Introduction

Prolonged strenuous exercise can transiently decrease cardiac function. Other studies have identified three major exercise-induced pulmonary changes: bronchoconstriction, dynamic hyperinflation and pulmonary oedema with reduced alveolar–capillary membrane diffusing capacity. This study investigated whether athletes with one of these pulmonary dysfunctions following a very long-distance triathlon exhibit similar cardiac alterations as those without dysfunctions.

Methods

Sixty trained male triathletes (age 39 ± 9 years) underwent baseline and post-race assessments, including echocardiography (with standard, 2D-strain and myocardial work assessments), spirometry and double-diffusion technique to evaluate alveolar–capillary membrane diffusing capacity for carbon monoxide (DM_CO). Cardiac function in athletes with exercise-induced bronchoconstriction (> 10% decrease FEV₁), dynamic hyperinflation (> 10% decrease inspiratory capacity) or impaired diffusion capacity (> 20% decrease DM_CO/alveolar volume) were compared with those without these dysfunctions.

Results

The race lasted 14 h 20 min ± 1 h 26 min. Both systolic and diastolic cardiac functions declined post-race. Post-race, 18% of athletes had bronchoconstriction, 58% dynamic hyperinflation and 40% impaired diffusing capacity. Right and left ventricular standard and 2D-strain parameters were similar before the race in all subgroups and changed similarly post-race, except E/E′, which decreased in the bronchoconstriction subgroup and increased in those with diffusion impairment. Global constructive work decreased by ~ 19% post-race (2302 ± 226 versus 1869 ± 328 mmHg%, P < 0.001), more pronounced in athletes with diffusion impairment compared with others (− 26 ± 13 versus − 15 ± 9%, P = 0.001) and positively correlated with DM_CO/alveolar volume reduction.

Conclusion

After a very long-distance triathlon, bronchoconstriction and hyperinflation were not associated with significant cardiac changes, whereas impaired alveolar–capillary membrane diffusing capacity was associated with a more significant decline in myocardial function. These findings highlight the complex relationship between pulmonary gas exchange abnormalities and cardiac fatigue following prolonged strenuous exercise.

中文翻译：

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超长距离铁人三项后运动诱发肺损伤的男性运动员的心脏疲劳

 介绍

长时间的剧烈运动会暂时降低心脏功能。其他研究已经确定了三种主要的运动诱发的肺部变化：支气管收缩、动态过度充气和肺水肿伴肺泡-毛细血管膜弥散能力降低。这项研究调查了在超长距离铁人三项后患有这些肺功能障碍之一的运动员是否表现出与没有功能障碍的运动员相似的心脏改变。

 方法

60 名训练有素的男性铁人三项运动员 （年龄 39 ± 9 岁） 接受了基线和赛后评估，包括超声心动图（标准、2D 应变和心肌工作评估）、肺活量测定和双扩散技术，以评估肺泡-毛细血管膜的一氧化碳弥散能力 （DM_CO）。将运动性支气管收缩 （> FEV₁₀% 降低）、动态过度充气 （> 吸气量降低 10%） 或弥散能力受损 （> DM_CO/肺泡体积降低 20%） 的运动员的心脏功能与没有这些功能障碍的运动员进行了比较。

 结果

比赛持续了 14 小时 20 分钟± 1 小时 26 分钟。赛后收缩和舒张心脏功能均下降。赛后，18% 的运动员出现支气管痉挛，58% 的运动员出现动态过度充气，40% 的运动员弥散能力受损。所有亚组的右心室和左心室标准参数和 2D 应变参数在赛前相似，赛后变化相似，但 E/E′ 除外，它在支气管收缩亚组中降低，在弥散障碍亚组中增加。赛后整体建设性工作减少了 ~ 19%（2302 ± 226 对 1869 ± 328 mmHg%，P < 0.001），与其他人相比，弥散障碍运动员更为明显（-26 ± 13 对 -15 ± 9%，P = 0.001），并且与 DM_CO/肺泡体积减少呈正相关。

 结论

在超长距离铁人三项后，支气管收缩和过度充气与显着的心脏变化无关，而肺泡-毛细血管膜弥散能力受损与心肌功能更显着的下降有关。这些发现强调了肺气体交换异常与长时间剧烈运动后心脏疲劳之间的复杂关系。