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

作　　者：王新宇[1] 崔哲 和清源[2] 邓湘宁[1] 郭歌[2] 冯新恒[1] 冯杰莉[1] WANG Xin-yu;CUI Zhe;HE Qing-yuan;DENG Xiang-ning;GUO Ge;FENG Xin-heng;FENG Jie-li(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;Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[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

出　　处：《北京大学学报（医学版）》2021年第5期832-837,共6页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81972149、81871850);北京市自然科学基金(7212125)。

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/m^(2)vs.(67.8±11.2)g/m^(2),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。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/m^(2) vs.(67.8±11.2)g/m^(2),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 at

关 键 词：超声心动图 运动员 心室 身体耐力 

分 类 号：R540.45[医药卫生—心血管疾病]