血流向量成像技术评价优秀女子冰球运动员左心室血流动力学特征研究  

Evaluation of Left Ventricular Eddy Current in Elite Female Ice Hockey Players by Using Vector Flow Mapping

作　　者：张剑梅 白美英 张瑞平 杨萍 范煜东 ZHANG Jianmei;BAI Meiying;ZHANG Ruiping;YANG Ping;FAN Yudong(Sports Medical Supervision Research Center,National Institute of Sports Medicine,Bejing 100061,China;Rehabilitation Department,Jilin Sports System Sports Trauma Hospital,Changchun 130022,China;Postdoctoral Mobile Station of Sports Science,Chengdu Sport University,Chengdu 610041,China;Cardiovascular Medicine Department,Emergency General Hospital,Beijing 100028,China)

机构地区：[1]国家体育总局运动医学研究所运动医务监督研究中心,北京100061 [2]吉林省体育系统运动创伤医院康复科,吉林长春130022 [3]成都体育学院体育学博士后流动站,四川成都610041 [4]北京应急总医院心血管内科,北京100028

出　　处：《体育科学》2023年第10期66-72,81,共8页China Sport Science

基　　金：科技部国家重点研发计划“主动健康和人口老龄化科技应对”重点专项(2022YFC2010200)。

摘　　要：目的:探讨经长期高强度训练的优秀女子冰球运动员心脏左心室内舒张期涡流变化。方法:对19例优秀青年女子冰球运动员(运动员组)及19例健康青年女性(对照组)进行常规经胸超声心动图检查,应用血流向量成像技术(vector flow mapping,VFM)在心尖三腔心视图下观察舒张早期(V1)、舒张晚期(V2)内涡流旋转方向、位置、相对持续时间和相对大小。结果:1)常规超声心动图参数:运动员组与对照组相对室壁厚度(relative wall thickness,RWT)、左心室后壁舒张末期厚度(posterior wall thickness in diastole,PWTd)、左心室射血分数(left ventricular ejection fraction,LVEF)、左心室缩短分数(left ventricular fractional shortening,LVFS)、二尖瓣舒张晚期血流峰值速度(A)均无统计学差异(P>0.05);与对照组相比,运动员组室间隔舒张末期厚度、左心室质量、左心室质量指数、左心室舒张末期内径、左心室舒张末期容积、左心室收缩末期容积、舒张早期(E)、E/A(E/A比值)、每搏输出量、心输出量等测量值均增大,差值有统计学意义(P<0.05);经体表面积标准化后,两组的左心室舒张末期容积和搏出量仍具有统计学意义(P<0.05)。2)VFM参数:运动员组和对照组V1、V2时期内涡流位置、方向、相对大小均无显著性差异(P>0.05),但两组V1、V2涡流相对持续时间有显著性差异(P<0.05);3)相关性分析:运动员组V2-涡流相对大小与V1-涡流相对大小、左心室舒张末期内径、左心室舒张末期容积、搏出量呈正相关性(P<0.05)。结论:1)参加长期高强度训练的优秀女子冰球运动员的心脏结构表现出正常的运动适应性改变,收缩和舒张功能良好;2)优秀女子冰球运动员左心室舒张期涡流持续时间延长,使多向的血流融合而不产生过多的能量损耗,保证左心室容积在充盈压不显著增加的情况下增大,有利于腔室顺应性,有助于运动员比赛期间在平均做功心率>90%HR_(Objective:To explore the changes of left ventricular vortex in elite female ice hockey players who conducted long-term high-intensity exercise training.Methods:A total of 19 elite female ice hockey players(athlete group) and 19 healthy young women(control group) were examined by transthoracic echocardiography,the vector flow mapping(VFM) technology was executed to calculate the rotation direction,position,relative duration and relative size of the vortex at the early diastolic phase(V1) and late diastolic phase(V2) under the apical three-chamber view.Results:1) No significant difference was observed in RWT,PWTd,LVEF,LVFS,and A between the two groups(P>0.05);compared with the control group,the IVSd,LVM,LVMI,LVEDD,LVEDV,LVESV,E,E/A,SV and CO were increased in the athlete group(P<0.05);standardized by BSA,the significant difference was still observed in LVEDV and SV between the two groups(P<0.05).2) There was no significant difference in position,direction,and relative size of vortex at V1 and V2 between the two groups(P>0.05);however,the relative duration of vortex was significant different at V1 and V2 between the two groups(P<0.05).3) The relative size of vortex at V2 was highly correlated with relative size of vortex at V1,LVEDD,LVEDV,and SV(P<0.05).Conclusion:1) The cardiac structure of female ice hockey players shows normal exercise adaptation,the cardiac systolic and diastolic functions are good.2) The duration of the left ventricular diastolic vortex in elite female ice hockey players is prolonged,which enables the fusion of multi-directional blood flow without excessive energy loss,and increases the left ventricular volume without significant increase in filling pressure.The abovementioned changes are conducive to ventricular compliance and diastolic function,and helpful to ensure the return blood volume under the condition of average working heart rate(WHR) >90%HRmax,improving the cardiac ejection function and benefit the muscle energy demand during exercise.

关 键 词：血流向量成像 冰球运动员 涡流 心脏功能 

分 类 号：G804.5[文化科学—运动人体科学]