少年运动员运动性心脏疲劳影响因素研究
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摘要
目的:以少年耐力运动员为被试者,在实验室条件下,观察运动强度对EICF影响及相继重复运动对EICF积累效应。
方法:被试者为13名二级少年男性中长跑运动员。实验要求被试者进行4次急性运动,包括一次递增负荷跑台运动测试(GXT)以及三次45min恒定跑速跑台运动。GXT的目的主要在于确定与随后的三次运动相对一致的个体化运动强度。首次恒定强度运动(Ⅰ)为个体80%通气无氧阈强度。首次运动后至少间隔4天,进行第二次(Ⅱ-1)及第三次(Ⅱ-2)恒定强度运动,运动强度为个体100%通气无氧阈强度,Ⅱ-1与Ⅱ-2间隔约4h。恒定强度跑台运动前以及运动后即刻利用超声心动仪进行心功能测定。
结果:1)与运动前相比,三次恒定强度运动后左室收缩功能均显著下降,表现为每搏量(SV)、射血分数(EF)及左心室短轴缩短率(FS)降低,且在首次高强度运动后,反映左室整体舒张功能的左室早期和晚期充盈峰值速度比值(E:A)也显著下降;2)比较Ⅰ与Ⅱ-1两次强度不同运动发现,配对t检验分别统计两次运动发现,在高强度运动(Ⅱ-1),运动后较运动前E:A下降及左室经线室壁应力(LVMWS)升高具有统计学显著性。而对于低强度运动(Ⅰ),这两项指标并无显著性差异;3)进一步将两次运动数据全部合并,利用两个重复测量的双因素方差分析统计发现,运动强度及相继重复两次运动主效应对心功能无显著影响。
结论:1)以模拟少年运动员日常训练运动应激水平的运动测试方案可导致少年运动员产生EICF。提示,少年耐力运动员在日常训练过程中可能经常出现EICF;2)相对于低强度耐力运动而言,青少年运动员高强度耐力运动倾向于使EICF程度加重;3)少年运动员相继重复两次运动未呈现出左室功能进一步下降的积累性效应。
Objective:Endurance exercise juvenile athletes were selected as subjects,to observe the effects of exercise intensity on EICF and the cumulative effects of consecutive repetitive exercise on EICF under the laboratory condition.
Methods:Objects are 13 juvenile middle-distance race athletes.4 radical sports are demanded,which includes a GXT and 3 times of constant running speed exercise in treadmill.Aim of GXT is to determine personalized sports intensity of following 3 repeated sports.Initial invariable intensity sport(Ⅰ) is personalized 80%of the ventilation anaerobic threshold intensity.At least 4 days after the initial sport,the 2nd (Ⅱ-1) and 3rd(Ⅱ-2)constant intensity exercise are conducted with the sports intensity maintained at the level of 100%the ventilation anaerobic threshold intensity.Time betweenⅡ-1 andⅡ-2 is at least 4 hours.Echo cardiograph is conducted immediately after constant running speed exercise in treadmill.
Results:①Significant depression of left ventricle systolic function after 3 constant running speed exercise,which manifests reduction of SV,EF and FS.Also after the first high-intensity sports,reduction is found in E/A,which reflect the left ventricular collective diastole function.②By comparingⅠandⅡ-1 sports of different intensify, paired t test indicates in high intensify sports statistic significance of depression of E:A after sports as well as LVMWS elevation.For low intensify sports,no significance of the two indexes.③After combination of the two sports data,double factirial analysis of variance shows insignificant effect of sports intensify and sequenced repeated sports on cardiac function.
Conclusion:1) Simulation of juvenile athletes routine exercise level can lead to EICF in the study objects,which indicates frequent EICF in the endurance sports juvenile athletes during routine sports exercise.2) High intensify sports is prone to deteriorate juvenile athletes EICF compared with low intensify ones.3) There is no collective effect of left ventricular function depression after sequenced repeated sports conducted in juvenile athletes
方法:被试者为13名二级少年男性中长跑运动员。实验要求被试者进行4次急性运动,包括一次递增负荷跑台运动测试(GXT)以及三次45min恒定跑速跑台运动。GXT的目的主要在于确定与随后的三次运动相对一致的个体化运动强度。首次恒定强度运动(Ⅰ)为个体80%通气无氧阈强度。首次运动后至少间隔4天,进行第二次(Ⅱ-1)及第三次(Ⅱ-2)恒定强度运动,运动强度为个体100%通气无氧阈强度,Ⅱ-1与Ⅱ-2间隔约4h。恒定强度跑台运动前以及运动后即刻利用超声心动仪进行心功能测定。
结果:1)与运动前相比,三次恒定强度运动后左室收缩功能均显著下降,表现为每搏量(SV)、射血分数(EF)及左心室短轴缩短率(FS)降低,且在首次高强度运动后,反映左室整体舒张功能的左室早期和晚期充盈峰值速度比值(E:A)也显著下降;2)比较Ⅰ与Ⅱ-1两次强度不同运动发现,配对t检验分别统计两次运动发现,在高强度运动(Ⅱ-1),运动后较运动前E:A下降及左室经线室壁应力(LVMWS)升高具有统计学显著性。而对于低强度运动(Ⅰ),这两项指标并无显著性差异;3)进一步将两次运动数据全部合并,利用两个重复测量的双因素方差分析统计发现,运动强度及相继重复两次运动主效应对心功能无显著影响。
结论:1)以模拟少年运动员日常训练运动应激水平的运动测试方案可导致少年运动员产生EICF。提示,少年耐力运动员在日常训练过程中可能经常出现EICF;2)相对于低强度耐力运动而言,青少年运动员高强度耐力运动倾向于使EICF程度加重;3)少年运动员相继重复两次运动未呈现出左室功能进一步下降的积累性效应。
Objective:Endurance exercise juvenile athletes were selected as subjects,to observe the effects of exercise intensity on EICF and the cumulative effects of consecutive repetitive exercise on EICF under the laboratory condition.
