Download Structure and function of distance runners` heart

Medicina (Kaunas) 2005; 41(8) - http://medicina.kmu.lt
685
Structure and function of distance runners’ heart
Tomas Venckūnas, Rasa Raugalienė1, Edita Jankauskienė2
Lithuanian Academy of Physical Education, 1Institute of Cardiology, Kaunas University of Medicine,
2
Kaunas University of Medicine, Lithuania
Key words: echocardiography, distance running, myocardial hypertrophy.
Summary. Objective. To compare ultra-long distance runners’ heart morphologic and
functional parameters at rest with those of long distance runners’ and middle distance
runners’.
Materials and methods. Standard Doppler, M-mode and 2-D-mode echocardiography
was performed at rest to 22 middle, 31 long and 11 ultra-long adult male distance runners.
Results. Long and ultra-long distance runners’ left ventricular mass and left ventricular
mass index were larger (p<0.05) than that of middle distance runners’ (groups’ means –
approximately 288, 305 and 250 g as well as 153, 160 and 130 g/m2, respectively) due to
both larger (p<0.05) end-diastolic interventricular wall thickness (10.6, 11.1 and 9.8 mm,
respectively) and left ventricular posterior wall thickness (10.7, 11.5 and 10.0 mm, respectively). Ultra-long distance runners’ left ventricular mass and mass index did not differ
significantly from long distance runners’ (p>0.05), but end-diastolic posterior wall thickness was higher (p<0.05). Relative left ventricular wall thickness was larger in ultra-long
distance runners as compared with middle distance runners (0.402 and 0.362, respectively; p<0.05). Ultra-long distance runners’ right ventricular end-diastolic diameter was
significantly larger (p<0.05) than that of middle and long distance runners (groups’ means
– 25.8, 20.7 and 21.4 mm, respectively). Right ventricular end-diastolic free wall was thicker
in ultra-long distance runners as compared with middle distance runners (groups’ means –
6.7 and 5.9 mm, respectively; p<0.05). Diastolic left ventricular function (evaluated as E/
A) as well as end-diastolic left ventricular diameter (groups’ mean – 55.5–56.4 mm) did not
differ between groups (p>0.05).
Conclusions. The hypertrophy of ultra-long (as well as long) distance runners’ myocardium of both ventricles is more pronounced than that of middle distance runners’.
Introduction
Balanced (affecting all chambers) cardiac hypertrophy due to regular and extensive endurance training is called athlete's heart (1). It is different from
pathological condition not only with regard to proportionally larger stroke volume and ejection fraction (EF)
during intense exercise (2), but also as having normal
end-diastolic left ventricular (LV) wall thickness to
diameter ratio (3), approximately equally increased
diameter as well as wall thickness of all four heart
chambers (4), and normal or even superior (especially
during exercise) LV diastolic function (5-8).
We may find quite a lot of information regarding the
relationship between morphological parameters of cardiovascular system and exercise capacity indices, such
as strong positive correlation between LV mass and av-
erage cycling velocity during ultra-endurance triathlon (9),
strong positive correlation between endurance athletes'
end-diastolic LV diameter and maximal oxygen uptake
(VO ) (10), LV mass index and VO (11) as well as
2max
2max
right or left ventricular mass and VO (1).
2max
The differences of heart structure between strength
and endurance athletes have been investigated and
published at least for a couple of decades (12). Lately
scientists tend to study possible differences of myocardium remodeling between similar endurance sport's
athletes (13). The differences of echocardiographic
parameters between middle and long or ultra-long distance runners haven't been published so far.
Objective. To compare morphologic function of
ultra-long distance runners' heart with those of long
distance runners' and middle distance runners'.
Correspondence to T. Venckūnas, Department of Applied Physiology and Health Education,
Lithuanian Academy of Physical Education, Sporto 6, 44221 Kaunas, Lithuania. E-mail: [email protected]
Tomas Venckūnas, Rasa Raugalienė, Edita Jankauskienė
686
Materials and methods
Subjects. We studies 64 competitive distance runners of national level: 22 - middle (the main distance run
during competitions - from 600 m to 2000 m), 31 - long
(the main competitive distance - from 3000 m to 21 km)
and 11 - ultra-long (the main distance - marathon (42,195
km) or longer). The age of the subjects ranged from 18
to 44 years, body mass - from 56 to 82 kg, training volume - from 3 to 22 h per week. All athletes were involved in their usual training at the time of investigation.
