有氧运动对中国人和美国白人心血管系统与自主神经功能的影响
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摘要
随着人们生活方式和饮食结构的改变,心血管疾病(CVD)的发病率正在逐年上升。目前CVD死亡率占到全球死亡率的1/3,远远超过其他疾病引发的死亡人数,占据全球死因第一位,CVD的发病率和死亡率的不断提高,大幅增加了全球医疗资源的耗费和财政支出。目前CVD已经成为全球性的对人类健康最具威胁的重大公共卫生问题。由于不同的种族在体质、生活方式以及饮食文化等方面的差异,CVD发病率和死亡率在各种族之间也存在差异。目前一致认为非洲裔黑人的CVD发病率最高,但是对美国白人(高加索)和中国人对比研究的结果却不尽相同。目前普遍认为,高血压、大动脉的收缩舒张功能障碍、心脏收缩舒张功能的减退和自主神经调节功能的降低是引发CVD的独立危险因素。
研究目的：本研究通过分析有氧运动对中国人和美国白人的血流动力学、动脉的收缩舒张功能、心脏形态学、心脏的舒缩功能以及心率变异性和动脉压力感受器敏感性等指标的影响,研究有氧运动对中国人和美国白人心血管系统与自主神经功能的影响。
研究方法：62名(32名中国人,30名美国白人,其中男、女各半)年龄在18-40岁的受试者通过招募自愿参加本次研究。所有受试者均没有高血压、肥胖和其他心血管以及代谢疾病,并且没有吸烟史。在第一次测试中,运用K4b2心肺功能测定仪(Quark b2;Cosmed, Italy)和跑台reeMotion;Fitness Blowout,USA),依据Bruce跑台模式,对受试者进行最大摄氧能力的测试(VO2max)。本次测试,主要获取受试者VO2peak、HRmax、R等指标。第一次测试结束后48小时-1周内进行第二次测试。在第二次测试中,首先测试受试者基础状态的指标：(1)利用自动血压测量仪(HEM-907XL；Omron, Japan)和脉搏波分析仪(Sphygmocor Px;Atcor Medical, Australia)测试受试者血流动力学和中心动脉功能指标以及安静状态心率；(2)利用彩色多普勒超声波(ProSound SSD-α10; Aloka, Japan)测试受试者颈动脉和股动脉动脉功能以及心脏形态学和功能指标；(3)利用逐级心跳检测仪(Finometer;FMS,Netherlands)测试受试者动脉压力感受器敏感性指标；(4)利用多导电生理记录仪(Biopac MP100; BioPac systems Inc, US)测试受试者心率变异性指标。在基础状态指标测试结束后,受试者进行45分钟70%心率储备[目标心率=(最大心率-安静心率)×70%+安静心率]的有氧运动,运动结束后30分钟和60分钟分别进行与基础状态相同指标的测试。在数据分析时,用独立样本t检验比较2个不同群体间的基础状态指标;用2×3repeatedmeasures ANOVA(2个种族×3个时间点)方法分析两个群体在运动前、运动后30分钟和运动后60分钟各指标间的差异,并用Turkey法检验组间差异。
结果：
(1)对血流动力学评价指标的影响：45分钟70%心率储备的一次急性有氧运动对中国人和美国白人血流动力学指标的影响存在显著性差异(p<0.05),可以降低中国人肱动脉SBP(从109±11mmHg到108±10mmHg到106±9mmHg)和美国白人(从121±9mmHg到117±11mmHg到114±11mmHg)肱动脉SBP;可以降低美国白人的肱动脉DBP(从65±6mmHg到65±5mmHg到64±5mmHg)和MBP(从82±6mmHg到83±6mmHg到81±6mmHg)；相反,增加中国人的肱动脉DBP(从60±5mmHg到61±5mmHg到62±5mmHg)和MBP(从75±6mmHg到77±6mmHg到77±5mmHg)；能够降低美国白人的颈动脉SBP(从112±12mmHg到114±16mmHg到108±16mmHg),对中国人的颈动脉SBP(从101±14mmHg到104±15mmHg到101±14mHg)影响不大。
(2)对动脉功能评价指标的影响：在运动前、运动后30分钟和运动后60分钟,颈动脉Ep在中国人(从63.3±16.0到70.2±21.6到68.4±18.6)和美国白人(从61.1±14.5到74.9±21.1到63.8±19.3)之间存在显著性差异(p<0.05),运动后60分钟时,中国人Ep升高的程度大于美国白人；颈动脉僵硬系数(p)在中国人(从5.9±1.3到6.5±1.7到6.5±1.6)和美国白人(从5.2±1.2到6.4±1.4到5.6±1.3)之间存在显著性差异(p<0.05)；颈动脉AC在中国人(从1.2±0.3到1.1±0.4到1.2±0.3)和美国白人(从1.3±0.4到1.0±0.3到1.3±0.4)之间存在显著性差异(p<0.05),但均能恢复到运动前水平；股动脉AC在中国人(从1.4±0.5到1.4±0.6到1.3±0.6)和美国白人(从1.3±0.5到1.2±0.4到1.4±0.6)之间也存在显著性差异(p<0.05),中国人AC略有降低,而美国白人略有升高。
(3)对心脏评价指标的影响：一次急性有氧运动可引起中国人LVIDd(从47.6±5.9mm到47.6±5.4mm到46.8±5.2mm)和EDV(从108±32ml到107±29ml到104±29m1)的减小,LVIDs(从29.6±4.0mm到30.8±4.5mm到30.0±4.0mm)和ESV(从35±12ml到39±14ml到36±11ml)的增加,而只引起美国白人的LVIDd(从50.2±5.5mm到48.04.7mm到49.3±4.7mm)和EDV(从121±31ml到110±27ml到116±27m1)的减小；学术检测,运动后60分钟美国白人的Em(从19.9±4.5cm/s到17.8±3.6cm/s到18.6±3.9cm/s)下降的程度大于中国人(从18.0±3.2cm/s到18.1±3.0cm/s到17.8±3.3cm/s),Am表现为,中国人(从8.5±2.3cm/s到9.6±2.3cm/s到9.8±2.4cm/s)增加的程度高于美国白人(从8.2±2.1cm/s到8.0±2.1cm/s到8.6±3.0cm/s)；PWD技术检测,中国人eV降低的程度(从86.4±13.04cm/s到77.6±11.84cm/s到76.7±12.14cm/s)大于美国白人(从84.1±16.24cm/s到78.1±12.74cm/s到79.5±13.04cm/s),中国人aV的变化幅度(从45.8±11.04cm/s到53.9±9.4cm/s到58.9±9.94cm/s)大于美国白人(从41.7±10.34cm/s到45.8±13.44cm/s到46.3±11.14cm/s)。
