2018, 20(12):96. doi: 10.1007/s11936-018-0691-2 pmid: 30367318
[2]	Galderisi M, Cardim N, D’Andrea A, et al. The multi-modality cardiac imaging approach to the athlete’s heart: An expert consensus of the European Association of Cardiovascular Imaging [J]. Eur Heart J Cardiovasc Imaging, 2015, 16(4):353. pmid: 25681828
[3]	Stephen FC, Strphanie W, John PE, et al. Echocardiographic and blood pressure characteristic of first-year collegiate American-style football players [J]. Am J Cardiol, 2016, 117(1):131-134. doi: 10.1016/j.amjcard.2015.09.049 pmid: 26554673
[4]	李莉锦, 滑少华, 孙梦娇, 等. 三维斑点追踪技术与相对室壁厚度对力量型运动员左室收缩功能的相关性研究 [J]. 中国超声医学杂志, 2017, 33(6):508-511.
[5]	Beaumont A, Grace F, Richards J, et al. Left ventricular speckle tracking derived cardiac strain and cardiac twist mechanics in athletes: A systematic review and meta-analysis of controlled studies [J]. Sport Med, 2017, 47(6):1145-1170. doi: 10.1007/s40279-016-0644-4
[6]	Richand V, Lafitte S, Reant P, et al. An ultrasound speckle tracking (two-dimensional strain) analysis of myocardial deformation in professional soccer players compared with healthy subjects and hypertrophic cardiomyopathy [J]. Am J Cardiol, 2007, 100(1):128-132. doi: 10.1016/j.amjcard.2007.02.063
[7]	丁磊, 范大立. 心脏影像学对左室射血分数的评估 [J]. 北京大学学报(医学版), 2012, 44(5):694-700.
[8]	Maurer MS, Packer M. How should physicians assess myocardial contraction? Redefining heart failure with a preserved ejection fraction [J]. JACC Cardiovasc Imaging, 2020, 13(3):873-878. doi: 10.1016/j.jcmg.2019.12.021
[9]	Swoboda PP, Erhayiem B, McDiarmid AK, et al. Relationship between cardiac deformation parameters measured by cardiovascular magnetic resonance and aerobic fitness in endurance athletes [J]. J Cardiovasc Magn Reson, 2016, 18(1):48. doi: 10.1186/s12968-016-0266-x
[10]	Hashemi D, Motzkus L, Blum M, et al. Myocardial deformation assessed among heart failure entities by cardiovascular magnetic resonance imaging [J]. ESC Heart Fail, 2021, 8(2):890-897. doi: 10.1002/ehf2.13193 pmid: 33539681
[11]	Marciniak M, Gilbert A, Loncaric F, et al. Septal curvature as a robust and reproducible marker for basal septal hypertrophy [J]. J Hypertens, 2021, 39(7):1421-1428. doi: 10.1097/HJH.0000000000002813 pmid: 33534345
[12]	Balzer P, Furber A, Delépine S, et al. Regional assessment of wall curvature and wall stress in left ventricle with magnetic resonance imaging [J]. Am J Physiol, 1999, 277(3):H901-H910.
[13]	连鹏鹄, 丁莉, 张学斌, 等. 嗜铬细胞瘤伴严重儿茶酚胺心肌病5例围手术期治疗 [J]. 北京大学学报(医学版), 2013, 45(4):605-608.
[14]	Gati S, Sharma S, Pennell D. The role of cardiovascular magnetic resonance imaging in the assessment of highly trained athletes [J]. JACC Cardiovasc Imaging, 2018, 11(2 Pt 1):247-259. doi: 10.1016/j.jcmg.2017.11.016

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斑点追踪技术评价中国优秀男子举重运动员心脏的改变

Assessment of heart’s changes of elite Chinese male weightlifter by speckle tracking echocardiography

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