All three groups were comparable in respect of anthropological indices. Means and 95% confidence intervals
of above mentioned and other characteristics of the
groups are presented in the Table 1.
Echocardiography. Standard transthoracic Doppler echocardiography was performed in the subjects
resting in a left lateral position, by means of an ultrasound scanner, AU3 Partner (Esaote Biomedica,
Genoa, Italy), with 2.5-MHz transducer. Size measurements were made from "frozen" M-mode tracings
obtained using two dimensional guiding in long axis
parasternal view. Internal LV diameter, septal and
posterior wall thickness were measured at end-diastole (just before QRS complex on ECG) and end-systole (just before T jut on ECG) as recommended by
the American Society of Echocardiography (14). Right
ventricular end-diastolic diameter and free wall thickness were measured as well. The same professional
cardiologist made three to five measures and the average was calculated. The subjects were asked to
refrain from intense exercise at least for 16 h and not
to have meals at least 2 h before echocardiography.
LV mass was calculated applying Penn convention to the Devereux formula (15):
LV mass (g) = 1.04 x [(IVSd + LVEDd +
3
3
LVPWd) - (LVEDd) ] - 13.6 ,
where IVSd is end-diastolic interventricular septum thickness; LVPWd - left ventricular end-diastolic
posterior wall thickness; and LVEDd - left ventricular
end-diastolic diameter (all in cm).
LV mass index was obtained dividing LV mass by body
surface area. LV was considered hypertrophied when its
2
mass index was higher than 125 g/m , according to the
recommendations of European Society of Cardiology and
European Society of Hypertension introduced in 2003.
Relative LV wall thickness was obtained by dividing the
sum of end-diastolic LV posterior wall thickness and interventricular wall thickness by LV end-diastolic diameter.
The early (E) and late (A) diastolic peak filling velocities (in m/s) were assessed using Doppler effect
and the E/A ratio was used as an index for evaluating
LV diastolic function.
Table 1. General characteristics of middle, long and ultra-long distance runners
Middle distance runners
(n=22)
Index
Long distance runners
(n=31)
Ultra-long distance runners
(n=11)
Mean
of the
sample
95% confidence
interval for the
mathematical
expectation
Mean
of the
sample
95% confidence
interval for the
mathematical
expectation
Mean
of the
sample
Age, years
21
20–22
22
20–24
35
95% confidence
interval for the
mathematical
expectation
33–38*·
Heaight, m
1.82
1.79–1.84
1.80
1.78–1.82
1.81
1.77–1.84
Body mass, kg
70.8
68–73.5
68.4
66.2–70.5
70.2
68.0–72.4
BMI, kg/m
21.5
20.7–22.3
21.1
20.4–21.7
21.5
20.6–22.5
HR at rest,
bpm
58.1
53.2–63.0
55.0
52.0–58.1
54.0
49.4–58.6
Systolic BP,
mmHg
136
131–141
130
125–135
133
129–137
Diastolic BP,
mmHg
71
66–76
71
68–73
80
72–87*·
Training
experience, years
7
6–8
8
6–11
18
13–23*·
7.7
6.5–8.8
8.6
7.2–10.0
11.3
8.8–13.8*·
2
Training
volume, h/week
BMI - body mass index; BP - blood pressure; HR - heart rate.
* The averages of indices are significantly different from middle distance runners' (p<0.05).
· The averages of indices are significantly different from long distance runners' (p<0.05).
Medicina (Kaunas) 2005; 41(8) - http://medicina.kmu.lt
Structure and function of distance runners’ heart
Heart rate (HR) was recorded at the end of the
echocardiographic examination (in lying position), while
arterial blood pressure (BP) - after the examination
(subjects were sitting). Runners also reported their
age, training experience (in years) and volume (in hours
per week).
Statistical methods. In order to estimate significance of the differences between means, t-test for
unpaired data was used. Differences were set significant at p<0.05.