(4)对自主神经功能评价指标的影响：一次急性有氧运动能够引起运动后LF/HF比值的增加,中国人的增加程度(从192±194到517±528到296±257)大于美国白人(从192±115到292±226到233±168)；中国人nHF指标(从0.43±0.2nu到0.26±0.16nu到0.32±0.16nu)降低的幅度大于美国白人(从0.38±0.14nu到0.32±0.15nu到0.36±0.16nu)；分析nLF发现,中国人升高的程度(从0.55±0.2nu到0.72±0.18nu到0.65±0.17nu)大于美国白人(从0.6nu±0.15到0.65±0.17nu到0.62±0.17nu)；时域指标pNN50在中国人(从23±18.1%到2.3±4.2%到12.3±17.8%)和美国白人(从31.8±24.6%到15.4±20.7%到21.3±21.7%)之间也存在显著性差异(p<0.05)；分析BRS发现,中国人表现降低后略微升高(从12.8±6.1ms/mmHg到10.7±15.61ms/mmHg到10.8±5.9]ms/mmHg)而美国白人表现持续升高(从14.2±91ms/mmHg到14.7±11.61ms/mmHg到15.8±9.91ms/mmHg)；BRS(up-up)在中国人(从18.7±10.3ms/mmHg到11.3±8.2ms/mmHg到15.7±11.1ms/mmHg)和美国白人(从20.2±14.7ms/mmHg到23±20ms/mmHg到19.5±13.3ms/mmHg)之间存在显著性差异(p<0.05),中国人表现为先降低后升高,美国白人表现为先升高后降低。
结论：
(1)有氧运动对两个群体间血流动力学的影响表现为,有氧运动能够降低中国人和美国白人的肱动脉SBP,而且降低美国白人肱动脉SBP的效果优于中国人；有氧运动还可以降低美国白人的肱动脉DBP和MAP,而增加中国人的肱动脉DBP和MAP；有氧运动能够降低美国白人颈动脉SBP,对中国人颈动脉SBP影响不大。结果提示,急性有氧运动在降低血压和心脏负荷方面,美国白人的效果优于中国人。
(2)有氧运动对两个群体间动脉功能的影响表现为,有氧运动可以提高美国白人颈动脉AC、Ep、p,降低中国人颈动脉AC和提高中国人颈动脉Ep、p,在对颈动脉AC、Ep和p指标的影响程度上美国白人均高于中国人；可以提高美国白人股动脉AC并降低中国人的股动脉AC,对股动脉其他指标(股动脉Ep、β)的影响,在两个群体间没有明显差异。研究结果提示,急性有氧运动可能通过提高美国白人动脉的顺应性和弹性而改善血管功能；可能会降低中国人动脉的顺应性和弹性功能。
(3)有氧运动对两个群体间心脏的影响表现为,有氧运动通过降低LVIDd口EDV,增加LVIDs和ESV的共同作用引起中国人的SV的降低,而主要通过降低LVIDd和EDV引起美国白人的SV的降低；运动后中国人CO增加的程度高于美国白人,CO的增加主要由于HR的增加引起。结果提示,急性有氧运动可以引起每分输出量增加,中国人的增加程度高于美国白人,其增加是由心率的增加引起的；也可以引起每博输出量的减少,其原因可能是中国人因为左心室收缩不完全,美国白人因为左心室舒张不全。有氧运动可以引起左心房收缩代偿性增加,中国人增加的程度高于美国白人；可以引起左心室舒张功能的减退,主要表现为左心室的主动松弛功能和左心室快速充盈功能的减退,而且中国人降低的程度大于美国白人。结果提示,急性有氧运动能够降低心脏舒张功能,而且中国人的心脏应激变化大于美国白人。
(4)有氧运动对两个群体间自主神经调节功能的影响表现为,有氧运动能够增强自主神经的调节功能,其功能的增强主要表现为交感神经兴奋性的增强和副交感神经兴奋性的降低。中国人交感神经兴奋性增强的程度和副交感神经兴奋性降低的程度均大于美国白人。结果提示,急性有氧运动可以增强自主神经的调节功能,中国人自主神经调节的应激变化大于美国白人。
With the changing of people's lifestyle and diet, the incidence of CVD (Cardiovascular disease) is increasing year by year. Now, CVD mortality accounts for1/3of the global mortality, far more than the number of deaths caused by other diseases, is the most important cause of death. With the increasing of the incidence and mortality of CVD, the consumption of medical resources and expenditure were increased in global. At present CVD has become the most threatening to human health major public health problem in global. The morbidity and mortality of CVD were difference among difference races because the different on Physical fitness, lifestyle and diet. The popular opinion is that the highest incidence rate of CVD is African American's. But the results of comparative study of white American (Caucasian) and the Chinese were not coincident. Now, widely recognized that hypertension, aortic systolic and diastolic dysfunction, cardiac contractility and diastolic dysfunction and autonomic nervous system balance decrease are independent risk factors lead to CVD.