Methods:Objects are 13 juvenile middle-distance race athletes.4 radical sports are demanded,which includes a GXT and 3 times of constant running speed exercise in treadmill.Aim of GXT is to determine personalized sports intensity of following 3 repeated sports.Initial invariable intensity sport(Ⅰ) is personalized 80%of the ventilation anaerobic threshold intensity.At least 4 days after the initial sport,the 2nd (Ⅱ-1) and 3rd(Ⅱ-2)constant intensity exercise are conducted with the sports intensity maintained at the level of 100%the ventilation anaerobic threshold intensity.Time betweenⅡ-1 andⅡ-2 is at least 4 hours.Echo cardiograph is conducted immediately after constant running speed exercise in treadmill.
Results:①Significant depression of left ventricle systolic function after 3 constant running speed exercise,which manifests reduction of SV,EF and FS.Also after the first high-intensity sports,reduction is found in E/A,which reflect the left ventricular collective diastole function.②By comparingⅠandⅡ-1 sports of different intensify, paired t test indicates in high intensify sports statistic significance of depression of E:A after sports as well as LVMWS elevation.For low intensify sports,no significance of the two indexes.③After combination of the two sports data,double factirial analysis of variance shows insignificant effect of sports intensify and sequenced repeated sports on cardiac function.
Conclusion:1) Simulation of juvenile athletes routine exercise level can lead to EICF in the study objects,which indicates frequent EICF in the endurance sports juvenile athletes during routine sports exercise.2) High intensify sports is prone to deteriorate juvenile athletes EICF compared with low intensify ones.3) There is no collective effect of left ventricular function depression after sequenced repeated sports conducted in juvenile athletes
引文
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[37]Hallermayer K,Klenner D,Vogel R.Use of recombinant human cardiac Troponin T for standardization of third generation Troponin T methods.Scand J Clin Lab Invest Suppl,1999,230:128-131.
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[2]Green DJ,Naylor LH,George K.Cardiac and vascular adaptations to exercise.Curr Opin Clin Nutr Metab Care,2006,9(6):677-684.
[3]McGavock JM,Warburton DE,Taylor D,et al.The effects of prolonged strenuous exercise on left ventricular function:a brief review.Heart Lung,2002,31(4):279-292.
[4]Rowe WJ.A world record marathon runner with silent ischemia without coronary atherosclerosis.Chest,1991,99(5):1306-1308.
[5]Rowe WJ.Extraordinary unremitting endurance exercise and permanent injury to normal heart.Lancet,1992,340(8821):712-714.
[6]Rowe WJ.Endurance exercise and injury to the heart.Sports Med,1993,16(2):73-79.
[7]Damm S,Andersson LG,Henriksen E,et al.Wall motion abnormalities in male elite orienteers are aggravated by exercise.Clin Physiol,1999,19(2):121-126.
[8]Achten J,Jeukendrup AE.Heart rate monitoring:applications and limitations.Sports Med,2003,33(7):517-538.
[9]Saltin B,STENBERG J.Circulatory response to prolonged severe exercise.J Appl Physiol,1964,19:833-838.
[10]Upton MT,Rerych SK,Roeback JR,Jr.,et al.Effect of brief and prolonged exercise on left ventricular function.Am J Cardiol,1980,45(6):1154-1160.
[11]Palatini P,Bongiovi S,Macor F,et al.Left ventricular performance during prolonged exercise and early recovery in healthy subjects.Eur J Appl Physiol Occup Physiol,1994,69(5):396-401.
[12]Goodman JM,McLaughlin PR,Liu PP.Left ventricular performance during prolonged exercise:absence of systolic dysfunction.Clin Sci(Lond),2001,100(5):529-537.
[13]Douglas PS,O'Toole ML,Hiller WD,et al.Cardiac fatigue after prolonged exercise.Circulation,1987,76(6):1206-1213.