Results
Significantly larger LV mass and LV mass index
of long and ultra-long distance runners were because
of the thicker interventricular septum as well as LV
posterior wall (p<0.05). There were no differences in
right ventricular morphological parameters between
middle and long distance runners, but ultra-long distance runners possessed significantly thicker right ventricular free wall thickness than that of middle distance runners, and significantly larger right ventricular end-diastolic diameter than that of the both other
groups (p<0.05). The echocardiographic data of the
runners are presented in the Table 2.
LV mass and mass index of ultra-long distance
runners was not different from those of long distance
runners (p>0.05).
Resting bradycardia (HR lower than 60 bpm) was
present in 72% of the athletes of overall group, and
myocardium hypertrophy in 8% of all runners (LV
2
mass index larger than 125 g/m ). Few runners during
echocardiographic examination had HR of lower than
45 bpm. Nine out of 22 middle (41%), four out of 31
long (13%) and no one of 11 investigated ultra-long
distance runners had LV mass index lower than 125
2
g/m . Long distance runner of medium level had the
2
lowest LV mass index (mass index was 92 g/m ). He
also had the smallest end-diastolic interventricular septum thickness (7.2 mm), end-diastolic LV posterior wall
thickness (7.8 mm) and relative wall thickness (0.263).
His diastolic LV function was normal (E/A=1.6). The
owner of the heaviest LV (mass and mass index 435
2
g and 225.4 g/m , respectively) as well as largest right
ventricle (end-diastolic diameter of 30.6 mm and wall
thickness of 10 mm) was Olympic-caliber long distance runner. His heart's interventricular septum thickness at end-diastole (14.4 mm), end-systole (18.6 mm),
LV posterior wall thickness at end-diastole (14.4 mm)
and end-systole (22.2 mm) as well as relative LV wall
thickness (0.52) were also the largest. Diastolic LV
function was normal (E/A>1.5).
Heavier than 300 g LV was calculated to be in 21
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687
athletes (33%) of overall group and in 3 middle distance runners (14%). Higher than 0,45 relative wall
thickness was present in 5 subjects (8%), no one of
them was middle distance runner.
Right ventricular diameter higher than 24 mm, enddiastolic interventricular septum thickness larger than
11 mm, and end-diastolic LV posterior wall thickness
bigger than 11 mm were present in 20 distance runners (31%). Larger than 7 mm right ventricular free
wall thickness was detected in 11 subjects of the overall
group (17%), and 39 runners (61%) possessed larger
than 55 mm end-diastolic LV diameter. The proportions were slightly less when middle distance runners
were analyzed as a separate group.
In the overall group, right ventricular diameter
ranged between 12,6 and 35 mm, right ventricular free
wall thickness - between 4.8 and 10 mm, E - between
0.61 and 0.98 m/s, A - between 0.28 and 0.62 m/s. E/
A ratio was higher than 2 in nine runners (14%).
EF at rest was significantly larger in middle distance runners as compared with long distance runners (p<0.05), and diastolic LV function (evaluated as
the ratio between E and A peak filling velocities through
mitral valve) did not differ significantly between the
groups (p>0.05), though long and ultra-long distance
runners' early peak filling (E) was significantly slower
than that of middle distance runners (p<0.05, Table
2). No one of our athletes tested had E/A ratio lower
than 1 (range 1.2-2.75).
Discussion
It is interesting to note that in spite of non-significantly lower resting systolic BP and HR as well as
body mass of long and ultra-long distance runners
(p>0.05, Table 1), their myocardium hypertrophy was
significantly more pronounced (interventricular septum and LV posterior wall thicker, LV mass and LV
mass index larger, p<0.05, Table 2) than in middle distance runners. We supposed that the observed difference of the pattern of myocardium remodeling was
triggered by the different training and competitive activity: long and especially ultra-long distance runners
employ in general only long sessions of rather constant intensity considerably below VO , but middle
2max
distance runners practice much more of the interval
training, which virtually is an alternation of rather intense (usually at or above VO ) exercise bouts
2max
interspaced with active or passive rest periods of different duration.