Objective:To compare the effect of aerobic exercise on cardiovascular and autonomic nervous system in Chinese and Caucasian by analyzing the data from hemodynamic parameters, arterial systolic and diastolic function, cardiac contractility and diastolic dysfunction, heart rate variability and baroreceptor sensitivity.
Methods:62(Chinese,32; Caucasian,30; half is male) subjects aged14-40yrs, who volunteered to participate in this study by recruiting and there were no hypertension, obesity and other cardiovascular and metabolic disease, no history of smoking. The first, V02max, HRmax, R value were gotten using metabolic cart (Quark b2; Cosmed, Italy) and treadmill (Free Motion; Fitness Blowout, USA) under the guidance of Bruce protocol. The second test was begun48hours to1week after the first test. The baseline data were gotten before aerobic exercise in the second test and then took the same measurements at30minutes and60minutes post aerobic exercise. Hemodynamic and arterial systolic and diastolic function were measured using Sphygmocor (Atcor Medical, Australia) and ProSound (Aloka, Japan); cardiac contractility and diastolic function were measured using ProSound (Aloka, Japan); baroreceptor sensitivity was measured using Finometer (FMS, Netherlands) and heart rate variability was measured using Biopac (BioPac systems Inc, US). The exercise is45minutes70%heart rate reserve aerobic exercise. Independent-samples t-test was used to compare the baseline data between Chinese and Caucasian.2×3repeats measures (2races×3 times) AVOVA was used to analyze the difference at30minutes and60minutes post a bout of acute aerobic exercise in Chinese and Caucasian.
Results:
(1)Hemodynamic parameters:There was different influence on hemodynamic parameters after a bout of45minutes70%heart rate reserve aerobic exercise in Chinese and Caucasian. The decrease of brachial SBP was difference in Chinese (from109±11mmHg to108±10mmHg to106±9mmHg) and Caucasian (from121±9mmHg to117±11mmHg to114±11mmHg)(p<0.05). The brachial DBP (form65±6mmHg to65±5mmHg to64±5mmHg) and MAP (from82±6mmHg to83±6mmHg to81±6mmHg) were decrease in Caucasian. But, the brachial DBP (from60±5mmHg to61±5mmHg to62±5mmHg) and MAP (form75±6mmHg to77±6mmHg to77±5mmHg) were increase in Chinese. The carotid SBP was decrease in Caucasian(from112±12mmHg to114±16mmHg to108±16mmHg)and there was no change in Chinese(from101±14mmHg to104±15mmHg to101±14mmHg)at60minutes post exercise.
