DOPPLER ECHOCARDIOGRAPHIC ANALYSIS OF EXERCISE-INDUCED ADAPTATION OF LEFT VENTRICULAR MUSCLE MASS AND ARTERIAL VESSELS IN YOUNG COMPETITIVE ATHLETES OF VARIOUS SPORTS / 体力科学

The purpose of this study was to analyze morphological and functional changes in the left ventricular muscle mass and vessel diameters of the arteries in young competitive athletes of various sports and evaluate the correlation between the heart and arterial vessel under the training environment in this latter half of the growth period. The subjects were 51 male college student athletes (mean age, 19.6±0.4 years) of 6 competitive sports (archery, weight lifting, swimming, short-distance races, middle-distance races, and long-distance races) . The diameters of the right and left common carotid arteries, right and left radial arteries, right and left foot dorsal arteries, and the aorta and the left ventricular muscle mass (LVM) were measured by Doppler echocardiography. To minimize the influences of the physique and body weight associated with growth and sport types, all data obtained by measurement were corrected by body surface area. The sum of the diameters of all the above arteries (total arterial diameter : TAD) was obtained to evaluate its correlation with the left ventricular muscle mass. The diameter of the foot dorsal artery was significantly higher in the long-distance runners than in the sprinters (P<0.05) . The diameter of the radial artery according to the 6 types of sport was the highest for weight lifting, followed in order by archery, longdistance races, middle-distance races, swimming, and short-distance races, showing a significant difference between weight lifting and short-distance races (P<0.05 ) . TAD was high for generalized endurance sports and correlated with the left ventricular muscle mass (r=0.893) . Thus, the arterial diameters significantly differed among competitive sports and were particularly increased for endurance exercise. The diameters of the local arteries used for local exercise were also increased. When TAD as a new parameter and its ratio per body surface area were calculated, there was a high correlation between the heart (left ventricular muscle mass) and the arterial diameter. These results suggest that exercise adaptation can he evaluated in the arterial system in svstemic circulation as well as the nervous and muscular systems.

Normal Values of Left Ventricular Mass and Left Ventricular Mass Index and Criteria for Left Ventricular Hypertrophy by Echocardiography in Korean

BACKGROUND: Left Ventricular hypertrophy(LVH) is welll known independent predictors of cardiovascular morbidity and mortality. Recently echocardiography is popular method to measure Left Ventricular Mass(LVM) and detect LVH. The purpose of this study is to determine the mean values of LVM and criteria for LVH in Korean. METHODS: Two hundered and fifty five subjects who participate in the health clinic were selected and studied(among them, 47 subjects were excluded according to exclusion criteria). History, physical examination, routine laboratories, and echocardiography were performed ot all of the subjects. RESULTS: The mean values of LVM, LVM corrected for body surface area(BSA), and LVM corrected for height are respectively : 199g, 114g/m2, and 119g/m in 119 Korean men, and 168g, 107g/m2, and 108g/m in 89 women, by echocardiography in accordance with the American Society of Echocardiography(ASE) convention. The criteria for LVH, based on mean plus two standard deviation for LVM, LVM/BSA, and LVM/height are, respectively : 301g, 168g/m2, and 181g/m in men, and 262g, 165g/m2, and 168g/m in women. CONCLUSIONS: The prevalence of LV hypertrophy in the evtire study group using LV mass/surface criteria and LV mass/height are respectively 7.6% in men and 10.9% in women and 6.9% in men and 10% in women. There are little difference of the prevalance rate of LV Hypertrophy by whichever criteria were used, either based on LVM/body surface or LVM/height while still correcting for body size.

The Difference of the Rate of Regression of the left Ventricular Mass between the Age Groups in the Hypertensive Patients with the Left Ventricular Hypertrophy with the Control of Blood Pressure by Angiotensin Converting Enzyme Inhibitor

The left ventricular hypertrophy(LVH) in the hypertensive patients is known to be associated with relatively higher risk for cardiovascular morbidity and mortality. In this sense the reversal of LVH with blood pressure control, if attained, could yeild an additional benefit of reducing cardiovascular morbidity and/or mortaility associated with hypertension. However pathogenesis of LVH, the attitude of the LVH to regerss with blood pressure control in a particular patient and whether the regression is really beneficial are not clear. In order to see the effect of angiotensin converting enzyme(ACE) inhibitors on LVH and the age group difference of the LVH regresion, if attainable, 26 hypertensive patients with LVH(LVMI:Left Ventricular Mass Index>125g/m2) were treated with enalapril or captopril for more than 12 weeks and the LVMI followed and the regression rates in younger group "A"(less than 50 years of age) and elder group "B" were compared(LVMI, level of blood pressure, kinds and dosage of enalapril or captopril were not different between the two groups). The LVMI was significantly decreased in both groups, in group A from 191.6+/-74.9g/m2 to 139.7+/-52.0g/m2, and in group B from 185.5+/-58.7g/m2 to 163.9+/-58.7g/m2. In group A the percent decrease of LVMI was significantly higher than that of group B(25.3+/-14.9% versus 10.3+/-8.6%, p<0.005). Above results suggest that enalapril and captopril are equally effective in reducing LVMI in hypertensive patients with LVH and the regression of the LVMI is more marked in the younger age group in this relatively short-term treated small population study.