Our echocardiographic parameters of ultra-long
distance runners were in a slight discrepancy to those
obtained during investigation of the Nipponese 100 km
688
Tomas Venckūnas, Rasa Raugalienė, Edita Jankauskienė
Table 2. Runners' echocardiographic data at rest
Middle distance runners
(n=22)
Index
Long distance runners
(n=31)
Ultra-long distance runners
(n=11)
Mean
of the
sample
95% confidence
interval for the
mathematical
expectation
Mean
of the
sample
95% confidence
interval for the
mathematical
expectation
Mean
of the
sample
95% confidence
interval for the
mathematical
expectation
End-diastolic
interventricular
septum thickness, mm
9.8
9.3–10.3
10.6
10.1–11.1*
11.1
10.5–11.7*
End-systolic
interventricular
septum thickness, mm
13.9
13.1–14.6
13.9
13.3–14.5
15.3
14.5–16.2*·
LV end-diastolic
diameter, mm
55.5
53.5–56.4
56.1
55.0–57.2
56.4
54.9–57.9
LV end-systolic
diameter, mm
33.8
32.3–35.3
37.0
35.8–38.2*
35.7
33.6–37.3
LV end-diastolic
posterior wall
thickness, mm
10.0
9.6–10.4
10.7
10.2–11.1*
11.5
10.8–12.1*·
LV end-systolic
posterior wall
thickness, mm
17.3
16.6–18.1
17.1
16.31–17.9
18.2
17.1–19.3
Relative LV wall
thickness, mm
0.362
0.343–0.381
0.380
0.362–0.400
0.402
0.372–0.431*
LV mass, g
250.0
229.7–270.3
287.6
269.5–305.7*
305.1
281.3–328.8*
LV mass index,
g/m2
130.1
120.0–140.2
152.8
143.0–162.6*
160.0
147.2–172.5*
Ejection
fraction, %
67.6
65.2–70.1
62.7
60.8–64.6*
65.9
62.1–69.6
RV end-diastolic
diameter, mm
20.7
19.2–22.2
21.4
19.7–23.1
25.8
23.0–28.7*·
RV end-diastolic
wall thickness, mm
5.9
5.5–6.2
6.3
5.9–6.7
6.7
6.0–7.4*
E, m/s
0.83
0.80–0.87
0.78
0.75–0.81*
0.75
0.70–0.79*
A, m/s
0.47
0.45–0.50
0.45
0.43–0.48
0.48
0.43–0.54
E/A
1.78
1.67–1.90
1.75
1.65–1.85
1.61
1.35–1.87
LV - left ventricle; RV - right ventricle.
* The averages of indices are significantly different from middle distance runners' (p<0.05).
· The averages of indices are significantly different from long distance runners' (p<0.05).
runners (16). We believe that our runners' LV diameter was smaller and walls were thicker probably due
to different training methods applied, as well as
ethnicity, because training volume and age of our subjects were similar to Nipponese.
The largest measured LV end-diastolic diameter
was 64 mm (that of the long distance runner's heart).
Nipponese scientists Nagashima et al. (16) have investigated 100 km (i.e. ultra-long distance) male runners and recorded that more than 10% of them had
LV end-diastolic diameter of more than 70 mm. So
we cannot state that our tested athletes possessed
extreme dilation of LV. Moreover, although LV cavity
size of our long and ultra-long distance runners was
only non-significantly larger (p>0.05) than that of middle
distance runners, we can imply that specialization (and
concomitantly training regimen) might influence the
degree of LV dilation.
Significant differences between means of some
echocardiographic parameters of long and ultra-long
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Structure and function of distance runners’ heart
distance runners' groups (see Table 2) let us to assume that the mastership of ultra-long distance runners, i.e. ability to perform for extended periods (to
run 42 km or more at a considerable pace) is dependent not only upon anaerobic thresholds, which are
more limited to the ability of working musculature to
extract and consume oxygen from blood rather than
maximal cardiac output (17), but also to a significant
degree on the ability of the myocardium to maintain
stroke volume during prolonged exercise what might
depend on the degree of its physiological hypertrophy.
