PDF(Pubmed)
Abstract：
We conducted a meta-analysis to synthesize the best available evidence comparing cardiac biventricular structure and function using cardiac magnetic resonance imaging (CMR) and transthoracic echocardiography (TTE) in elite female athletes and healthy controls (HC). Chronic exposure to exercise may induce cardiac chamber enlargement as a means to augment stroke volume, a condition known as the \"athlete\'s heart.\" These changes have not been clearly characterized in female athletes. Multiple databases were searched from inception to June 18, 2019. Outcomes of interest included left ventricular (LV) and right ventricular (RV) dimensional, volumetric, mass, and functional assessments in female athletes. Most values were indexed to body surface area. The final search yielded 22 studies, including 1000 female athletes from endurance, strength, and mixed athletic disciplines. CMR-derived LV end-diastolic volume (LVEDV) and RV end-diastolic volume (RVEDV) were greater in endurance athletes (EA) versus HC (17.0% and 18.5%, respectively; both p < 0.001). Similarly, TTE-derived LVEDV and RVEDV were greater in EA versus HC (16.8% and 28.0%, respectively; both p < 0.001). Both LVEF and RVEF were lower in EA versus HC, with the most pronounced difference observed in RVEF via TTE (9%) (p < 0.001). LV stroke volume was greater in EA versus HC via both CMR (18.5%) and TTE (13.2%) (both p < 0.05). Few studies reported data for the mixed athlete (MA) population and even fewer studies reported data for strength athletes (SA), therefore a limited analysis was performed on MA and no analysis was performed on SA. This evidence-synthesis review demonstrates the RV may be more susceptible to ventricular enlargement. General changes in LV and RV structure and function in female EA mirrored changes observed in male counterparts. Further studies are needed to determine if potential adverse outcomes occur secondary to these changes.
摘要：
我们进行了一项荟萃分析，以综合使用心脏磁共振成像（CMR）和经胸超声心动图（TTE）在精英女运动员和健康对照（HC）中比较心脏双心室结构和功能的最佳可用证据。长期暴露于运动可能会导致心腔扩大，作为增加每搏输出量的一种手段。一种被称为“运动员心脏”的疾病。“这些变化在女运动员中还没有得到明确的描述。从开始到2019年6月18日搜索了多个数据库。感兴趣的结果包括左心室（LV）和右心室（RV）尺寸，体积,质量,和女运动员的功能评估。大多数值以体表面积为索引。最终搜索产生了22项研究，包括1000名来自耐力的女运动员，力量,和混合运动学科。与HC相比，耐力运动员（EA）的CMR衍生的LV舒张末期容积（LVEDV）和RV舒张末期容积（RVEDV）更大（17.0％和18.5％，分别；两者p<0.001)。同样，与HC相比，EA中TTE得出的LVEDV和RVEDV更高（16.8％和28.0％，分别；两者p<0.001)。与HC相比，EA的LVEF和RVEF均较低，通过TTE在RVEF中观察到最显著的差异(9%)(p<0.001)。通过CMR（18.5%）和TTE（13.2%），EA与HC相比，LV每搏输出量更大（均p<0.05）。很少有研究报告了混合运动员（MA）人群的数据，甚至更少的研究报告了力量运动员（SA）的数据。因此对MA进行了有限的分析,未对SA进行分析.这项证据综合审查表明，RV可能更容易受到心室扩大的影响。女性EA中LV和RV结构和功能的一般变化反映了男性同行中观察到的变化。需要进一步的研究来确定这些变化是否会发生潜在的不良后果。
