Seçkin atletlerde tam kan viskozitesi ve sol ventrikül geometrisi: atlet kalbi üzerine bir çalışma

Abstract

Amaç: Bu çalışmada, bir grup seçkin sporcudaki tam kan viskozitesi ile sol ventriküler yeniden şekillenme arasında olası ilişki değerlendirilmiştir.

Gereç ve Yöntemler: Bu çalışma seçkin atletlerin (65 futbolcu, 12 basketbolcu) katılımı ile gerçekleştirildi. Sol ventrikül kütlesi, transtorasik ekokardiyografi ile hesaplandı. Tam kan viskozitesinin hesaplanması hematokriti ve toplam plazma protein konsantrasyonunu kullanan formüller aracılığıyla hem yüksek kesme hızı (HSR= 208/s) hem de düşük kesme hızında (LSR= 0.5/s) gerçekleştirildi. Sol ventrikül kütle indeksi 115 g/m2 üzeri olması sol ventrikül hipertrofisi olarak tanımlandı, Katılımcıların tam kan viskoziteleri ve klinik özellikleri sol ventrikül hipertrofisi olup olmamasına göre karşılaştırıldı.

Bulgular: Çalışmaya katılan 24 sporcuda sol ventrikül hipertrofisi mevcut idi. Tam kan viskozitesi hem yüksek kesme hızında (sol ventrikül hipertrofisi olmayan grup için HSR tam kan viskozitesi=17,4±0,89 cP karşın hipertrofi olan grup HSR tam kan viskozitesi= 17,95±0,78 cP; p= 0,011), hem de düşük kesme hızında (sol ventrikül hipertrofisi olmayan grup  için HSR tam kan viskozitesi=63,7±18,9 cP karşın hipertrofi olan grup LSR tam kan viskozitesi= 76,36±16,35 cP; p=0,006) sol ventrikül hipertrofisi  olan sporcu grubunda anlamlı şekilde daha yüksekti. Çoklu değişkenli lojistik regresyon analizinde tam kan viskozitesi düşük ve yüksek kesme değerleri için ayrı ayrı ayrı modellere alındı. Tam kan viskozitesi hem düşük kesme hızında (OR=1,057, %95 CI: 1,017-1,098; p=0,005), hem de yüksek kesme hızında (OR=2,885, %95 CI: 1,319-6,313; p=0,008) sol ventrikül hipertrofisi ile ilişki bulundu.

Sonuç: Seçkin sporcularda gözlenen sol ventrikül hipertrofisinde tam kan viskozitesinin muhtemel bir rolü olabilir.

Keywords

• sporcu
• sol ventrikül hipertrofisi
• kan viskozitesi

Whole blood viscosity and left ventricle geometry in elite athletes: a study on athlete's heart

Abstract

Aim: In this study, the relationship between whole blood viscosity and left ventricular remodeling in a group of elite athletes was evaluated.

Material and Methods: This study was carried out with the participation of elite athletes (65 footballers, 12 basketball players). Left ventricular mass was calculated by transthoracic echocardiography. The calculation of the whole blood viscosity was performed by using both the high shear rate (HSR = 208/s) and the lower shear rate (LSR = 0.5/s) through the formulas using hematocrit and total plasma protein concentration. Left ventricular mass index above 115 g/m2 was defined as left ventricular hypertrophy. The whole blood viscosities and clinical features of the participants were compared according to the presence of left ventricular hypertrophy.

Results: Left ventricular hypertrophy was present in 24 athletes.Left ventricular hypertrophy was present in 24 athletes. Whole blood viscosity at both high shear rate (HSR whole blood viscosity for the group without left ventricular hypertrophy = 17.4 ± 0.89 cP, vs  HSR whole blood viscosity for the group with hypertrophy= 17.95 ± 0.78 cP; p = 0.011), LSR whole blood viscosity for group without left ventricular hypertrophy = 63.7 ± 18.9 cP vs  LSR whole blood viscosity for the group  with hypertrophy = 76.36 ± 16.35 cP; p = 0.006) left ventricular hypertrophy was significantly higher in the group of athletes. In multivariate logistic regression analysis, whole blood viscosity was taken to separate models for low and high shear rates. Whole blood viscosity at the low shear rate (OR=1.057, 95% CI: 1.017-1.098; p=0.005), as well as at the high shear rate (OR=2.885, 95% CI: 1.319-6.313; p=0.008) was significantly associated with left ventricular hypertrophy.