It is necessary to point out that hypertrophy of the
myocardium does not manifest in every endurancetrained athlete. One of the reasons of the absence of
myocardium remodeling response might be insufficient
training program stimulus in this regard (2, 18). This
standpoint could explain the result obtained during
analysis of our data that 41% of middle distance runners, 13% of long distance runners and no one of the
ultra-long distance runners had LV mass index below
2
125 g/m (ultra-long distance runners' training volume
was significantly higher than that of the other two
groups, see Table 1).
Resting bradycardia (HR lower than 60 bpm) and
myocardial hypertrophy (LV mass index larger than
2
125 g/m ), considered to be two most common attributes of "athlete's heart" (19, 20), together were
present in 38 (60%) of our examined runners.
Echocardiographic data of Lithuanian middle distance runners were similar to that of long distance
runners of Netherlands (13), but our long and ultralong distance runners' LV mass as well as LV mass
index were larger than those reported in their subjects
due to thicker myocardium walls, that is to say due to
more pronounced concentric hypertrophy (end-diastolic LV diameter the same). It is known that LV wall
thickness is governed by genetic factors too (21, 24).
Three of our runners (5%) had LV end-diastolic
diameter larger than 60 mm (i.e. inside the interval of
idiopathic dilated cardiomyopathy; frequency corresponds reported by other authors (20, 22)). One of the
signs that larger than 60 mm LV end-diastolic diameter of our athletes represented physiological adaptation was higher EF of than 60% in all these three cases.
Athletes rarely possess LV posterior wall thickness in excess of 13 mm (20, 22, 23). End-diastolic
LV posterior wall was thicker than 13 mm (i.e. inside
the interval of hypertrophic cardiomyopathy) in only
two of our athletes (3%). The frequency corresponds
to that of reported by other authors (22). In spite of
the fact that their relative LV wall thickness was increased (0.49 and 0.52), LV end-diastolic diameter
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689
was respectively 54 and 55.5 mm, ratio between enddiastolic interventricular septum and LV posterior wall
thickness was respectively 0.94 and 1.00, and diastolic function normal (in both cases E/A>1.4), leading
us to conclude that mentioned disease did not exist,
because it is known that in a case of hypertrophic cardiomyopathy LV does not dilate, and its diastolic function deteriorates (18). No one of our runners approached 16 mm LV posterior wall thickness, which
is speculated to be an upper limit of physiological hypertrophy and may be reached in single cases in professional endurance athletes (23).
It is known that after the discontinuation of regular
exercise (end of sport career) LV wall thickness decreases to normal values of general healthy population within few months, and, therefore, it is believed
that high-performance athletes' myocardium hypertrophy represents totally physiological phenomenon (24).
The notion that we observed a physiological phenomenon in all our subjects was also supported by the fact
that no one of the athletes approached a ratio between
end-diastolic interventricular septum and LV posterior wall thickness of 1.3 (range - 0.84-1.12; mean of
the overall group was 0.99).
It has been noticed long time ago that relative LV
wall thickness (index of hypertrophy) is often larger
than that of healthy non-athletes (4, 23, 25). LV relative wall thickness is considered to be increased
(above-normal) if higher than 0.42 (concentric remodeling) and decreased (below-normal) if lower than 0.30
(eccentric remodeling) (26). According to such classification, three of our runners (5%) had LV relative
wall thickness below normal, and 12 (19%) - above
normal. Five athletes (8%) (all representatives of long
and ultra-long distance runners) had LV relative wall
thickness of over 0.45. We denied pathological condition primarily because LV diastolic function was normal in all five cases (E/A>1.4), and it is established
that it normally does not exceed 1 in a case of hypertrophic cardiomyopathy (18). Secondly, all these subjects were high-caliber endurance athletes, and it is
widely accepted that patients with such disease as hypertrophic cardiomyopathy usually do not possess high
working capacity (20, 27). Thirdly, only one athlete
had index of hypertrophy above 0.5 (0.52), but this
was lower than values really typical in patients suffering from hypertrophic cardiomyopathy (>0.55).
