摘要
目的 评价动脉硬化成人安静及运动状态下心脏结构和功能的特点,旨在评估运动时心脏改变的风险性和不良后果。方法 选取107名40~59岁的北京市居民,其中男性21名,女性86名,依照臂踝脉搏波传导速度(baPWV)评价标准,分成动脉硬度正常组(n=71)、动脉硬化组(n=36)。每名受试者蹬骑卧式功率车进行起始25 W,每2 min递增25 W的运动,每个等级运动结束前30 s及恢复期获取超声心动图和血压数据。结果 (1)与动脉硬度正常组相比,动脉硬化组室间隔舒张末厚度、左心室后壁舒张末厚度(LVPWd)、左心室质量、左心室质量指数、射血分数(EF)、短轴缩短分数(FS)显著增加(P<0.05),二尖瓣血流舒张早期最大流速E峰与心房收缩期最大流速A峰的比值(E/A)显著下降(P<0.05)。(2)动脉硬化组发生左心室肥厚的比例显著高于动脉硬度正常组(P<0.05)。(3)baPWV与心率、EF、每搏输出量、FS呈正相关(P<0.05)。(4)运动过程中动脉硬化组左心室舒张末内径、LVPWd、收缩压显著高于动脉硬度正常组(P<0.05)。结论 动脉硬化者心脏表现为室壁增厚,左心室质量增加,收缩功能增强,舒张功能下降,左心室几何构型重构,且收缩功能的改变独立于血压的变化。相比于心脏的变化,动脉硬化者更应预防运动中血压过高。
Aim To evaluate the characteristics of cardiac structure and function in atherosclerotic adults during quietness and exercise in order to assess the risk and adverse consequences of cardiac changes during exercise. Methods 107 Beijing residents aged 40-59,including 21 males and 86 females,were selected. According to the criteria of brachial-ankle pulse wave velocity( ba PWV),the participants were divided into normal arterial stiffness group( n = 71)and arteriosclerosis group( n = 36). After resting echocardiography,all participants performed a horizontal exercise test that the initial load was 25 W,increasing 25 W every two minutes. Echocardiography and blood pressure data were obtained at 30 seconds before the end of each exercise and convalescence. Results( 1) Compared with the normal arterial stiffness group,the arteriosclerosis group showed increasing interventricular septum thickness at end-diastole,left ventricular posterior wall thickness at end-diastole( LVPWd),left ventricular mass,left ventricular mass index,ejection fraction( EF),fractional shortening( FS)( P<0.05) and decreasing peak flow velocity of early diastole/peak flow velocity of atrial contraction( E/A)( P<0.05).( 2) Left ventricular hypertrophy in the arteriosclerosis group was much higher than the normal arterial stiffness group( P< 0.05).( 3) Ba PWV was positively correlated with heart rate,EF,stroke volume and FS( P<0.05).( 4) During exercise,left ventricular end-diastolic diameter,LVPWd and systolic blood pressure in atherosclerosis group were significantly higher than those in normal arterial stiffness group( P<0.05). Conclusions Cardiac manifestations of atherosclerosis individuals include thickening of ventricular wall,increase of left ventricular mass,enhancement of systolic function,decrease of diastolic function,and remodeling of left ventricular geometry,and the change of systolic function is independent on the change of blood pressure. Compared with heart changes,arteriosclerotic people should prevent excessive blood pressure during exercise.
作者
陈贻珊
李俊平
孔振兴
于晶晶
张瀚月
张一民
CHEN Yishan;LI Junping;KONG Zhenxing;YU Jingjing;ZHANG Hanyue;ZHANG Yimin(Institute of Human Movement Science & Key Laboratory of Physical Fitness and Exercise of Ministry of Education,Belling Sport University,Belling 100084,China)
出处
《中国动脉硬化杂志》
CAS
2018年第11期1140-1146,共7页
Chinese Journal of Arteriosclerosis
基金
“十二五”国家科技支撑计划课题资助项目(2012BAK21B01)
关键词
动脉硬化
心脏结构
心脏功能
运动负荷试验
臂踝脉搏波传导速度
arteriosclerosis
cardiac structure
cardiac function
exercise stress test
brachial-ankle pulse wave velocity
作者简介
陈贻珊,博士研究生,研究方向为运动促进健康的理论与实践,E-mail:chenyishanbsu@126.com;通信作者:张一民,博士,教授,研究方向为运动促进健康的理论与实践,E-mail:ymzhangno1@163.com。
