运动员心肌纤维化:风险标志物还是生理适应?
Vasiliki Katsi1, Epameinondas Triantafyllou1, Christos Fragoulis1
1First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.
Biomedicines
|November 27, 2025
概括
过度的耐力运动可能会导致心肌纤维化,这是一种可以通过心脏MRI检测到的情况. 这种纤维化可能是心律失常或良性适应症的风险标志物,需要在运动员中仔细解释.
科学领域:
- 心脏病学 心脏病学
- 运动医学 运动医学
- 医疗成像医学成像
背景情况:
- 耐力运动提供了心血管方面的好处,如改善寿命和代谢健康.
- 过度训练可能会导致不良的心脏变化,包括心肌纤维化,通过心磁共振成像 (CMR) 的晚期加多增强 (LGE) 确定.
- 运动员心肌纤维化呈现出复杂的情况,可能表明心律失常风险或生理重塑.
研究的目的:
- 审查心肌纤维化在运动员中的双重作用.
- 为了检查纤维化作为风险标志物与良性适应.
- 讨论耐力运动员纤维化的诊断和临床影响.
主要方法:
- 对运动员心肌纤维化现有文献的综述.
- 对心脏磁共振成像 (CMR) 发现的分析,特别是晚期加多增强 (LGE).
- 纤维化模式与临床结果的相关性,包括心律失常和心脏突然死亡.
主要成果:
- 超耐力运动员可能会显示心室尺寸和质量增加,运动后心脏生物标志物升高.
- 在左心室 (LV) 的心下/心心中斑块性LGE模式与恶性心律不整的发病率较高有关 (在研究中为22%).
- 纤维化的解释可能是复杂的,因为它可能代表病理变化或适应性重塑.
结论:
- 运动员心肌纤维化,特别是具有特定LGE模式的运动员心肌纤维化是一个重要的发现,需要仔细的风险分层.
- 运动员纤维化机制尚未完全理解,但可能涉及压力,炎症或斑块动态.
- 进一步的研究是必不可少的,以澄清纤维化机制,完善诊断标准,并确保运动员的安全,同时最大限度地发挥运动的好处.
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