(2)Vascular: Compare to baseline, there was different (p<0.05) change on carotid Ep between Chinese (from63.3±16.0to70.2±21.6to68.4±18.6) and Caucasian (from61.1±14.5to74.9±21.1to63.8±19.3) at30minutes and60minutes post exercise; The change of carotid P was difference (p<0.05) in Chinese (from5.9±1.3to6.5±1.7to6.5±1.6) and Caucasian (from5.2±1.2to6.4±1.4to5.6±1.3); The change on carotid AC also was difference (p<0.05) between Chinese (from1.2±0.3to l.l±0.4to1.2±0.3) and Caucasian (from1.3±0.4to1.0±0.3to1.3±0.4); there was different (p<0.05) change on femoral AC in Chinese (from1.4±0.5to1.4±0.6to1.3±0.6) and Caucasian (from1.3±0.5to1.2±0.4to1.4±0.6)
(3)Cardiac: A bout of aerobic exercise reduced SV by decreasing LVIDd (from47.6±5.9mm to47.6±5.4mm to46.8±5.2mm) and EDV (from108±32ml to107±29ml to104±29ml) and increasing LVIDs (from29.6±4.0mm to30.8±4.5mm to30.0±4.0mm) and EDV (from35±12ml to39±14ml to36±1lml) in Caucasian, the change of SV was caused by decreasing LVIDd (from50.2±5.5mm to48.0±4.7mm to49.3±4.7mm) and EDV (from121±31ml to110±27ml to116±27ml) in Chinese. Compare to baseline, the change of decrease on Em is higher in Caucasian (from19.9±4.5cm/s to17.8±3.6cm/s to18.6±3.9cm/s) than Chinese (from18.0±3.2cm/s to18.1±3.0cm/s to17.8±3.3cm/s)at60minutes post exercise; the change of increase on Am is higher in Chinese(from8.5±2.3cm/s to9.6±2.3cm/s to9.8±2.4cm/s)than Caucasian(from8.2±2.1cm/s to8.0±2.1cm/s to8.6±3.0cm/s); the change of reduce on eV is higher in Chinese(from86.4±13.04cm/s to 77.6±11.84cm/s to76.7±12.14cm/s) than Caucasian (from84.1±16.24cm/s to78.1±12.74cm/s to79.5±13.04cm/s); the change of aV is higher in Chinese (from45.8±11.04cm/s to53.9±9.4cm/s to58.9±9.94cm/s) than Caucasian (from41.7±10.34cm/s to45.8±13.44cm/s to46.3±11.14cm/s).
(4) Autonomic nervous system: LF/HF was increased after a bout of acute aerobic exercise, the change of increase was higher in Chinese (from192±194to517±528to296±257) than Caucasian (from192±115to292±226to233±168); The change of nHF was lower in Chinese (from0.43±0.2nu to0.26±0.16nu to0.32±0.16nu) than Caucasian (from0.38±0.14nu to0.32±0.15nu to0.36±0.16nu); The relative increase in nLF is higher in Chinese (from0.55±0.2nu to0.72±0.18nu to0.65±0.17nu) that in Caucasian (from0.6nu±0.15to0.65±0.17nu to0.62±0.17nu);The change of pNN50was difference between Chinese (from23±18.1%to2.3±4.2%tO12.3±17.8%) and Chinese (from31.8±24.6%to15.4±20.7%to21.3±21.7%). The BRS decreased and increased in Chinese (from12.8±6.1ms/mmHg to10.7±15.61ms/mmHg to10.8±5.91ms/mmHg) but increased in Caucasian (M.14.2±91ms/mmHg to14.7±11.61ms/mmHg to15.8±9.91ms/mmHg);The value of BRS (up-up) decreased and then increased in Chinese (from18.7±10.3ms/mmHg to11.3±8.2ms/mmHg to15.7±11.1ms/mmHg) but increased and then decreased in Caucasian (from20.2±14.7ms/mmHg to23±20ms/mmHg to19.5±13.3ms/mmHg)
Conclusions:
(1)The effect of aerobic exercise on hemodynamic: a bout of acute aerobic exercise can reduce the SBP of the brachial artery of the Chinese and Caucasian, but the change of SBP reduces was high in white Americans compare to Chinese; A bout of acute aerobic exercise can increase brachial DBP and MAP in Chinese, but decreased brachial DBP and MAP in Caucasian; Carotid SBP can been decreased in Caucasian caused by acute exercise and there was no change in Chinese. These results suggest that it is better in lowing blood pressure and cardiac load following a bout of acute aerobic exercise in Caucasian than Chinese.
(2)The effect of aerobic exercises on artery: the value of carotid AC, Ep,β can been increased in Caucasian after a bout of acute aerobic exercise, but decreased in carotid AC and increased in carotid Ep and p in Chinese and the impact was greater in Caucasian than Chinese. The exercise can reduced femoral AC in Chinese and increased in Caucasian. These results suggest that the improvement of arterial function may be due to improve arterial compliance and elasticity in Caucasian following a bout of acute aerobic exercise. But the arterial compliance and elasticity were reduced in Chinese after a bout of acute aerobic exercise.
(3) The effect of aerobic exercises on cardiac:a bout of aerobic exercise reduced SV by decreasing LVIDd and EDV, increasing LVIDs and EDV in Caucasian, the reduction of SV was caused by decreasing LVIDd and EDV in Chinese. Mainly, the left ventricular contraction is not complete in Chinese, and diastolic incomplete in Caucasian; the absolute increase in CO was higher in Chinese than Caucasian which caused by increase of heart rate after exercise; Exercise could cause a decrease in left ventricular diastolic function, but the Chinese to.recover earlier than Caucasian; could reduce left ventricular active relaxation ability, and the reduction was greater in Caucasian than Chinese; Could reduce the blood flow form left atrium to left ventricular during early diastolic, the reduction was lower in Chinese than Caucasian; could improve left ventricular compliance, the degree of improvement of left ventricular compliance of the Chinese more than Caucasian; Could reduce the left ventricular rapid filling, The change of decrease is greater in Chinese than Caucasian; could cause increasing of left atrium contraction in a compensatory which is greater in Chinese than Caucasian. These results suggest that cardiac diastolic function was reduced following a bout of acute aerobic exercise, the changes in cardiac stress was greater in Chinese than Caucasian.