Conclusion: Whole blood viscosity may have a possible role in left ventricular hypertrophy observed in elite athletes. 

Keywords

• athlete
• left ventricular hypertrophy
• blood viscosity

References

1. 1. Sloop GD, Weidman JJ, St Cyr JA. The systemic vascular resistance response: a cardiovascular response modulating blood viscosity with implications for primary hypertension and certain anemias. Ther Adv Cardiovasc Dis 2015; 9: 403-11.
2. 2. Sloop G, Holsworth RE Jr, Weidman JJ, St Cyr JA. The role of chronic hyperviscosity in vascular disease. Ther Adv Cardiovasc Dis 2015; 9: 19-25.
3. 3. Devereux RB, Drayer JI, Chien S et al. Whole blood viscosity as a determinant of cardiac hypertrophy in systemic hypertension. Am J Cardiol 1984; 54: 592-95.
4. 4. Höieggen A, Fossum E, Reims H, Kjeldsen SE. Serum uric acid and hemorheology in borderline hypertensives and in subjects with established hypertension and left ventricular hypertrophy. Blood Press 2003; 12: 104-10.
5. 5. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975; 82: 521-24.
6. 6. Fagard RH. Impact of different sports and training on cardiac structure and function. Cardiol Clin 1997; 15: 397-412.
7. 7. Mosteller RD. Simplified calculation of body-surface area. N Engl J Med 1987; 317: 1098
8. 8. Lang RM, Badano LP, 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. Eur Heart J Cardiovasc Imaging 2015; 16: 233–70.

9. 9. Galderisi M, Cosyns B, Edvardsen T et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2017; 18: 1301-10.
10. 10. Devereux RB, Alonso DR, Lutas EM et al. Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am J Cardiol 1986; 57: 450-58
11. 11. de Simone G, Devereux RB, Chien S, Alderman MH, Atlas SA, Laragh JH. Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults. Circulation 1990; 81: 107–17.
12. 12. Tamariz LJ, Young JH, Pankow JS et al. Blood viscosity and hematocrit as risk factors for type 2 diabetes mellitus: the atherosclerosis risk in communities (ARIC) study. Am J Epidemiol 2008; 168: 1153–1160.
13. 13. Nwose EU, Richards RS. Whole blood viscosity extrapolation formula: note on appropriateness of units. N Am J Med Sci 2011; 3: 384–86.
14. 14. Rawlins J, Bhan A, Sharma S. Left ventricular hypertrophy in athletes. Eur J Echocardiogr 2009; 10: 350-356.
15. 15. Caselli S, Pelliccia A. Interpretation of left ventricular geometry in athletes. Int J Cardiol 2018; 267: 143-44.
16. 16. Ghorayeb N, Batlouni M, Pinto IM, Dioguardi GS. Left ventricular hypertrophy of athletes: adaptative physiologic response of the heart. Bras Cardiol 2005; 85: 191-97
17. 17. Holsworth RE Jr, Cho YI, Weidman J. Effect of hydration on whole blood viscosity in firefighters. Altern Ther Health Med 2013; 19: 44-49.
18. 18. Oh MS, Cho SJ, Sung J, Hong KP. Higher blood pressure during light exercise is associated with increased left ventricular mass index in normotensive subjects. Hypertens Res 2018; 41: 382-87.
19. 19. Montgomery HE, Clarkson P, Dollery CM et al. Association of angiotensin-converting enzymes gene I/D polymorphism with change in left ventricular mass in response to physical training. Circulation 1997; 96: 741-47.