摘要
目的:应用心血管磁共振成像特征追踪(cMRI-FT)技术评估长期马拉松运动对双侧心室结构和功能的影响.方法:对31名跑龄大于2年的业余马拉松运动员[年龄(40.94±4.90)岁,跑龄(5.97±0.76年)]和16名年龄和性别相匹配的健康志愿者[年龄(41.94±5.31)岁]进行cMRI检查,获得左室长轴位两腔心、三腔心、四腔心及心室短轴位电影序列图像,采用CVI42后处理软件分析和测量心脏结构和功能等相关参数,包括左、右心室舒张末期容积(EDV)、舒张末期容积指数(EDVi)、收缩末期容积(ESV)、收缩末期容积指数(ESVi)、心输出量(CO)、心输出量指数(COi)、每搏输出量(SV)、每搏输出量指数(SVi)、左室射血分数(LVEF)及左心室质量指数(LVMI).采用FT技术分析双侧心室的心肌应变参数,包括左、右心室整体及节段(基底段、中间段、心尖段)的纵向应变(LS)、周向应变(CS)和径向应变(RS).采用问卷调查形式获得马拉松运动的相关参数(跑步年限、每周跑步时长及每周跑步距离)及临床参数[静息心率和体表面积(BSA)等].采用独立样本t检验和非参数检验等方法比较2组间各项心脏定量参数的差异,并采用Spearman相关性分析对运动员组的心功能及跑步参数与心肌应变参数的相关性进行分析.结果:马拉松组的静息心率和BSA显著低于对照组(P<0.05).与对照组相比:马拉松组的左室质量分数(LVMI)、左心室舒张末期容积指数(LVEDVi)、右心室舒张末期容积指数(RVEDVi)、左心室收缩末期容积指数(LVESVi)、右心室收缩末期容积指数(RVESVi)均显著升高(P<0.001);左心室整体径向应变(LV-GRS)、左心室整体周向应变(LV-GCS)和右心室整体纵向应变(RV-GLS)均显著减低(P<0.05);左心室基底段及中间段的径向应变,左心室基底段、中间段及心尖段的周向应变均显著减低(P<0.05);但左心室整体及各节段的纵向应变无显著差异(P>0.05);两组间LVEF无显著差异(P>0.05).每周跑步距离与LVEDV(r=0.528,P=0.003)和RV-EDV(r=0.503,P=0.005)呈中度正相关.结论:在左室射血分数正常的情况下,业余马拉松运动员左、右心室的部分收缩及舒张功能升高,而左、右心室心肌应变力减低,这可认为是心室对耐力运动的良好适应.业余马拉松运动员的每周训练量与双心室容量有一定相关性.
Abstract
Objective:The purpose of this study was to assess the long-term effect of marathon on the biventricular structure and function of amateur marathoners using cardiovascular magnetic reso-nance imaging with feature-tracking (cMRI-FT)technique.Methods:A total of 31 amateur maratho-ners[age of (40.94±4.90)years,running age of (5.97±0.76)yrs]and 16 healthy volunteers[age of (41.94±5.31)yrs]with matching age and sex underwent cardiovascular magnetic resonance imaging (cMRI),cine sequences images of the left ventricular long axis two-chamber,three-chamber,four-chamber,and short-axis views were obtained.The cardiac structure and functional parameters were analyzed and measured using CVI42 post-processing software,including left and right ventricular end-diastolic volume (EDV),end-diastolic volume index (EDVi),end-systolic volume (ESV),end-systolic volume index (ESVi),cardiac output (CO),cardiac output index (COi),stroke volume (SV),stroke volume index (SVi),left ventricular ejection fraction (LVEF),and left ventricular mass index (LV-MI).Feature tracking (FT)technique was employed to analyze myocardial strain parameters of left and right ventricles,including longitudinal strain (LS),circumferential strain (CS),and radial strain (RS)of the glo-bal and segmental (basal,mid,apical)ventricle.Running parameters (years of run-ning,weekly running time and distance)and clinical parameters (resting heart rate,body surface area (BSA),etc.)were obtained through questionnaire survey.Results:Amateur marathoners showed lo-wer resting heart rate and BSA (P<0.05).Left ventricular mass index (LVMI)of amateur maratho-ners was significantly higher (P<0.001).Left ventricular end-diastolic volume index (LVEDVi),right ventricular end-diastolic volume index (RVEDVi ),left ventricular end-systolic volume index (LVESVi)and right ventri-cular end-systolic volume index (RVESVi)were significantly higher in amateur marathoners (P<0.001).The left ventricular global radial strain (LV-GRS),circumferential strain (LV-GCS)and right ventricular global longitudinal strain (RV-GLS)of amateur marathoners were lower than the control group (all P<0.05).The radial strain of basal and mid-segments in left ventricle and the circumferential strain of basal,mid and apical segments in left ventricle decreased (all P<0.05),but there was no significant difference in the left ventricular global and segmental longitu-dinal strain (all P>0.05).There was no significant difference in LVEF (P>0.05).Finally,we found that weekly running distance was associated with LVEDV (r=0.528,P=0.003)and RVEDV (r=0.503,P=0.005).Conclusion:Under the condition of normal left ventricular ejection fraction,amateur marathon athletes have increased partial systolic and diastolic function of left and right ventricle and decreased left and right ventricular myocardial strain,which can be considered as a good adaptation of ventricle to endurance exercise.There is a certain correlation between the weekly training distance of amateur marathoners and the biventricular volume.
基金项目
山西省基础研究计划(20210302123015)
NETL
NSTL
万方数据