Abstract：
OBJECTIVE: The aim of this study was to detect possible differences in reversible cardiac remodeling occurring in sport training and twin pregnancy.
BACKGROUND: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar.
METHODS: 21 female elite athletes (23.2 ± 5.3 years), 25 women with twin pregnancies (35.4 ± 5.7 years) and 25 healthy competitive female athletes (controls), age-matched with pregnant women (34.9 ± 7.9 years), were enrolled. This latter group was included to minimize the effect of age on cardiac remodeling. All women evaluated through anamnestic collection, physical examination, 12 leads ECG, standard echocardiogram and strain analysis. Sphericity (SI) and apical conicity (ACI) indexes were also calculated.
RESULTS: Pregnant women showed higher LA dimension (p < 0.001) compared to both groups of athletes. LV e RV GLS were significantly different in pregnant women compared to female athletes (p = 0.02 and 0.03, respectively). RV GLS was also different between pregnant women and controls (p = 0.02). Pregnant women showed significantly higher S\' wave compared to female athletes (p = 0.02) but not controls. Parameters of diastolic function were significantly higher in athletes (p = 0.08 for IVRT and p < 0.001 for E/A,). SI was lower in athletes in both diastole (p = 0.01) and systole (p < 0.001), while ACIs was lower in pregnant women (p = 0.04).
CONCLUSIONS: Cardiac remodeling of athletes and pregnant women could be similar at first sight but different in LV shape and in GLS, highlighting a profound difference in longitudinal deformation between athletes and pregnant women. This difference seems not to be related with age. These findings suggest that an initial maternal cardiovascular maladaptation could occur in the third trimester of twin pregnancies.
BACKGROUND: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar.
METHODS: 21 female elite athletes (23.2 ± 5.3 years), 25 women with twin pregnancies (35.4 ± 5.7 years) and 25 healthy competitive female athletes (controls), age-matched with pregnant women (34.9 ± 7.9 years), were enrolled. This latter group was included to minimize the effect of age on cardiac remodeling. All women evaluated through anamnestic collection, physical examination, 12 leads ECG, standard echocardiogram and strain analysis. Sphericity (SI) and apical conicity (ACI) indexes were also calculated.
RESULTS: Pregnant women showed higher LA dimension (p < 0.001) compared to both groups of athletes. LV e RV GLS were significantly different in pregnant women compared to female athletes (p = 0.02 and 0.03, respectively). RV GLS was also different between pregnant women and controls (p = 0.02). Pregnant women showed significantly higher S\' wave compared to female athletes (p = 0.02) but not controls. Parameters of diastolic function were significantly higher in athletes (p = 0.08 for IVRT and p < 0.001 for E/A,). SI was lower in athletes in both diastole (p = 0.01) and systole (p < 0.001), while ACIs was lower in pregnant women (p = 0.04).
CONCLUSIONS: Cardiac remodeling of athletes and pregnant women could be similar at first sight but different in LV shape and in GLS, highlighting a profound difference in longitudinal deformation between athletes and pregnant women. This difference seems not to be related with age. These findings suggest that an initial maternal cardiovascular maladaptation could occur in the third trimester of twin pregnancies.
摘要：
目的：本研究的目的是检测运动训练和双胎妊娠发生的可逆性心脏重塑的可能差异。
背景：由于训练和胎儿要求，运动员和孕妇会发生心脏重塑，分别。这些变化显然是相似的。
方法：21名女子精英运动员（23.2±5.3岁），25名双胎妊娠妇女（35.4±5.7岁）和25名健康的竞技女运动员（对照），与孕妇年龄相匹配（34.9±7.9岁），已注册。纳入后一组是为了最大程度地减少年龄对心脏重塑的影响。所有通过记忆收集评估的女性，体检,12导联心电图,标准超声心动图和应变分析。还计算了球形度（SI）和顶端圆锥度（ACI）指数。
结果：与两组运动员相比，孕妇的LA维度更高（p<0.001）。与女运动员相比，孕妇的LVeRVGLS存在显着差异（分别为p=0.02和0.03）。孕妇和对照组之间的RVGLS也不同（p=0.02）。与女性运动员（p=0.02）相比，孕妇表现出明显更高的S'波，而对照组则没有。运动员的舒张功能参数显着升高（IVRT的p=0.08，E/A的p<0.001，).SI在运动员的舒张期(p=0.01)和收缩期(p<0.001)均较低，而孕妇的ACI较低（p=0.04）。
结论：运动员和孕妇的心脏重塑乍一看可能相似，但LV形状和GLS不同，突出了运动员和孕妇之间在纵向变形方面的深刻差异。这种差异似乎与年龄无关。这些发现表明，最初的母体心血管适应不良可能发生在双胎妊娠的第三个三个月。
背景：由于训练和胎儿要求，运动员和孕妇会发生心脏重塑，分别。这些变化显然是相似的。
方法：21名女子精英运动员（23.2±5.3岁），25名双胎妊娠妇女（35.4±5.7岁）和25名健康的竞技女运动员（对照），与孕妇年龄相匹配（34.9±7.9岁），已注册。纳入后一组是为了最大程度地减少年龄对心脏重塑的影响。所有通过记忆收集评估的女性，体检,12导联心电图,标准超声心动图和应变分析。还计算了球形度（SI）和顶端圆锥度（ACI）指数。
结果：与两组运动员相比，孕妇的LA维度更高（p<0.001）。与女运动员相比，孕妇的LVeRVGLS存在显着差异（分别为p=0.02和0.03）。孕妇和对照组之间的RVGLS也不同（p=0.02）。与女性运动员（p=0.02）相比，孕妇表现出明显更高的S'波，而对照组则没有。运动员的舒张功能参数显着升高（IVRT的p=0.08，E/A的p<0.001，).SI在运动员的舒张期(p=0.01)和收缩期(p<0.001)均较低，而孕妇的ACI较低（p=0.04）。
结论：运动员和孕妇的心脏重塑乍一看可能相似，但LV形状和GLS不同，突出了运动员和孕妇之间在纵向变形方面的深刻差异。这种差异似乎与年龄无关。这些发现表明，最初的母体心血管适应不良可能发生在双胎妊娠的第三个三个月。
