МОРФОФУНКЦИОНАЛЬНЫЕ ОСНОВЫ ВЫСОКИХ ФУНКЦИОНАЛЬНЫХ ВОЗМОЖНОСТЕЙ СПОРТСМЕНОВ В СВЕТЕ УПРОЩЕННОЙ ЗАРУБЕЖНОЙ КЛАССИФИКАЦИИ СПОРТА. ЧАСТЬ 1
Ключевые слова:
спортсмены, классификация Pelliccia A., ремоделирование сердца, гипертрофия миокарда левого желудочка, пиковое потребление кислорода
Аннотация
Цель исследования: определить морфологические изменения сердца и физиологические возможности спортсменов в разных группах спортивных дисциплин (СД). Оценить приемлемость классификации Pelliccia A. для профессиональных спортсменов массового уровня. Материалы и методы. Обследованы 2647 спортсменов национального уровня, представляющих 40 СД, сгруппированных в четыре группы: требующие сложно-координационных навыков, силы, смешанных качеств, выносливости. Выполнены ЭКГ в 12 отведениях и эхокардиография с нормализацией показателей по площади поверхности тела (ППТ). Для оценки функциональных возможностей использовали кардиопульмональный тест. Результаты. Основным трендом было увеличение частоты и величины эксцентрической гипертрофии левого желудочка (ЛЖ), а также VO2 Peak, VO2 ПАНО и мощности работы от первой к четвертой группе. Наибольшую корреляцию с функциональными показателями спортсменов демонстрировали не линейные, а объемные характеристики ЛЖ, индексированные по ППТ. В группах количество лиц с признаками ремоделирования ЛЖ различалось от 14,4 до 45 %. Сходные результаты отмечались по литературным данным для спортсменов, выступающих на международных универсиадах и олимпиадах. Заключение. Классификация Pelliccia A. отражает общие закономерности ремоделирования сердца в видах спорта, однако их количественное выражение подвержено значительным колебаниям, в связи с чем применение к спортсменам ниже международного уровня должно быть ограничено. Оценку размеров сердца целесообразно проводить по центильным показателям, полученным для каждой из классификационных групп.
Литература
1. Adea J.B., Leonor R.ML., Lu C.H. et al. Sport Disciplines and Cardiac Remodeling in Elite University Athletes Competing in 2017 Taipei Summer Universiade. Medicine (Baltimore), 2020, vol. 99, no. 45, e23144. DOI: 10.1097/MD.0000000000023144
2. Budts W., Pieles G.E., Roos-Hesselink J.W. et al. Recommendations for Participation in Competitive Sport in Adolescent and Adult Athletes with Congenital Heart Disease (CHD): Position Statement of the Sports Cardiology & Exercise Section of the European Association of Preventive Cardiology (EAPC), the European Society of Cardiology (ESC) Working Group on Adult Congenital Heart Disease and the Sports Cardiology, Physical Activity and Prevention Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC) [published online ahead of print, 2020 Aug 26]. European Journal of Cardiology, 2020, ehaa501. DOI: 10.1093/eurheartj/ehaa501
3. Caselli S., Di Paolo F.M., Pisicchio C. et al. Patterns of Left Ventricular Diastolic Function-in Olympic Athletes. Journal of the American Society of Echocardiography, 2015, vol. 28, no. 2, pp. 236–244. DOI: 10.1016/j.echo.2014.09.013
4. Caselli S., Vaquer Segui A., Quattrini F. et al. Upper Normal Values of Blood Pressure Response to Exercise in Olympic Athletes. American Journal of Cardiology, 2016, no. 177, pp. 120–128. DOI: 10.1016/j.ahj.2016.04.020
5. Lang R.M., Badano L.P., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: an Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Journal of Cardiology. Cardio-vasc Imag, 2015, vol. 16, no. 3, pp. 233–270. DOI: 10.1093/ehjci/jev014
6. Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for Chamber Quantification. European Journal Echocardiogramm, 2006, vol. 7, no. 2, pp. 79–108. DOI: 10.1016/j.euje.2005.12.014
7. Levine B.D., Baggish A.L., Kovacs R.J. et al. Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact: a Scientific Statement from the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology, 2015, vol. 66, pp. 2350–2355. DOI: 10.1016/j.jacc.2015.09.033
8. Mitchell J.H., Haskell W., Snell P., Van Camp S.P. Task Force 8: Classification of Sports. Journal of the American College of Cardiology, 2005, vol. 45, no. 8, pp. 1364–1367.
