对青少年足球运动员的心脏的右心室评估
D X Augustine1,2, J Willis1, S Sivalokanathan3
1Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
运动训练可能会导致右心室变化,模仿心律失常的右心室心肌病变 (ARVC). 许多年轻的足球运动员超过成人心脏大小规范,但进一步的评估证实在这些情况下没有实际的ARVC.
科学领域:
- 心脏病学 心脏病学
- 运动医学 运动医学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 运动训练可以诱导右心室 (RV) 的结构和电气变化,可能模仿心律失常的右心室心肌病 (ARVC).
- 误解这些变化可能导致错误的诊断,影响运动员的职业生涯和健康管理.
- 在青少年运动员中建立正常的VR维度参考范围对于准确的诊断至关重要.
研究的目的:
- 为了确定不同种族的青少年男性足球运动员的正常VR维度参考范围.
- 分析青少年足球运动员VR尺寸和ARVC诊断标准之间的重叠.
- 为了比较青少年足球运动员的RV尺寸与成熟的成年人参考范围.
主要方法:
- 分析了来自1087名男子学院足球运动员 (年龄在13-18岁) 的心电图 (ECG) 和心声图数据.
- 参与者按种族分类:白人,黑人 (非洲/加勒比地区) 和混合种族.
- 根据ARVC的主要标准进行评估,包括T波逆转和RV尺寸.
主要成果:
- 3.3%的队列表现出T波逆转,在黑人足球运动员中更为普遍 (12%).
- 高达59%的人超过了成人RV参考范围,但价值与成人运动员相似;没有发现RV尺寸的种族差异.
- 0.2%符合"确定的"ARVC标准,2.2%符合基于VR尺寸和心电图变化的"边界"ARVC标准,主要是黑人足球运动员. 然而,全面的临床评估排除了所有这些运动员的ARVC.
结论:
- 很大一部分青少年足球运动员的RV尺寸超过了成年人的标准,这是一个常见的适应训练.
- 像T波逆转这样的心电图变化可能发生,并可能引起对ARVC的怀疑.
- 专家评估是必要的,以区分训练诱导的适应和运动员实际的ARVC.
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