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운동유발성 고혈압 마라톤주자의 심전도상 좌심실 비대와 QT분산에 관한 연구

The study of left ventricular hypertrophy in ECG and QT dispersion in marathon runner with exercise-induced hypertension.

김영주|오재근|박순철
한국운동생리학회|2015.05|운동과학 (Exercise Science)|제24권 제2호|pp. 117-123|DOI 10.15857/ksep.2015.24.2.117

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중년남성ECG심전도마라톤marathonmiddle-aged menQT 분산운동유발성고혈압좌심실 비대exercise induced hypertension(EIH)left ventricular hypertrophyQT dispersion

초록

연구목적: 본 연구는 중년 남성 마라톤 주자들을 대상으로 급사의 예측 요인으로 알려진 좌심실 비대와 QT dispersion을 비교⦁분석하기 위하여 실시하였다. 연구방법: 연구 대상자는 40세 이상 60세 이하의 신체 건강한 남성 아마추어 중년 마라톤 주자들을 대상으로 Exercise-Induced Hypertension 집단(n=16), Normal 집단(n=16), 그리고 마라톤 운동 경험이 없는 Control 집단(n=16)을 표집대상으로 구성하였다. 모든 집단은 좌심실 비대와 QT dispersion와 운동부하검사를 실시하였다. 연구결과 1. 심박수변화로 안정시 및 최대심박수는 집단 간 차이가 없었다. 회복기 심박수는 2분과 5분때에 A집단이 C집단보다 각각 유의하게 낮았으며(p<.05) 회복기 3분때는 A 집단과 B집단이 C집단에 비해 각각 유의하게 낮은 것으로 나타났다(p<.001, p<.01). 2. 혈압의 변화로 안정시 수축기혈압은 A와 B집단이 C집단보다 각각 유의하게 높았지만(p<.05) 안정시 이완기 혈압은 집단 간 차이가 없었다. 최대수축기 혈압은 A집단이 B와 C집단보다 각각 유의하게 높았으며(p<.001) B집단이 C집단보다 유의하게 높았다(p<.05). 최대 이완기혈압은 집단 간 유의한 차이가 없었다. 회복기 2분과 3분때의 수축기혈압은 A집단이 B집단보다 각각 유의하게 높았고(p<.01, p<.05), A집단은 C집단보다 각각 유의하게 높았으며(p<.001), B집단은 C집단보다 각각 유의하게 높았다(p<.05, p<.01). 회복기 5분때의 수축기 혈압은 A집단이 B집단과 C집단보다 각각 유의하게 높았다(p<.01, p<.001). 회복기 이완기혈압은 2분, 3분, 5분때에 집단 간 차이는 없었다. 3. 최대산소섭취량(VO2max)과 운동부하검사 시간(ET)은 A와 B집단이 C집단보다 각각 유의하게 높은 것으로 나타났다(p<.001). 4. 좌심실 비대(LVH)는 A집단과 B집단이 C집단보다 유의하게 큰 것으로 나타났다(p<.001, p<.01). 5. 안정시 QT dispersion은 A집단이 C집단에 비해 유의하게 높은 것으로 나타났다(p<.05). 회복기 2분, 3분, 5분 QT dispersion은 집단 간 차이는 없었다. 결론: 심폐체력은 EIH 집단과 Normal 집단이 Control 집단보다 유의하게 높았다. 반면에 EIH집단과 Normal 집단은 control 집단보다 높은 좌심실 비대와 안정시 수축기 혈압이 높았으며 EIH는 Control 집단보다 유의하게 높은 QT dispersion을 보였다. 이와 같이 중년 남성 마라톤 주자들에서 심혈관계에 부정적인 요인들이 발견되었으므로 EIH 집단에서 Control 집단보다 유의하게 높았지만 정상 범위로 나타나 향후 EIH 집단에 대한 임상적인 평가를 위해 추적 관찰이 필요할 것이다.

Abstract

PURPOSE: The purpose of this study was to compare and analyze left ventricular hypertrophy(LVH) and QT dispersion which have been known as unpredictable causes of sudden death, among Exercise-Induced Hypertension(EIH). METHODS: Normal Hypertension Group and Control Group in middle age-marathoners. Total 48 healthy male marathoners(EIH: 16, NG: 16, Con: 16) were participated in this research. Quinton stress test system was used to measure Left Ventricular Hypertrophy(LVH) and QT dispersion. Graded exercise test was executed by treadmill. RESULTS: LVH in EIH and Normal group(NG) was significantly greater than in Control group(CON)(p<.001, p<.01). Heart rate in EIH and NG during recovery phases(2 min. and 3 min.) was more lower than in CON(p<.001, p<.01) and heart rate of EIH at recovery 5 min. is lower than in CON(p<.05). The systolic blood pressure at rest, EIH was greater than in NG and CON(p<.05, p<.01). The systolic blood pressure of EIH at maximal, was higher than in the other groups and NG was also greater than in CON(p<.001, p<.001, p<.05). The systolic blood pressure of EIH at recovery 2 was higher than in the other groups and NG was also greater than in CON(p<.01, p<.001, p<.05). At recovery 3 min., systolic blood pressure of EIH was higher than in the others and NG was significant greater than in CON(p<.05, p<.001, p<.01). Systolic blood pressure in EIH at recovery 5 min. was higher than in NG and CON(p<.01, p<.001). Cardiopulmonary function in EIH and NG were significantly greater compared to CON(p<.001). QT dispersion of EIH at rest was significantly higher than in CON(p<.05). There were no differences among the groups at recovery phases(2 min., 3 min. and 5 min.). CONCLUSIONS: In EIH group, systolic blood pressure and QT dispersion that could have a negative effect on cardiovascular diseases is significantly greater than CON at rest. So this study could suggest that negative factors in middle-aged male marathoners with EIH have been found. Further researches will be necessary for identifying an effect of continuous high intensity exercise on cardiovascular system.

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