9. Nes B.M., Janszky I., Wisloff U. et al. Age-Predicted Maximal Heart Rate in Healthy Subjects: The HUNT Fitness Study. Scandinavian Journal of Medicine and Science in Sports, 2013, vol. 23, no. 6, pp. 697–704. DOI: 10.1111/j.1600-0838.2012.01445.x
10. Pelliccia A., Caselli S., Sharma S. et al. Internal Reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) Joint Position Statement: Recommendations for the Indicationand Interpretation of Cardiovascular Imaging in the Evaluation of the Athlete’s Heart. European Journal of Cardiology, 2018, vol. 39, no. 21, pp. 1949–1969. DOI: 10.1093/eurheartj/ehx53
11. Sharma S., Drezner J.A., Baggish A. et al. International Recommendations for Electrocardiographic Interpretation in Athletes. European Journal of Cardiology, 2018, vol. 39, no. 16, pp. 1466–1480. DOI: 10.1093/eurheartj/ehw631
12. Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 2018, vol. 39, no. 33, pp. 3021–3104. DOI: 10.1093/eurheartj/ehy339
2. Budts W., Pieles G.E., Roos-Hesselink J.W. et al. Recommendations for Participation in Competitive Sport in Adolescent and Adult Athletes with Congenital Heart Disease (CHD): Position Statement of the Sports Cardiology & Exercise Section of the European Association of Preventive Cardiology (EAPC), the European Society of Cardiology (ESC) Working Group on Adult Congenital Heart Disease and the Sports Cardiology, Physical Activity and Prevention Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC) [published online ahead of print, 2020 Aug 26]. European Journal of Cardiology, 2020, ehaa501. DOI: 10.1093/eurheartj/ehaa501
3. Caselli S., Di Paolo F.M., Pisicchio C. et al. Patterns of Left Ventricular Diastolic Function-in Olympic Athletes. Journal of the American Society of Echocardiography, 2015, vol. 28, no. 2, pp. 236–244. DOI: 10.1016/j.echo.2014.09.013
4. Caselli S., Vaquer Segui A., Quattrini F. et al. Upper Normal Values of Blood Pressure Response to Exercise in Olympic Athletes. American Journal of Cardiology, 2016, no. 177, pp. 120–128. DOI: 10.1016/j.ahj.2016.04.020
5. Lang R.M., Badano L.P., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: an Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Journal of Cardiology. Cardio-vasc Imag, 2015, vol. 16, no. 3, pp. 233–270. DOI: 10.1093/ehjci/jev014
6. Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for Chamber Quantification. European Journal Echocardiogramm, 2006, vol. 7, no. 2, pp. 79–108. DOI: 10.1016/j.euje.2005.12.014
7. Levine B.D., Baggish A.L., Kovacs R.J. et al. Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact: a Scientific Statement from the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology, 2015, vol. 66, pp. 2350–2355. DOI: 10.1016/j.jacc.2015.09.033
8. Mitchell J.H., Haskell W., Snell P., Van Camp S.P. Task Force 8: Classification of Sports. Journal of the American College of Cardiology, 2005, vol. 45, no. 8, pp. 1364–1367.
