背景:左心室小梁(LVTs)是运动员的常见表现。关于临床意义的信息有限,管理,和结果。
目的:研究优秀运动员LVT的患病率和形态学特征,重点关注临床相关因素和预后意义。
方法:我们用心电图登记了1.492名不同运动学科的奥运精英运动员,超声心动图,和运动压力测试。明确诊断为左心室致密化不全(LVNC)的个体被排除在外,专注于LVT不符合LVNC标准的运动员。
结果:四百三十五(29.1%)运动员进行了LVT。男性LVT更为常见(62.1%vs.53.5%,p=0.002),黑人运动员与高加索人相比(7.1%与2.4%,p<0.0001)和耐力运动员(p=0.0005)。与小梁的部位或程度无关,均未发现差异。耐力运动员表现出更高的LVTs比例和更大的左心室(LV)容积(舒张末期和收缩末期,分别为91.5±19.8mL与79.3±29.9mL,p=0.002和33.1±10mLvs.28.6±11.7mL,p=0.007)和具有较高E波(p=0.01)和e间隔速度(p=0.02)的舒张模式。14%的LVT与11.6%的无LVT运动员发现室性心律失常(p=0.22)。位置和LVT延伸均与室性心律失常无关。随访52±32个月,没有观察到心律失常负担的差异(LVTs运动员的11.1%vs10.2%,p=0.51)。
结论:LVTs在运动员中相当普遍,大部分是男性,黑色和耐力,可能是适应性重塑的表达。在没有相关临床异常的情况下,如左心室收缩和舒张功能损害,心电图复极异常,或者心肌病的家庭证据,患有LVT的运动员具有良性的临床意义,不需要进一步的检查.
BACKGROUND: Left ventricular (LV) trabeculations (LVTs) are common findings in athletes. Limited information exists regarding clinical significance, management, and outcome.
OBJECTIVE: The purpose of this study is to examine the prevalence and morphologic characteristics of LVTs in elite athletes, with a focus on clinical correlates and prognostic significance.
METHODS: We enrolled 1,492 Olympic elite athletes of different sports disciplines with electrocardiogram, echocardiogram, and exercise stress test. Individuals with a definite diagnosis of LV noncompaction (LVNC) were excluded; we focused on athletes with LVTs not meeting the criteria for LVNC.
RESULTS: Four hundred thirty-five (29.1%) athletes presented with LVTs, which were more frequent in male athletes (62.1% vs 53.5%, P = .002) and Black athletes compared with Caucasian (7.1% vs 2.4%, P < .0001) and endurance athletes (P = .0005). No differences were found with relation to either the site or extent of trabeculations. Endurance athletes showed a higher proportion of LVTs and larger LV volumes (end-diastolic and end-systolic, respectively, 91.5 ± 19.8 mL vs 79.3 ± 29.9 mL, P = .002; and 33.1 ± 10 mL vs 28.6 ± 11.7 mL, P = .007) and diastolic pattern with higher E wave (P = .01) and e\' septal velocities (P = .02). Ventricular arrhythmias were found in 14% of LVTs versus 11.6% of athletes without LVTs (P = .22). Neither the location nor the LVTs\' extension were correlated to ventricular arrhythmias. At 52 ± 32 months of follow-up, no differences in arrhythmic burden were observed (11.1% in LVT athletes vs 10.2%, P = .51).
CONCLUSIONS: Left ventricular trabeculations are quite common in athletes, mostly male, Black, and endurance, likely as the expression of adaptive remodeling. In the absence of associated clinical abnormalities, such as LV systolic and diastolic impairment, electrocardiogram repolarization abnormalities, or family evidence of cardiomyopathy, athletes with LVTs have benign clinical significance and should not require further investigation.