(4) The effect of aerobic exercises on ANS:aerobic exercise could enhance the regulatory function of the ANS which is greater in Chinese than Caucasian. The enhancement of the regulatory function of the autonomic nervous system was caused by enhancing sympathetic nervous system excitability and reducing parasympathetic nervous system excitability. The change of enhancement of sympathetic nervous system and reduction of parasympathetic nervous system excitability were greater in Chinese than Caucasian. These results suggest that ANS function was increased following a bout of acute aerobic exercise, the changes ANS stress was greater in Chinese than Caucasian.
研究目的：本研究通过分析有氧运动对中国人和美国白人的血流动力学、动脉的收缩舒张功能、心脏形态学、心脏的舒缩功能以及心率变异性和动脉压力感受器敏感性等指标的影响,研究有氧运动对中国人和美国白人心血管系统与自主神经功能的影响。
研究方法：62名(32名中国人,30名美国白人,其中男、女各半)年龄在18-40岁的受试者通过招募自愿参加本次研究。所有受试者均没有高血压、肥胖和其他心血管以及代谢疾病,并且没有吸烟史。在第一次测试中,运用K4b2心肺功能测定仪(Quark b2;Cosmed, Italy)和跑台reeMotion;Fitness Blowout,USA),依据Bruce跑台模式,对受试者进行最大摄氧能力的测试(VO2max)。本次测试,主要获取受试者VO2peak、HRmax、R等指标。第一次测试结束后48小时-1周内进行第二次测试。在第二次测试中,首先测试受试者基础状态的指标：(1)利用自动血压测量仪(HEM-907XL；Omron, Japan)和脉搏波分析仪(Sphygmocor Px;Atcor Medical, Australia)测试受试者血流动力学和中心动脉功能指标以及安静状态心率；(2)利用彩色多普勒超声波(ProSound SSD-α10; Aloka, Japan)测试受试者颈动脉和股动脉动脉功能以及心脏形态学和功能指标；(3)利用逐级心跳检测仪(Finometer;FMS,Netherlands)测试受试者动脉压力感受器敏感性指标；(4)利用多导电生理记录仪(Biopac MP100; BioPac systems Inc, US)测试受试者心率变异性指标。在基础状态指标测试结束后,受试者进行45分钟70%心率储备[目标心率=(最大心率-安静心率)×70%+安静心率]的有氧运动,运动结束后30分钟和60分钟分别进行与基础状态相同指标的测试。在数据分析时,用独立样本t检验比较2个不同群体间的基础状态指标;用2×3repeatedmeasures ANOVA(2个种族×3个时间点)方法分析两个群体在运动前、运动后30分钟和运动后60分钟各指标间的差异,并用Turkey法检验组间差异。
结果：
(1)对血流动力学评价指标的影响：45分钟70%心率储备的一次急性有氧运动对中国人和美国白人血流动力学指标的影响存在显著性差异(p<0.05),可以降低中国人肱动脉SBP(从109±11mmHg到108±10mmHg到106±9mmHg)和美国白人(从121±9mmHg到117±11mmHg到114±11mmHg)肱动脉SBP;可以降低美国白人的肱动脉DBP(从65±6mmHg到65±5mmHg到64±5mmHg)和MBP(从82±6mmHg到83±6mmHg到81±6mmHg)；相反,增加中国人的肱动脉DBP(从60±5mmHg到61±5mmHg到62±5mmHg)和MBP(从75±6mmHg到77±6mmHg到77±5mmHg)；能够降低美国白人的颈动脉SBP(从112±12mmHg到114±16mmHg到108±16mmHg),对中国人的颈动脉SBP(从101±14mmHg到104±15mmHg到101±14mHg)影响不大。
(2)对动脉功能评价指标的影响：在运动前、运动后30分钟和运动后60分钟,颈动脉Ep在中国人(从63.3±16.0到70.2±21.6到68.4±18.6)和美国白人(从61.1±14.5到74.9±21.1到63.8±19.3)之间存在显著性差异(p<0.05),运动后60分钟时,中国人Ep升高的程度大于美国白人；颈动脉僵硬系数(p)在中国人(从5.9±1.3到6.5±1.7到6.5±1.6)和美国白人(从5.2±1.2到6.4±1.4到5.6±1.3)之间存在显著性差异(p<0.05)；颈动脉AC在中国人(从1.2±0.3到1.1±0.4到1.2±0.3)和美国白人(从1.3±0.4到1.0±0.3到1.3±0.4)之间存在显著性差异(p<0.05),但均能恢复到运动前水平；股动脉AC在中国人(从1.4±0.5到1.4±0.6到1.3±0.6)和美国白人(从1.3±0.5到1.2±0.4到1.4±0.6)之间也存在显著性差异(p<0.05),中国人AC略有降低,而美国白人略有升高。
(3)对心脏评价指标的影响：一次急性有氧运动可引起中国人LVIDd(从47.6±5.9mm到47.6±5.4mm到46.8±5.2mm)和EDV(从108±32ml到107±29ml到104±29m1)的减小,LVIDs(从29.6±4.0mm到30.8±4.5mm到30.0±4.0mm)和ESV(从35±12ml到39±14ml到36±11ml)的增加,而只引起美国白人的LVIDd(从50.2±5.5mm到48.04.7mm到49.3±4.7mm)和EDV(从121±31ml到110±27ml到116±27m1)的减小；学术检测,运动后60分钟美国白人的Em(从19.9±4.5cm/s到17.8±3.6cm/s到18.6±3.9cm/s)下降的程度大于中国人(从18.0±3.2cm/s到18.1±3.0cm/s到17.8±3.3cm/s),Am表现为,中国人(从8.5±2.3cm/s到9.6±2.3cm/s到9.8±2.4cm/s)增加的程度高于美国白人(从8.2±2.1cm/s到8.0±2.1cm/s到8.6±3.0cm/s)；PWD技术检测,中国人eV降低的程度(从86.4±13.04cm/s到77.6±11.84cm/s到76.7±12.14cm/s)大于美国白人(从84.1±16.24cm/s到78.1±12.74cm/s到79.5±13.04cm/s),中国人aV的变化幅度(从45.8±11.04cm/s到53.9±9.4cm/s到58.9±9.94cm/s)大于美国白人(从41.7±10.34cm/s到45.8±13.44cm/s到46.3±11.14cm/s)。
