(P=1.000) I HRV. [DOI] /j.issn

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1 Med J Chin PLA, Vol. 43, No. 4, April 1, [ ] (COR) C (hs- CRP) T(cTnT) (H-FABP)40 36 (HRV) COR hs-crp(p<0.05)ctnt H-FABP (P<0.01)(P<0.05) (P=1.000) I (P<0.05) HRV (P<0.01) HRV [ ] [ ] R823 [ ] A [ ] (2018) [DOI] /j.issn Effects of high intensity military training on cardiovascular system of military personnel FAN Yong-yan 1, LI Yang 2, CHENG Wen-kun 2, WANG Yu-tang 1,3*, XUE Qiao 2* 1 College of Medicine, Nankai University, Tianjin , China 2 Departments of Cardiology, 3 Departments of Geriatric Cardiology, Chinese PLA General Hospital, Beijing , China * Corresponding author. WANG Yu-tang, wyt301@sina.com; XUE Qiao, xueqiao301@126.com This work was supported by the Project of the Twelfth Five-Year Plan of Medical Science and Technique of PLA (CWS12J122) [Abstract] Objective To explore the changes of cardiovascular system of military personnel during highly intensive training. Methods One hundred and seventy officers and soldiers were as research subjects, including 100 individuals in highintensity group and 70 in control group. The levels of serum cortisol (COR), high sensitivity C-reactive protein (hs-crp), cardiacspecific Troponin T (ctnt) and human heart fatty acid binding protein (H-FABP) were measured when military training ended. All subjects were tested with fatigue assessment instrument (FAI). The data of blood pressure and electrocardiogram were collected from 40 individuals randomly selected from high-intensity group and 36 from control group before and after training for analyzing the blood pressure, arrhythmia and heart rate variability (HRV). Results The levels of COR (indicator related to stress) and hs-crp (indicator related to inflammation) were significantly higher in high intensity group than in control group (P<0.05). Highly intensive training can lead to the emergence of myocardial micro-injury, the levels of ctnt and H-FABP were obviously higher than those in control group (P<0.01), and the mean blood pressure and the severity of fatigue status were significantly higher than those in control group (P<0.05). The incidence of severe ventricular arrhythmia was lower in both groups (P=1.000). The average heart rate, total heart beats, total number of atrial premature beat, total number of ventricular premature beat, the incidence of sinus arrhythmia and intermittent second degree type I atrioventricular block were significantly higher in high intensity group than in control group (P<0.05). The HRV of high intensity group was obviously decreased (P<0.01). Conclusion Highly intensive training may induce the military personnel into the state of acute stress and inflammation, which may lead to myocardial injury, increase severity of fatigue status, accompanied with the rise of blood pressure, low HRV and increased incidence of various arrhythmias. [Key words] military stress; cardiovascular system; heart rate variability; fatigue [ ] (CWS12J122) [ ] [ ] ( ) ( ) ( ) [ ] wyt301@sina.com xueqiao301@126.com

2 ( ) [1] [2-4] [5-6] [7] ( ) ( ) km 400m 8h3d 70 ( ) 1.3 ( GE MAC5500 ) (MIC-12H ) ( SunTech Oscar2 ) ( ) T ( ) Roche ELISA (HK401) Hycult Biotech C (5322) Beckman Coulter d d 24h 24h (heart rate variability HRV)24h HRV [8] NN 50ms (PNN50) NN(SDNN) 5min NN(SDANN) NN (SDSD) NN (RMSSD) NN NN (HRV ) % (fatigue assessment instrument FAI) Schwartz [9] ( ) 2 ( ) ( ) 3( ) 4( ) :00 (cortisol COR) C (high sensitivity C-reactive protein hs-crp) T(cardiac-specific troponin T ctnt) (human heart fatty acid binding protein H-FABP) 1.5 SPSS 19.0 x±s t M(Min Max) Mann-Whitney U

