在青少年中区分左心室缩和高缩性心肌病:一项纵向观察研究
Marianne I Forså1,2, Marit K Smedsrud1,3, Kristina H Haugaa1,2
1ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.
European journal of preventive cardiology
|November 22, 2023
概括
在基线时,左心室缩在青少年运动员和高缩性心肌病患者中是相似的,但仅在高缩性心肌病 (HCM) 患者中进展. 通过评估壁壁厚度和体积进展,可以将运动员的生理性缩与早期的HCM区分开来.
科学领域:
- 心脏病学 心脏病学
- 运动医学 运动医学
- 遗传学 遗传学 是一个
背景情况:
- 在青少年运动员中区分生理左心室 (LV) 缩和病理原因,如缩性心肌病变 (HCM) 是至关重要的.
- 早期发现HCM对于预防心脏不良事件至关重要.
研究的目的:
- 探索青少年运动员与HCM基因型阳性患者相比,LV缩的表型,进展和潜在重叠 ("灰色区域").
- 为了识别能区分生理性 LV 缩与早期 HCM 的回声心脏学标记.
主要方法:
- 一项纵向观察性研究,将76名12岁的运动员与55名年龄和性别匹配的HCM基因型阳性患者进行比较.
- 使用儿科参考值评估了心声学参数,包括腹腔隔膜直径Z-score (ZIVSd) 和LV终端腹腔体积Z-score (ZLVEDV).
- 临床数据和心脏事件的平均随访时间为3.2年.
主要成果:
- 在基线时,LV缩的患病率相似 (28%的运动员和21%的HCM患者).
- 隔膜厚度 (ZIVSd) 在基线没有显著差异,但仅在HCM患者中进展 (P=0.002).
- 运动员的LV体积 (ZLVEDV) 显著增加 (P<0.001),在两组中都没有显著的进展.
结论:
- 在青春期早期观察到类似比例的LV缩,但仅在HCM基因型阳性患者中表现出进展.
- 在ZIVSd为2.0和3.3.3之间,确定了LV缩的潜在灰色区域.
- 监测LV壁厚度和体积的进展有助于区分运动员与早期HCM的生理性缩.
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