超声心动图联合心电图对游泳运动员左心室肥厚的预测价值

Value of echocardiography combined with electrocardiogram in predicting left ventricular hypertrophy among high-level swimming athletes in a university

目的探讨超声心动图和心电图(ECG)的联合检查对某高校高水平游泳运动员左心室肥厚的预测。方法选取北京外国语大学2019年1月~2020年12月152名在校大学生为研究对象并开展相应的回顾性分析,40名高水平游泳运动员作为运动员组,另选取同期参加排球、网球、足球或田径等比赛的112名普通大学生作为对照组,所有同学均行ECG检查。对所有高水平运动员及心电图提示左心室高电压的普通大学生进行心脏超声检查。结果在152例研究对象中,有16例心电图结果显示左心室高电压,同时对40名高水平运动员及8名心电图异常的普通大学生进行进一步超声检查,其中,8名心电图异常普通大学生心脏超声静息状态下左心结构及收缩功能未见明显异常。在40名高水平运动员中,有21例(52.5%)超声心电图提示左心室增大或是饱满。其中,运动员的主动脉根部内径(AoD)、左房前后径(LAAPD)、左室舒张末期室间隔厚度(IVSd)、左室舒张末期后壁厚度(LVPWd)、左室舒张末期前后径(LVEDD)、左室收缩末期前后径(LVESD)、左室心肌重量(LVM)、左室心肌质量指数(LVMI)均大于普通大学生(P<0.05),差异有统计学意义,左室射血分数(LVEF)及左室缩短分数(LVFS)低于普通大学生,有显著差异(P<0.05)。结论心电图单纯左心室高电压阳性率低,高水平游泳运动员经超声心动图诊断为左心室异常的阳性率较高,医生心电图诊断下心室肥厚的结论需慎重。

Objective To assess the value of echocardiography combined with electrocardiogram(ECG)in predicting left ventricular hypertrophy among high-level swimming athletes in a university.Methods A retrospective analysis was conducted on 152 college students selected from Beijing Foreign Studies University from January 2019 to December 2020.including 40 high-level swimmers as an athlete group,and 112 ordinary college students who participated in volleyball,tennis,football,or track and field competitions during the same period as a control group.All students underwent ECG examination.Cardiac ultrasound examination was performed on all high-level athletes and ordinary college students whose ECG indicated high left ventricular voltage.Results Among the 152 study subjects included,16 had left ventricular high voltage on ECG.Further ultrasound examinations were conducted on 40 high-level athletes and 8 ordinary college students with abnormal electrocardiogram.Among them,8 ordinary college students with abnormal electrocardiogram showed no significant abnormalities in left heart structure and systolic function on resting state echocardiography.Among 40 high-level athletes,21(52.5%)had ECG indicating left ventricular enlargement or fullness.The aortic root diameter(AoD),left atrial anteroposterior diameter(LAAPD),left ventricular end diastolic septal thickness(IVSd),left ventricular end diastolic posterior wall thickness(LVPWd),left ventricular end diastolic anteroposterior diameter(LVEDD),left ventricular end systolic anteroposterior diameter(LVESD),left ventricular myocardial weight(LVM),and left ventricular myocardial mass index(LVMI)of athletes were all significantly higher than those of ordinary college students(P<0.05),but athletes had significantly lower left ventricular ejection fraction(LVEF)and left ventricular shortening fraction(LVFS)than ordinary college students(P<0.05).Conclusion The positive rate of pure left ventricular high voltage on ECG is low,and high-level swimmers have a higher positive rate of left ventricular abnormalities diagnosed by ECG.Doctors should be cautious when making conclusions about ventricular hypertrophy by ECG diagnosis.