Title (srp)

Krvni pritisak kod profesionalnih sportista: povezanost sa morfofunkcionalnim karakteristikama leve komore i aerobnim kapacitetom : doktorska disertacija

Author

Suzić Lazić, Jelena, 1981-

Contributor

Mazić, Sanja, 1965-
Radosavljević-Radovanović, Mina, 1964-
Nešić, Dejan, 1974-
Tadić, Marijana, 1982-

Description (eng)

Background High blood pressure (BP) is the most common cardiovascular (CV) disease inathletes. As many as 80% of adolescent athletes with elevated CP on preventive examinationswill develop chronic hypertension after one year, and elevated BP in early adulthood isassociated with a higher incidence of mortality and morbidity from CV disease a few decadeslater.Aims To evaluate the aerobic capacity and morphofunctional characteristics of the heart ofhealthy athletes in groups formed according to blood pressure and to examine the relationshipbetween blood pressure, echocardiographic characteristics of the left ventricle (LV), andaerobic capacity of athletes.Methods The cross-sectional study was performed in the pre-competition period. It included332 professional athletes. Subjects were divided into three groups according to blood pressurevalues, by the current recommendations of the European Society of Cardiology (2018): (1)optimal KP <120/80mmHg, (2) normal KP: SKP 120-129mmHg and/or DKP 80-84mmHgand (3) highly normal: SKP 130-139mmHg and/or DKP 85-89mmHg. After clinicalexamination, all subjects underwent biochemical blood analysis, anthropometricmeasurements, and transthoracic echocardiography. Aerobic capacity was determined using aprogressive, maximal cardiopulmonary exercise test on a treadmill. Maximum oxygenconsumption (VO2 max) was measured directly, and the kinetics of heart rate and BP weremonitored during the test.Results Our research has shown that athletes with high normal blood pressure, whencompared to counterparts with normal and optimal BP levels, have significantly lower aerobiccapacity. There were significantly higher values of resting heart rate and heart rate reserves inathletes with high normal blood pressure. Echocardiography revealed significantmorphological and functional differences among athletes in relation to blood pressure:athletes with high normal BP had significantly higher left ventricular volume and enddiastolicdiameter of the LV, but also significantly different variables obtained by tissueDoppler: averaged peak annular early diastolic filling velocity (e'), the ratio of the maximumvelocity of transmitral flow and peak annular early diastolic filling velocity (E/e`) and theratio of peak annular early and late diastolic filling velocity (e'/a'). Multivariate analysis hasshown that the variables E/e and e’/a’, sensitive markers of myocardial mechanics duringdiastole, are independent predictors of VO2 max in all subjects.Conclusion Professional athletes with high normal blood pressure had significantly loweraerobic capacity, less favorable autonomic balance as well as variables of diastolic functioncompared to those who had optimal and normal blood pressure. Echocardiographicexamination and cardiopulmonary testing of professional athletes during preparticipationscreening enable the identification of athletes with high normal blood pressure, stratificationof cardiovascular risk, and timely implementation of preventive measures.

Description (srp)

Uvod Povišen krvni pritisak (KP) je najčešće kardiovaskularno (KV) oboljenje kod sportista.Čak 80% adolescenata sportista sa povišenim KP na preventivnim pregledima će razvitihroničnu hipertenziju nakon godinu dana, a povišen KP u ranom odraslom dobu povezuje sesa višom incidencom mortaliteta i morbiditeta od KV oboljenja nekoliko decenija kasnije.Cilj Evaluacija aerobnog kapaciteta i morfofunkciolnalnih karakteristika srca zdravihsportista u grupama formiranim prema visini krvnog pritiska i ispitivanje povezanosti izmeđuvisine krvnog pritiska, ehokardiografskih karakteristika leve komore srca (LK) i aerobnogkapaciteta sportista.Metode Studija preseka je obavljena u predtakmičarsko periodu. Obuhvatila je 332profesionalnih sportista, muškog pola. Ispitanici su podeljeni u tri grupe prema vrednostimakrvnog pritiska, u skladu sa aktuelnim preporukama Evropskog udruženja kardiologa (2018):(1) optimalan KP<120/80mmHg, (2) normalan KP: SKP 120-129mmHg i/ili DKP 80-84mmHg i (3) visoko normalan: SKP 130-139mmHg i/ili DKP 85-89mmHg. Svimispitanicima je nakon detaljne anamneze i fizikalnog pregleda, urađena biohemijska analizakrvi i izvršena antropometrijska merenja, kao i transtorakalna ehokardiografija. Aerobnikapacitet je određen primenom progresivno rastućeg, maksimalnog ergospirometrijskog testana pokretnoj traci, direktnim merenjem maksimalne potrošnje kiseonika (VO2 max). Tokomtesta su praćene i kinetika srčane frekvencije i KP.Rezultati Istraživanje je pokazalo da sportisti u grupi visoko normalan KP, u poređenju sasportistima sa optimalnim i normalnim KP, imaju statistički značajno niži aerobni kapacitet.Utvrđene su značajno više vrednosti srčane frekvencije u miru i rezerve srčane frekvencijekod sportista sa visoko normalnim vrednostima krvnog pritiska u poređenju sa onima koji suimali optimalan KP. Sportisti sa visoko normalnim KP imali su značajno veći volumen LK iend-dijastolni dijametar LK, ali i značajno različite vrednosti varijabli dobijene tkivnimdoplerom: maksimalne brzine ekskurzije mitralnog anulusa u ranoj dijastoli (e'), odnosmaksimalne brzine transmitralnog protoka i ekskurzije mitralnog anulusa u ranoj dijastoli(E/e`) i odnos maksimalnih brzina transmitralnog protoka u ranoj i kasnoj dijastoli (e’/a’).Multivarijantnom analizom pokazano je da su varijable E/e i e’/a’, koje su senzitivni markerimehanike miokarda tokom dijastole, nezavisni prediktori maksimalne potrošnje kiseonika kodsvih ispitanika.Zaključak Kod profesionalnih sportisti sa visoko normalnim krvnim pritiskom utvrđen jestatistički značajno niži aerobni kapacitet, nepovoljniji autonomni balans i izmenjene varijabledijastolne funkcije u poređenju sa onima čije su vrednosti krvnog pritiska bile u kategorijioptimalan i normalan KP. Ehokardiografski pregled i merenje aerobnog kapaciteta u okviruobaveznog sportskomedicinskog pregleda omogućava identifikaciju sportista sa visokonormalnim KP, stratifikaciju KV rizika i blagovremenu implementaciju preventivnih mera.

Description (srp)

Medicina - Kardiologija / Medicine- Cardiology Datum odbrane: 30.09.2022.

Object languages

Serbian

Date

2022

Rights

Creative Commons License
This work is licensed under a
CC BY-NC-ND 3.0 AT - Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Austria License.

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Subject

OSNO - Opšta sistematizacija naučnih oblasti, Kardiologija

blood pressure, aerobic capacity, professional athletes, ergospirometry, echocardiography

Identifiers