Возможности эхокардиографического скрининга у спортсменов. Часть 1. Нормативные показатели

Цель исследования: оценить пригодность существующих отечественных и международных рекомендаций по использованию ЭхоКГ в качестве скрининговой методики обследования спортсменов; выбрать нормативы, характеризующие сердце в разных видах спорта на основании собственных исследований.
Материалы и методы: проведен метаанализ 38 отечественных и зарубежных источников литературы по результатам эхокардиографического обследования спортсменов. Изучены показатели 2647 спортсменов‑мужчин в возрасте от 16 до 45 лет, выступающих за сборные команды Москвы и прошедших углубленное медицинское обследование на базе Клиники спортивной медицины МНПЦМРВиСМ ДЗ г. Москвы.
Результаты: размеры сердца у спортсменов незначительно отличаются от популяционных показателей, однако в 14–45% случаев выходят за референсные значения. В отсутствие заболеваний сердца наибольшие размеры левого желудочка (ЛЖ) отмечаются у лиц, тренирующих выносливость. При этом высокие функциональные возможности коррелируют с увеличенным объемом ЛЖ, индексированным по ППТ (для КДО/ППТ и VO2 ПАНО r = 0,52, p < 0,05).
Заключение: эхокардиографический скрининг спортсменов позволяет получить достаточную информацию для выявления врожденной или возникшей в процессе чрезмерных тренировочных нагрузок патологии. В качестве нормативов целесообразно использовать популяционные показатели, выраженные в центильных величинах.

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