(4)对自主神经功能评价指标的影响：一次急性有氧运动能够引起运动后LF/HF比值的增加,中国人的增加程度(从192±194到517±528到296±257)大于美国白人(从192±115到292±226到233±168)；中国人nHF指标(从0.43±0.2nu到0.26±0.16nu到0.32±0.16nu)降低的幅度大于美国白人(从0.38±0.14nu到0.32±0.15nu到0.36±0.16nu)；分析nLF发现,中国人升高的程度(从0.55±0.2nu到0.72±0.18nu到0.65±0.17nu)大于美国白人(从0.6nu±0.15到0.65±0.17nu到0.62±0.17nu)；时域指标pNN50在中国人(从23±18.1%到2.3±4.2%到12.3±17.8%)和美国白人(从31.8±24.6%到15.4±20.7%到21.3±21.7%)之间也存在显著性差异(p<0.05)；分析BRS发现,中国人表现降低后略微升高(从12.8±6.1ms/mmHg到10.7±15.61ms/mmHg到10.8±5.9]ms/mmHg)而美国白人表现持续升高(从14.2±91ms/mmHg到14.7±11.61ms/mmHg到15.8±9.91ms/mmHg)；BRS(up-up)在中国人(从18.7±10.3ms/mmHg到11.3±8.2ms/mmHg到15.7±11.1ms/mmHg)和美国白人(从20.2±14.7ms/mmHg到23±20ms/mmHg到19.5±13.3ms/mmHg)之间存在显著性差异(p<0.05),中国人表现为先降低后升高,美国白人表现为先升高后降低。
结论：
(1)有氧运动对两个群体间血流动力学的影响表现为,有氧运动能够降低中国人和美国白人的肱动脉SBP,而且降低美国白人肱动脉SBP的效果优于中国人；有氧运动还可以降低美国白人的肱动脉DBP和MAP,而增加中国人的肱动脉DBP和MAP；有氧运动能够降低美国白人颈动脉SBP,对中国人颈动脉SBP影响不大。结果提示,急性有氧运动在降低血压和心脏负荷方面,美国白人的效果优于中国人。
(2)有氧运动对两个群体间动脉功能的影响表现为,有氧运动可以提高美国白人颈动脉AC、Ep、p,降低中国人颈动脉AC和提高中国人颈动脉Ep、p,在对颈动脉AC、Ep和p指标的影响程度上美国白人均高于中国人；可以提高美国白人股动脉AC并降低中国人的股动脉AC,对股动脉其他指标(股动脉Ep、β)的影响,在两个群体间没有明显差异。研究结果提示,急性有氧运动可能通过提高美国白人动脉的顺应性和弹性而改善血管功能；可能会降低中国人动脉的顺应性和弹性功能。
(3)有氧运动对两个群体间心脏的影响表现为,有氧运动通过降低LVIDd口EDV,增加LVIDs和ESV的共同作用引起中国人的SV的降低,而主要通过降低LVIDd和EDV引起美国白人的SV的降低；运动后中国人CO增加的程度高于美国白人,CO的增加主要由于HR的增加引起。结果提示,急性有氧运动可以引起每分输出量增加,中国人的增加程度高于美国白人,其增加是由心率的增加引起的；也可以引起每博输出量的减少,其原因可能是中国人因为左心室收缩不完全,美国白人因为左心室舒张不全。有氧运动可以引起左心房收缩代偿性增加,中国人增加的程度高于美国白人；可以引起左心室舒张功能的减退,主要表现为左心室的主动松弛功能和左心室快速充盈功能的减退,而且中国人降低的程度大于美国白人。结果提示,急性有氧运动能够降低心脏舒张功能,而且中国人的心脏应激变化大于美国白人。
(4)有氧运动对两个群体间自主神经调节功能的影响表现为,有氧运动能够增强自主神经的调节功能,其功能的增强主要表现为交感神经兴奋性的增强和副交感神经兴奋性的降低。中国人交感神经兴奋性增强的程度和副交感神经兴奋性降低的程度均大于美国白人。结果提示,急性有氧运动可以增强自主神经的调节功能,中国人自主神经调节的应激变化大于美国白人。
With the changing of people's lifestyle and diet, the incidence of CVD (Cardiovascular disease) is increasing year by year. Now, CVD mortality accounts for1/3of the global mortality, far more than the number of deaths caused by other diseases, is the most important cause of death. With the increasing of the incidence and mortality of CVD, the consumption of medical resources and expenditure were increased in global. At present CVD has become the most threatening to human health major public health problem in global. The morbidity and mortality of CVD were difference among difference races because the different on Physical fitness, lifestyle and diet. The popular opinion is that the highest incidence rate of CVD is African American's. But the results of comparative study of white American (Caucasian) and the Chinese were not coincident. Now, widely recognized that hypertension, aortic systolic and diastolic dysfunction, cardiac contractility and diastolic dysfunction and autonomic nervous system balance decrease are independent risk factors lead to CVD.