Fourthly, athlete with the largest LV relative wall thickness was national record holder, permanent member
of national athletic team, and participant of the Olympic Games; several cases of suchlike high values of
LV relative wall thickness were reported in top-level
690
Tomas Venckūnas, Rasa Raugalienė, Edita Jankauskienė
athletes by other scientists (24, 28). On average, our
data put together with other researchers' lead us to
maintain that distance runners' myocardium remodeling is not purely eccentric: wall thickness often increases more than it could be expected in participants
of such a dynamic (isotonic) sport as running is.
German scientists Urhausen & Kindermann (18)
state that during some of the dynamic exercises (e.g.
rowing, cycling) part of the musculature contract isometrically determining bigger peripheral resistance
to ejection of blood out of the LV so generating larger
than observed during "pure" dynamic exercises (e.g.
running, swimming) pressure overload to myocardium
and being a stimulus for more pronounced and more
concentric its hypertrophy. That is considered to be
the main reason why distance runners develop smaller
myocardium hypertrophy than for example road cyclists. However, our results showed that long and especially ultra-long distance running training predisposes athletes to have thicker myocardium walls, so
not only training mode, but also its volume and intensity seem to be important factors of changes in geometrical pattern of myocardium. On the other hand,
this study cannot deny the possibility that our long
and ultra-long distance runners were naturally preselected into their favorite events because of genetic
predisposition, which may also involve myocardial
hypertrophy (21, 24).
Scientists agree that exercise capacity of the endurance athlete should increase together with increasing LV mass (18, 29), otherwise myocardium remodeling may be due to other cause (e.g. arterial hypertension) rather than habitual endurance exercise itself. The data basis of echocardiographic parameters
of our studied distance runners of medium to high level
(mastership) not only allow to support this opinion, but
also to maintain that the extent of long-term myocardium adaptation to chronic endurance exercise depends
upon the intensity and mode of training sessions.
Although it is known that advancing age may change
LV diastolic function (30), our long as well as ultralong distance runners' early peak filling velocity (E)
through mitral valve was significantly lower at least
not only due to older age: only long distance runners
were of comparable age with middle distance runners
(Table 1). One of the other likely reasons could be
attributed to though insignificantly, but perhaps substantially lower HR of long and ultra-long distance
runners (on an average 3 and 4 bpm, correspondingly).
It was found that road cyclists' E (on the average
roughly 0.84 m/s) was higher than healthy non-athletes' (about 0.71 m/s) (13). In general, there is sub-
stantially accumulating evidence of superior diastolic
LV (greater E/A ratio) in endurance athletes (4, 23,
24). Our results on E/A support unimpaired diastolic
LV function in distance runners at rest.
The EF of our studied athletes (average about 65%)
was normal for healthy population (30). Only one athlete (high-level long distance runner) had EF at rest of
less than 50%, but sport cardiologists do not consider
this as a sign of inability of myocardium to contract
(so not pathology), because it is known that such heart
is capable to increase contraction force and EF already during submaximal exercise (18). High-caliber
middle distance runner had the highest EF (78%), but
here it is worth to note that cardiologists generally do
not consider EF at rest as an index that shows working capacity of the heart of athlete (7). It is evaluated
that EF of endurance athletes does not differ from
healthy controls at rest and is equal to approximately
60% (1, 24). Thus our runners exhibited slightly elevated myocardium contractility at rest (EF at rest 68,
63 and 66% for middle, long and ultra-long distance
runners, respectively).
It has been stated that we still lack data about longterm morphofunctional adaptation of the "right heart" to
regular intense exercise (20). Our investigation warrants us to support existing knowledge from few published reports that right ventricle of endurance athletes'
heart changes in geometrical pattern together with LV
(1, 31): chronic volume overload results in slight but significant increase in its diameter and free wall thickness.
On a whole, the results of our study allow us to
confirm hypothesis that the degree of physiological
myocardium hypertrophy depends on the duration of
the isotonic dynamic endurance sport event (which in
turn determines training volume, intensity and perhaps
mode) and the mastership. This was also suggested
by other authors (4, 24, 32).
Conclusions
1. Most of distance runners have moderate physiological myocardium hypertrophy, and this is due to both
dilation of cavities and balanced thickening of walls.