9. Nes B.M., Janszky I., Wisloff U. et al. Age-Predicted Maximal Heart Rate in Healthy Subjects: The HUNT Fitness Study. Scandinavian Journal of Medicine and Science in Sports, 2013, vol. 23, no. 6, pp. 697–704. DOI: 10.1111/j.1600-0838.2012.01445.x
10. Pelliccia A., Caselli S., Sharma S. et al. Internal Reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) Joint Position Statement: Recommendations for the Indicationand Interpretation of Cardiovascular Imaging in the Evaluation of the Athlete’s Heart. European Journal of Cardiology, 2018, vol. 39, no. 21, pp. 1949–1969. DOI: 10.1093/eurheartj/ehx53
11. Sharma S., Drezner J.A., Baggish A. et al. International Recommendations for Electrocardiographic Interpretation in Athletes. European Journal of Cardiology, 2018, vol. 39, no. 16, pp. 1466–1480. DOI: 10.1093/eurheartj/ehw631
12. Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 2018, vol. 39, no. 33, pp. 3021–3104. DOI: 10.1093/eurheartj/ehy339
2. Budts W., Pieles G.E., Roos-Hesselink J.W. et al. Recommendations for Participation in Competitive Sport in Adolescent and Adult Athletes with Congenital Heart Disease (CHD): Position Statement of the Sports Cardiology & Exercise Section of the European Association of Preventive Cardiology (EAPC), the European Society of Cardiology (ESC) Working Group on Adult Congenital Heart Disease and the Sports Cardiology, Physical Activity and Prevention Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC) [published online ahead of print, 2020 Aug 26]. European Journal of Cardiology, 2020, ehaa501. DOI: 10.1093/eurheartj/ehaa501
3. Caselli S., Di Paolo F.M., Pisicchio C. et al. Patterns of Left Ventricular Diastolic Function-in Olympic Athletes. Journal of the American Society of Echocardiography, 2015, vol. 28, no. 2, pp. 236–244. DOI: 10.1016/j.echo.2014.09.013
4. Caselli S., Vaquer Segui A., Quattrini F. et al. Upper Normal Values of Blood Pressure Response to Exercise in Olympic Athletes. American Journal of Cardiology, 2016, no. 177, pp. 120–128. DOI: 10.1016/j.ahj.2016.04.020
5. Lang R.M., Badano L.P., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: an Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Journal of Cardiology. Cardio-vasc Imag, 2015, vol. 16, no. 3, pp. 233–270. DOI: 10.1093/ehjci/jev014
6. Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for Chamber Quantification. European Journal Echocardiogramm, 2006, vol. 7, no. 2, pp. 79–108. DOI: 10.1016/j.euje.2005.12.014
7. Levine B.D., Baggish A.L., Kovacs R.J. et al. Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact: a Scientific Statement from the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology, 2015, vol. 66, pp. 2350–2355. DOI: 10.1016/j.jacc.2015.09.033
8. Mitchell J.H., Haskell W., Snell P., Van Camp S.P. Task Force 8: Classification of Sports. Journal of the American College of Cardiology, 2005, vol. 45, no. 8, pp. 1364–1367.
9. Nes B.M., Janszky I., Wisloff U. et al. Age-Predicted Maximal Heart Rate in Healthy Subjects: The HUNT Fitness Study. Scandinavian Journal of Medicine and Science in Sports, 2013, vol. 23, no. 6, pp. 697–704. DOI: 10.1111/j.1600-0838.2012.01445.x
10. Pelliccia A., Caselli S., Sharma S. et al. Internal Reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) Joint Position Statement: Recommendations for the Indicationand Interpretation of Cardiovascular Imaging in the Evaluation of the Athlete’s Heart. European Journal of Cardiology, 2018, vol. 39, no. 21, pp. 1949–1969. DOI: 10.1093/eurheartj/ehx53
11. Sharma S., Drezner J.A., Baggish A. et al. International Recommendations for Electrocardiographic Interpretation in Athletes. European Journal of Cardiology, 2018, vol. 39, no. 16, pp. 1466–1480. DOI: 10.1093/eurheartj/ehw631
12. Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 2018, vol. 39, no. 33, pp. 3021–3104. DOI: 10.1093/eurheartj/ehy339
References
1. Adea J.B., Leonor R.ML., Lu C.H. et al. Sport Disciplines and Cardiac Remodeling in Elite University Athletes Competing in 2017 Taipei Summer Universiade. Medicine (Baltimore), 2020, vol. 99, no. 45, e23144. DOI: 10.1097/MD.00000000000231442. Budts W., Pieles G.E., Roos-Hesselink J.W. et al. Recommendations for Participation in Competitive Sport in Adolescent and Adult Athletes with Congenital Heart Disease (CHD): Position Statement of the Sports Cardiology & Exercise Section of the European Association of Preventive Cardiology (EAPC), the European Society of Cardiology (ESC) Working Group on Adult Congenital Heart Disease and the Sports Cardiology, Physical Activity and Prevention Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC) [published online ahead of print, 2020 Aug 26]. European Journal of Cardiology, 2020, ehaa501. DOI: 10.1093/eurheartj/ehaa501
3. Caselli S., Di Paolo F.M., Pisicchio C. et al. Patterns of Left Ventricular Diastolic Function-in Olympic Athletes. Journal of the American Society of Echocardiography, 2015, vol. 28, no. 2, pp. 236–244. DOI: 10.1016/j.echo.2014.09.013
4. Caselli S., Vaquer Segui A., Quattrini F. et al. Upper Normal Values of Blood Pressure Response to Exercise in Olympic Athletes. American Journal of Cardiology, 2016, no. 177, pp. 120–128. DOI: 10.1016/j.ahj.2016.04.020
5. Lang R.M., Badano L.P., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: an Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Journal of Cardiology. Cardio-vasc Imag, 2015, vol. 16, no. 3, pp. 233–270. DOI: 10.1093/ehjci/jev014
6. Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for Chamber Quantification. European Journal Echocardiogramm, 2006, vol. 7, no. 2, pp. 79–108. DOI: 10.1016/j.euje.2005.12.014
7. Levine B.D., Baggish A.L., Kovacs R.J. et al. Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact: a Scientific Statement from the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology, 2015, vol. 66, pp. 2350–2355. DOI: 10.1016/j.jacc.2015.09.033
8. Mitchell J.H., Haskell W., Snell P., Van Camp S.P. Task Force 8: Classification of Sports. Journal of the American College of Cardiology, 2005, vol. 45, no. 8, pp. 1364–1367.
9. Nes B.M., Janszky I., Wisloff U. et al. Age-Predicted Maximal Heart Rate in Healthy Subjects: The HUNT Fitness Study. Scandinavian Journal of Medicine and Science in Sports, 2013, vol. 23, no. 6, pp. 697–704. DOI: 10.1111/j.1600-0838.2012.01445.x
10. Pelliccia A., Caselli S., Sharma S. et al. Internal Reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) Joint Position Statement: Recommendations for the Indicationand Interpretation of Cardiovascular Imaging in the Evaluation of the Athlete’s Heart. European Journal of Cardiology, 2018, vol. 39, no. 21, pp. 1949–1969. DOI: 10.1093/eurheartj/ehx53
11. Sharma S., Drezner J.A., Baggish A. et al. International Recommendations for Electrocardiographic Interpretation in Athletes. European Journal of Cardiology, 2018, vol. 39, no. 16, pp. 1466–1480. DOI: 10.1093/eurheartj/ehw631
12. Williams B., Mancia G., Spiering W. et al. 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 2018, vol. 39, no. 33, pp. 3021–3104. DOI: 10.1093/eurheartj/ehy339
Опубликован
2023-03-09
Как цитировать
Шарыкин, А., Бадтиева, В., Павлов, В., Иванова, Ю., & Усманов, Д. (2023). МОРФОФУНКЦИОНАЛЬНЫЕ ОСНОВЫ ВЫСОКИХ ФУНКЦИОНАЛЬНЫХ ВОЗМОЖНОСТЕЙ СПОРТСМЕНОВ В СВЕТЕ УПРОЩЕННОЙ ЗАРУБЕЖНОЙ КЛАССИФИКАЦИИ СПОРТА. ЧАСТЬ 1. Человек. Спорт. Медицина, 22(4), 158-169. https://doi.org/10.14529/hsm220419
Выпуск
Раздел
Спортивная тренировка