3 Med J Chin PLA, Vol. 43, No. 4, April 1, χ 2 Fisher P< (P>0.05 1) ST-T (P>0.05 2) (P>0.05) ( /min) ( /min) ( /min) ( /min) (P<0.01) 24h (P<0.05) 1 Tab.1 Baseline data of subjects in the two groups High-intensity group (n=100) (n=70) Age (year) Height (cm) Weight (kg) msbp (mmhg) mdbp (mmhg) msbp. Mean systolic blood pressure; mdbp. Mean diastolic blood pressure 2 Tab.2 Data of resting electrocardiogram of high-intensity and control groups High-intensity group (n=40) (n=36) Average HR (/min) Sinus bradycardia [n(%)] 1(2.50) 2(5.56) Sinus tachycardia [n(%)] 3(7.50) 1(2.78) Atrial premature beat [n(%)] Ventricular premature beat [n(%)] Non-specific ST-T changes [n(%)] 1(2.50) Complete right bundle branch block [n(%)] 3(7.50) 2(5.56) HR. Heart rate 3 Tab.3 Data of dynamic electrocardiogram of high-intensity and control groups High-intensity group (n=40) (n=36) Total recording time (h) HR max (/min) HR min (/min) Average HR (/min) Total heart beats Total number of sinus bradycardia [M(Min, Max)] (1606.8, ) 891.0(9.5, ) Total number of sinus tachycardia [M(Min, Max)] (8648.3, ) (2534.0, ) Sinus arrhythmia [n(%)] 23(57.50) 10(27.78) Total number of atrial premature beat [M(Min, Max)] 78.0(0, 269.0) 19.4(0, 40.0) Atrial premature beat [n(%)] 32(80.0) 32(88.9) Atrial tachycardia [n(%)] 6(15.0) 2(5.6) Total number of ventricular premature beat [M(Min, Max)] 68.0(0, 387.0) 17.9(0, 60.0) Ventricular premature beat [n(%)] 10(25.0) 6(16.7) Ventricular tachycardia [n(%)] 1(2.5) Complete right bundle branch block [n(%)] 3(7.5) 2(5.6) Intermittent second degree type I atrioventricular block [n(%)] 8(20.0) Non-specific ST-T changes [n(%)] 7(17.5) 1(2.8) Early repolarization [n(%)] 2(5.0) HR max. Maximal heart rate; HR min. Minimal heart rate; HR. Heart rate (P<0.05) 1 I (P<0.01) ST-T (P>0.05)

4 PNN50 SDNN SDANN SDSD RMSSD HRV (P<0.01) (P>0.05 6) 2.6 COR hs-crp ctnt H-FABP (P<0.05 P<0.01 7) 4 Tab.4 Data of time-domain indexes of heart rate variability of high-intensity and control groups High-intensity group (n=40) (n=36) PNN50 (%) 3.25( ) 11.15( ) SDNN (ms) SDANN (ms) SDSD (ms) RMSSD (ms) HRV triangular index PNN50. Proportion of NN50 divided by total number of NNs; SDNN. Standard deviation of NN intervals; SDANN. Standard deviation of the average NN intervals calculated over short periods, usually 5 minutes; SDSD. Standard deviation of successive differences; RMSSD. Root mean square of successive differences; HRV. Heart rate variability 2.4 (P<0.05 5) 6 Tab.6 Factor score of Fatigue Assessment Instrument of highintensity and control groups High-intensity group (n=99) (n=67) Factor Factor Factor Factor Factor 1. Global fatigue severity subscale; Factor 2. Situation specific fatigue subscale; Factor 3. Fatigue consequence subscale; Factor 4. Responsiveness to rest/sleep subscale 7 Tab.7 Indicators related to stress and biomarkers of myocardial micro-injury in the two groups High-intensity group (n=100) (n=70) COR (mg/l) hs-crp (mg/l) 0.380( ) 0.315( ) ctnt (ng/ml) 0.031( ) 0.003( ) H-FABP (ng/ml) 1.978( ) 0.893( ) ctnt. Cardiac-specific Troponin T; HUMAN H-FABP. Human heart fatty acid binding protein; COR. Cortisol; hs-crp. High sensitivity C-reactive protein 5 Tab.5 Data of ambulatory blood pressure of high-intensity and control groups High-intensity group (n=40) (n=36) Total recording time (h) msbp (mmhg) mdbp (mmhg) dsbp (mmhg) ddbp (mmhg) nsbp (mmhg) ndbp (mmhg) msbp. Mean systolic blood pressure; mdbp. Mean diastolic blood pressure; dsbp. Day mean systolic blood pressure; ddbp. Day mean diastolic blood pressure; nsbp. Night mean systolic blood pressure; ndbp. Night mean diastolic blood pressure 2.5 (P<0.05) (P<0.01) 3 HRV HRV [8] HRV [10] Varró [2] 2~4 Baldesberger [11]

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