Such anatomical changes in parallel with LV occur also in right ventricle.
2. Regular intense distance running training does not
influence LV diastolic or global systolic function at
rest.
3. LV mass in ultra-long as well as long distance runners is larger than that of middle distance runners
due to thicker walls. Right ventricular diameter and
free wall thickness are the largest in marathoners
as compared with track distance runners.
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Structure and function of distance runners’ heart
691
Bėgikų širdies struktūra ir funkcija
Tomas Venckūnas, Rasa Raugalienė1, Edita Jankauskienė2
Lietuvos kūno kultūros akademija, 1Kauno medicinos universiteto Kardiologijos institutas,
2
Kauno medicinos universitetas
Raktažodžiai: echokardiografija, miokardo hipertrofija, vidutinių ir ilgųjų nuotolių bėgimas.
Santrauka. Darbo tikslas. Palyginti skirtingos specializacijos aerobinę ištvermę lavinančių bėgikų širdies
struktūrą ir funkciją ramybės būsenos metu.
Tyrimo medžiaga ir metodai. 22 vidutinių, 31 ilgųjų ir 11 ilgiausiųjų nuotolių vidutinio ir aukšto meistriškumo
suaugusiems bėgikams (vyrams), gulintiems ant kairiojo šono, atlikome standartinę M, 2-D režimų ir doplerio
echokardiografiją.
Rezultatai. Ilgųjų ir ilgiausiųjų nuotolių bėgikų kairiojo skilvelio masė ir kairiojo skilvelio masės indeksas buvo
didesni (p<0,05) už vidutinių nuotolių bėgikų (grupių vidurkiai: apie 288, 305 ir 250 g bei 153, 160 ir 130 g/m2,
atitinkamai) esant didesniam (p<0,05) tiek diastoliniam tarpskilvelinės pertvaros (10,6, 11,1 ir 9,8 mm, atitinkamai),
tiek diastoliniam kairiojo skilvelio užpakalinės sienos (10,7, 11,5 ir 10,0 mm, atitinkamai) storiui. Ilgiausiųjų nuotolių
bėgikų kairiojo skilvelio masė ir jo masės indeksas nuo ilgųjų nuotolių bėgikų nesiskyrė (p>0,05), tačiau diastolinis
kairiojo skilvelio užpakalinės sienos storis buvo didesnis (p<0,05). Ilgiausiųjų nuotolių bėgikų santykinis kairiojo
skilvelio sienos storis buvo reikšmingai (p<0,05) didesnis už vidutinių nuotolių bėgikų (0,402 ir 0,362, atitinkamai).
Ilgiausiųjų nuotolių bėgikų dešiniojo skilvelio ertmės skersmuo buvo statistiškai reikšmingai (p<0,05) didesnis ir
už vidutinių, ir už ilgųjų nuotolių bėgikų (grupių vidurkiai – 25,8, 20,7 ir 21,4 mm, atitinkamai), o dešiniojo skilvelio
siena storesnė už vidutinių nuotolių bėgikų (grupių vidurkiai – 6,7 ir 5,9 mm, atitinkamai) (p<0,05). Diastolinė
kairiojo skilvelio funkcija, vertinta pagal santykį tarp pradinio ir dėl prieširdžio susitraukimo maksimalių kraujo
greičių per mitralinį vožtuvą, taip pat diastolinis kairiojo skilvelio skersmuo (grupių vidurkis – 55,5–56,4 mm)
tarp skirtingos specializacijos bėgikų nesiskyrė (p>0,05).
Išvados. Ilgųjų ir ilgiausiųjų nuotolių bėgikų miokardas yra hipertrofavęsis labiau nei vidutinių nuotolių bėgikų
dėl ryškesnio fiziologinio kompensacinio sienos sustorėjimo adaptuojantis specifiškiems aerobinę ištvermę
lavinantiems fiziniams krūviams.
Adresas susirašinėti: T. Venckūnas, Lietuvos kūno kultūros akademijos Taikomosios fiziologijos ir sveikatos ugdymo
katedra, Sporto 6, 44221 Kaunas. El. paštas: [email protected]
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Received 16 August 2004, accepted 13 May 2005
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