[14]Niemela K,Palatsi I,Ikaheimo M,et al.Impaired left ventricular diastolic function in athletes after utterly strenuous prolonged exercise.Int J Sports Med,1987,8(2):61-65.
[15]Whyte GP,George K,Sharma S,et al.Cardiac fatigue following prolonged endurance exercise of differing distances.Med Sci Sports Exerc,2000,32(6):1067-1072.
[16]Dawson EA,Shave R,George K,et al.Cardiac drift during prolonged exercise with echocardiographic evidence of reduced diastolic function of the heart.Eur J Appl Physiol,2005,94(3):305-309.
[17]Lucia A,Moran M,Perez M,et al.Short-term effects of marathon running in master runners:no evidence of myocardial injury.Int J Sports Med,1999,20(7):482-486.
[18]George K,Oxborough D,Forster J,et al.Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans.J Physiol,2005,569(Pt 1):305-313.
[19]Neilan TG,Yoerger DM,Douglas PS,et al.Persistent and reversible cardiac dysfunction among amateur marathon runners.Eur Heart J,2006,27(9):1079-1084.
[20]Middleton N,Shave R,George K,et al.Left ventricular function immediately following prolonged exercise:A meta-analysis.Med Sci Sports Exerc,2006,38(4):681-687.
[21]Ketelhut R,Losem CJ,Messerli FH.Depressed systolic and diastolic cardiac function after prolonged aerobic exercise in healthy subjects.Int J Sports Med,1992,13(4):293-297.
[22]Dawson E,George K,Shave R,et al.Does the human heart fatigue subsequent to prolonged exercise? Sports Med,2003,33(5):365-380.
[23]Niemela KO,Palatsi IJ,Ikaheimo MJ,et al.Evidence of impaired left ventricular performance after an uninterrupted competitive 24 hour run.Circulation,1984,70(3):350-356.
[24]Shave RE,Dawson E,Whyte G et al.Evidence of exercise-induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race.Int J Sports Med,2002,23(7):489-494.
[25]Siegel AJ,Lewandrowski KB,Strauss HW,et al.Normal post-race antimyosin myocardial scintigraphy in asymptomatic marathon runners with elevated serum creatine kinase MB isoenzyme and troponin T levels.Evidence against silent myocardial cell necrosis.Cardiology,1995,86(6):451-456.
[26]Vanoverschelde JL,Younis LT,Melin JA,et al.Prolonged exercise induces left ventricular dysfunction in healthy subjects.J Appl Physiol,1991,70(3):1356-1363.
[27]Lucia A,Serratosa L,Saborido A,et al.Short-term effects of marathon running:no evidence of cardiac dysfunction.Med Sci Sports Exerc,1999,31(10):1414-1421.
[28]Perrault H,Peronnet F,Lebeau R,et al.Echocardiographic assessment of left ventricular performance before and after marathon running.Am Heart J,1986,112(5):1026-1031.
[29]Davila-Roman VG Guest TM,Tuteur PG,et al.Transient right but not left ventricular dysfunction after strenuous exercise at high altitude.J Am Coll Cardiol,1997,30(2):468-473.
[30]Starnes JW,Bowles DK.Role of exercise in the cause and prevention of cardiac dysfunction.Exerc Sport Sci Rev,1995,23:349-373.
[31]Ohman EM,Teo KK,Johnson AH,et al.Abnormal cardiac enzyme responses after strenuous exercise:alternative diagnostic aids.Br Med J(Clin Res Ed),1982,285(6354):1523-1526.
[32]Apple FS,Rogers MA,Casal DC,et al.Skeletal muscle creatine kinase MB alterations in women marathon runners.Eur J Appl Physiol Occup Physiol,1987,56(1):49-52.
[33]Apple FS,Billadello JJ.Expression of creatine kinase M and B mRNAs in treadmill trained rat skeletal muscle.Life Sci,1994,55(8):585-592.
[34]Apple FS,Rogers MA,Sherman WM,et al.Profile of creatine kinase isoenzymes in skeletal muscles of marathon runners.Clin Chem,1984,30(3):413-416.
[35]Collinson PO,Stubbs PJ.Are troponins confusing? Heart,2003,89(11):1285-1287.
[36.]Collinson PO,Boa FG Gaze DC.Measurement of cardiac troponins.Ann Clin Biochem,2001,38(Pt 5):423-449.
[37]Hallermayer K,Klenner D,Vogel R.Use of recombinant human cardiac Troponin T for standardization of third generation Troponin T methods.Scand J Clin Lab Invest Suppl,1999,230:128-131.
[38]Chen Y,Serfass RC,Mackey-Bojack SM,et al.Cardiac troponin T alterations in myocardiumand serum of rats after stressful,prolonged intense exercise.J Appl Physiol,2000,88(5):1749-1755.
[39]Wu AH,Valdes R,Jr.,Hawker CD.Guidelines and recommendations in laboratory medicine.Clin Chem,2002,48(7):1135-1136.
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