Objective:To compare the effect of aerobic exercise on cardiovascular and autonomic nervous system in Chinese and Caucasian by analyzing the data from hemodynamic parameters, arterial systolic and diastolic function, cardiac contractility and diastolic dysfunction, heart rate variability and baroreceptor sensitivity.
Methods:62(Chinese,32; Caucasian,30; half is male) subjects aged14-40yrs, who volunteered to participate in this study by recruiting and there were no hypertension, obesity and other cardiovascular and metabolic disease, no history of smoking. The first, V02max, HRmax, R value were gotten using metabolic cart (Quark b2; Cosmed, Italy) and treadmill (Free Motion; Fitness Blowout, USA) under the guidance of Bruce protocol. The second test was begun48hours to1week after the first test. The baseline data were gotten before aerobic exercise in the second test and then took the same measurements at30minutes and60minutes post aerobic exercise. Hemodynamic and arterial systolic and diastolic function were measured using Sphygmocor (Atcor Medical, Australia) and ProSound (Aloka, Japan); cardiac contractility and diastolic function were measured using ProSound (Aloka, Japan); baroreceptor sensitivity was measured using Finometer (FMS, Netherlands) and heart rate variability was measured using Biopac (BioPac systems Inc, US). The exercise is45minutes70%heart rate reserve aerobic exercise. Independent-samples t-test was used to compare the baseline data between Chinese and Caucasian.2×3repeats measures (2races×3 times) AVOVA was used to analyze the difference at30minutes and60minutes post a bout of acute aerobic exercise in Chinese and Caucasian.
Results:
(1)Hemodynamic parameters:There was different influence on hemodynamic parameters after a bout of45minutes70%heart rate reserve aerobic exercise in Chinese and Caucasian. The decrease of brachial SBP was difference in Chinese (from109±11mmHg to108±10mmHg to106±9mmHg) and Caucasian (from121±9mmHg to117±11mmHg to114±11mmHg)(p<0.05). The brachial DBP (form65±6mmHg to65±5mmHg to64±5mmHg) and MAP (from82±6mmHg to83±6mmHg to81±6mmHg) were decrease in Caucasian. But, the brachial DBP (from60±5mmHg to61±5mmHg to62±5mmHg) and MAP (form75±6mmHg to77±6mmHg to77±5mmHg) were increase in Chinese. The carotid SBP was decrease in Caucasian(from112±12mmHg to114±16mmHg to108±16mmHg)and there was no change in Chinese(from101±14mmHg to104±15mmHg to101±14mmHg)at60minutes post exercise.
(2)Vascular: Compare to baseline, there was different (p<0.05) change on carotid Ep between Chinese (from63.3±16.0to70.2±21.6to68.4±18.6) and Caucasian (from61.1±14.5to74.9±21.1to63.8±19.3) at30minutes and60minutes post exercise; The change of carotid P was difference (p<0.05) in Chinese (from5.9±1.3to6.5±1.7to6.5±1.6) and Caucasian (from5.2±1.2to6.4±1.4to5.6±1.3); The change on carotid AC also was difference (p<0.05) between Chinese (from1.2±0.3to l.l±0.4to1.2±0.3) and Caucasian (from1.3±0.4to1.0±0.3to1.3±0.4); there was different (p<0.05) change on femoral AC in Chinese (from1.4±0.5to1.4±0.6to1.3±0.6) and Caucasian (from1.3±0.5to1.2±0.4to1.4±0.6)
(3)Cardiac: A bout of aerobic exercise reduced SV by decreasing LVIDd (from47.6±5.9mm to47.6±5.4mm to46.8±5.2mm) and EDV (from108±32ml to107±29ml to104±29ml) and increasing LVIDs (from29.6±4.0mm to30.8±4.5mm to30.0±4.0mm) and EDV (from35±12ml to39±14ml to36±1lml) in Caucasian, the change of SV was caused by decreasing LVIDd (from50.2±5.5mm to48.0±4.7mm to49.3±4.7mm) and EDV (from121±31ml to110±27ml to116±27ml) in Chinese. Compare to baseline, the change of decrease on Em is higher in Caucasian (from19.9±4.5cm/s to17.8±3.6cm/s to18.6±3.9cm/s) than Chinese (from18.0±3.2cm/s to18.1±3.0cm/s to17.8±3.3cm/s)at60minutes post exercise; the change of increase on Am is higher in Chinese(from8.5±2.3cm/s to9.6±2.3cm/s to9.8±2.4cm/s)than Caucasian(from8.2±2.1cm/s to8.0±2.1cm/s to8.6±3.0cm/s); the change of reduce on eV is higher in Chinese(from86.4±13.04cm/s to 77.6±11.84cm/s to76.7±12.14cm/s) than Caucasian (from84.1±16.24cm/s to78.1±12.74cm/s to79.5±13.04cm/s); the change of aV is higher in Chinese (from45.8±11.04cm/s to53.9±9.4cm/s to58.9±9.94cm/s) than Caucasian (from41.7±10.34cm/s to45.8±13.44cm/s to46.3±11.14cm/s).
