超声心动图与心脏磁共振成像对比评价中国男举重运动员心脏结构变化

Left ventricular function and remodeling assessed by echocardiography and cardiac magnetic resonance imaging in Chinese weightlifter athletes

目的:超声心动图与心脏磁共振成像(CMR)对比评价力量训练对运动员心脏结构的影响。方法:该研究为病例对照研究。纳入2019年1月16日至11月1日于北京大学第三医院接受健康体检的男性举重运动员14名,为举重组。纳入14名年龄与之匹配的健康中国男性为对照组。分别采用超声心动图和CMR对受试者心脏结构和功能进行检测。结果:举重组运动员的年龄为(21±3)岁,训练时间为(9±4)年。举重组运动员每周运动时间>15 h,对照组人群每周运动时间<3 h。超声心动图测量结果显示,举重组运动员的室间隔室壁厚度大于对照组[(9.3±1.3)mm比(8.1±0.5)mm, P=0.006];CMR测量结果显示,举重组运动员的室间隔室壁厚度亦大于对照组[(11.0±1.5)mm比(10.0±0.5)mm, P=0.003]。举重组中,超声心动图测量的左心室容积的各指标[左心室舒张末期容积(LVEDV)、左心室舒张末期容积指数(LVEDVI)、左心室收缩末期容积、左心室收缩末期容积指数]及室间隔室壁厚度均小于CMR的测量结果( P均<0.05),而超声心动图测量的左心室射血分数[(67.0±3.8)%比(59.0±3.9)%, P<0.001]及左心室整体应变绝对值[(19.3±2.9)%比(11.2±1.2)%, P<0.001]均高于CMR测值。举重组中,超声心动图和CMR测得的左心室舒张末期内径、LVEDV和LVEDVI超过正常上限者的比例差异均无统计学意义( P均>0.05);超声心动图测得的室间隔室壁厚度均在正常范围,CMR测量结果显示有9名(9/14)受试者的室间隔室壁厚度>11 mm,最大厚度为13.8 mm,发生在下室间隔。 结论:举重会造成室间隔增厚,CMR较超声心动图能更好地检测出左心室壁增厚,对运动医学监督有帮助。

Objectives To explore the impact of strength sport on heart structure by echocardiography(ECHO)and cardiac resonance imaging(CMR).Methods This is a case control study.A total of 14 male weightlifter athletes who underwent physical examination in Peking University Third Hospital from January 16,2019 to November 1,2019 were included in this study.Fourteen age-matched healthy Chinese men served as the control group.ECHO and CMR were used to detect the heart structure and function of the participants.Results The age of athlete group was(21±3)years,and the training time was(9±4)years.The weekly exercise time of athlete group was more than 15 hours,while that of control group was less than 3 hours.ECHO-derived interventricular septal(IVS)thickness value((9.3±1.3)mm vs.(8.1±0.5)mm,P=0.006)and CMR-derived IVS value((11.0±1.5)mm vs.(10.0±0.5)mm,P=0.003)was both significantly higher in the athlete group than in the control group.For the athlete group,the indicators of left ventricular volume measured by ECHO(left ventricular end diastolic volume(LVEDV),left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume,left ventricular end systolic volume index)and IVS thickness were significantly lower than those measured by CMR(all P<0.05).Left ventricular ejection fraction((67.0±3.8)%vs.(59.0±3.9)%,P<0.001)and left ventricular global longitudinal strain((19.3±2.9)%vs.(11.2±1.2)%,P<0.001)values measured by ECHO were significantly higher than those measured by CMR.There was no significant difference in the proportion of subjects with the left ventricular end diastolic diameter,LVEDV and LVEDVI above the upper limit of normal as measured by ECHOs and CMR(all P>0.05).IVS values measured by ECHO were all within the normal range,and CMR showed that 9(9/14)weightlifter athletes had IVS>11 mm with a maximum thickness of 13.8 mm,which occurred in the inferoseptum.Conclusion Weightlifter sport could result in thickening of the left ventricular inferoseptum,and CMR is superior to ECHO in detecting the thickening of the left ventricular wall,which serves as a helpful tool for sports medicine supervision.