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首页> 外文期刊>Pulmonary Circulation >The Response of the Pulmonary Circulation and Right Ventricle to Exercise: Exercise-Induced Right Ventricular Dysfunction and Structural Remodeling in Endurance Athletes (2013 Grover Conference Series):
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The Response of the Pulmonary Circulation and Right Ventricle to Exercise: Exercise-Induced Right Ventricular Dysfunction and Structural Remodeling in Endurance Athletes (2013 Grover Conference Series):

机译：肺循环和右心室对运动的反应：运动引起的右心室功能障碍和耐力运动员的结构重塑（2013年格罗弗会议系列）：

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There is unequivocal evidence that exercise results in considerable health benefits. These are the result of positive hormonal, metabolic, neuronal, and structural changes brought about by the intermittent physiological challenge of exercise. However, there is evolving evidence that intense exercise may place disproportionate physiological stress on the right ventricle (RV) and the pulmonary circulation. Both echocardiographic and invasive studies are consistent in demonstrating that pulmonary arterial pressures increase progressively with exercise intensity, such that the harder one exercises, the greater the load on the RV. This disproportionate load can result in fatigue or damage of the RV if the intensity and duration of exercise is sufficiently prolonged. This is distinctly different from the load imposed by exercise on the left ventricle (LV), which is moderated by a greater capacity for reductions in systemic afterload. Finally, given the increasing RV demand during exercise, it may be hypothesized that chronic exercise–induced cardiac remodeling (the so-called athlete's heart) may also disproportionately affect the RV. Indeed, there is evidence, although somewhat inconsistent, that RV volume increases may be relatively greater than those for the LV. Perhaps more importantly, there is a suggestion that chronic endurance exercise may cause electrical remodeling, predisposing some athletes to serious arrhythmias originating from the RV. Thus, a relatively consistent picture is emerging of acute stress, prolonged fatigue, and long-term remodeling, which all disproportionately affect the RV. Thus, we contend that the RV should be considered a potential Achilles' heel of the exercising heart.
机译：有明确的证据表明，锻炼可带来相当大的健康益处。这些是运动间歇性生理挑战带来的激素，代谢，神经元和结构性正变化的结果。但是，有不断发展的证据表明，剧烈运动可能会在右心室（RV）和肺循环上施加不成比例的生理压力。超声心动图和侵入性研究均一致表明肺动脉压随运动强度逐渐增加，因此，运动越艰苦，右室负荷就越大。如果充分延长运动强度和持续时间，这种不相称的负荷可能导致RV疲劳或损坏。这与左心室（LV）的运动负荷明显不同，左心室（LV）的负荷较大，可以减轻全身后负荷。最后，鉴于运动期间对RV的需求增加，可以假设慢性运动引起的心脏重塑（所谓的运动员心脏）也可能对RV产生不成比例的影响。确实，有证据表明，尽管略有不一致，但右室容积的增加可能相对大于左室容积的增加。也许更重要的是，有一项建议表明，长期耐力运动可能会导致电重构，使一些运动员容易患上源自RV的严重心律不齐。因此，出现了相对一致的急性压力，长期疲劳和长期重塑的现象，这些都对RV产生了不成比例的影响。因此，我们认为应将RV视为锻炼心脏的潜在跟腱。

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