(4) Autonomic nervous system: LF/HF was increased after a bout of acute aerobic exercise, the change of increase was higher in Chinese (from192±194to517±528to296±257) than Caucasian (from192±115to292±226to233±168); The change of nHF was lower in Chinese (from0.43±0.2nu to0.26±0.16nu to0.32±0.16nu) than Caucasian (from0.38±0.14nu to0.32±0.15nu to0.36±0.16nu); The relative increase in nLF is higher in Chinese (from0.55±0.2nu to0.72±0.18nu to0.65±0.17nu) that in Caucasian (from0.6nu±0.15to0.65±0.17nu to0.62±0.17nu);The change of pNN50was difference between Chinese (from23±18.1%to2.3±4.2%tO12.3±17.8%) and Chinese (from31.8±24.6%to15.4±20.7%to21.3±21.7%). The BRS decreased and increased in Chinese (from12.8±6.1ms/mmHg to10.7±15.61ms/mmHg to10.8±5.91ms/mmHg) but increased in Caucasian (M.14.2±91ms/mmHg to14.7±11.61ms/mmHg to15.8±9.91ms/mmHg);The value of BRS (up-up) decreased and then increased in Chinese (from18.7±10.3ms/mmHg to11.3±8.2ms/mmHg to15.7±11.1ms/mmHg) but increased and then decreased in Caucasian (from20.2±14.7ms/mmHg to23±20ms/mmHg to19.5±13.3ms/mmHg)
Conclusions:
(1)The effect of aerobic exercise on hemodynamic: a bout of acute aerobic exercise can reduce the SBP of the brachial artery of the Chinese and Caucasian, but the change of SBP reduces was high in white Americans compare to Chinese; A bout of acute aerobic exercise can increase brachial DBP and MAP in Chinese, but decreased brachial DBP and MAP in Caucasian; Carotid SBP can been decreased in Caucasian caused by acute exercise and there was no change in Chinese. These results suggest that it is better in lowing blood pressure and cardiac load following a bout of acute aerobic exercise in Caucasian than Chinese.
(2)The effect of aerobic exercises on artery: the value of carotid AC, Ep,β can been increased in Caucasian after a bout of acute aerobic exercise, but decreased in carotid AC and increased in carotid Ep and p in Chinese and the impact was greater in Caucasian than Chinese. The exercise can reduced femoral AC in Chinese and increased in Caucasian. These results suggest that the improvement of arterial function may be due to improve arterial compliance and elasticity in Caucasian following a bout of acute aerobic exercise. But the arterial compliance and elasticity were reduced in Chinese after a bout of acute aerobic exercise.
(3) The effect of aerobic exercises on cardiac:a bout of aerobic exercise reduced SV by decreasing LVIDd and EDV, increasing LVIDs and EDV in Caucasian, the reduction of SV was caused by decreasing LVIDd and EDV in Chinese. Mainly, the left ventricular contraction is not complete in Chinese, and diastolic incomplete in Caucasian; the absolute increase in CO was higher in Chinese than Caucasian which caused by increase of heart rate after exercise; Exercise could cause a decrease in left ventricular diastolic function, but the Chinese to.recover earlier than Caucasian; could reduce left ventricular active relaxation ability, and the reduction was greater in Caucasian than Chinese; Could reduce the blood flow form left atrium to left ventricular during early diastolic, the reduction was lower in Chinese than Caucasian; could improve left ventricular compliance, the degree of improvement of left ventricular compliance of the Chinese more than Caucasian; Could reduce the left ventricular rapid filling, The change of decrease is greater in Chinese than Caucasian; could cause increasing of left atrium contraction in a compensatory which is greater in Chinese than Caucasian. These results suggest that cardiac diastolic function was reduced following a bout of acute aerobic exercise, the changes in cardiac stress was greater in Chinese than Caucasian.
(4) The effect of aerobic exercises on ANS:aerobic exercise could enhance the regulatory function of the ANS which is greater in Chinese than Caucasian. The enhancement of the regulatory function of the autonomic nervous system was caused by enhancing sympathetic nervous system excitability and reducing parasympathetic nervous system excitability. The change of enhancement of sympathetic nervous system and reduction of parasympathetic nervous system excitability were greater in Chinese than Caucasian. These results suggest that ANS function was increased following a bout of acute aerobic exercise, the changes ANS stress was greater in Chinese than Caucasian.
引文
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