Burke A P, Farb A, Virmani R, Goodin J, Smialek J E
Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Am Heart J. 1991 Feb;121(2 Pt 1):568-75. doi: 10.1016/0002-8703(91)90727-y.
Sports-related sudden cardiac deaths were compared with non-sports-related sudden cardiac death in individuals (14 to 40 years old) who were autopsied from 1981 to 1988 at the Maryland Medical Examiner's Office. Thirty-four of 690 total cases of sudden cardiac death were sports-related, which represents 5% of sudden cardiac death in this age group. Causes of death were severe atherosclerosis (nine), hypertrophic cardiomyopathy with asymmetry (eight), coronary artery anomalies (four), idiopathic concentric left ventricular hypertrophy (three), myocarditis (two), arrhythmogenic right ventricle (one), Kawasaki disease (one), and unknown (six); two of the cases with unknown causes had tunnel arteries. Exercise-related deaths were more likely due to hypertrophic cardiomyopathy (p = 0.0007) compared with 102 age-, sex-, and race-matched controls in the non-exercise group; there was no difference in the incidence of severe atherosclerosis (p = 0.4). The mean age of individuals with hypertrophic cardiomyopathy with asymmetry was less than that of those with severe atherosclerosis (24 vs 32 years, p = 0.03). Thus exercise precipitates sudden cardiac death in younger individuals with hypertrophic cardiomyopathy.
对1981年至1988年在马里兰州法医办公室接受尸检的14至40岁个体中与运动相关的心脏性猝死和非运动相关的心脏性猝死进行了比较。在690例心脏性猝死总病例中，有34例与运动相关，占该年龄组心脏性猝死的5%。死亡原因包括严重动脉粥样硬化（9例）、不对称性肥厚型心肌病（8例）、冠状动脉异常（4例）、特发性同心性左心室肥厚（3例）、心肌炎（2例）、致心律失常性右心室（1例）、川崎病（1例）以及原因不明（6例）；原因不明的病例中有2例存在隧道动脉。与非运动组102名年龄、性别和种族匹配的对照相比，运动相关死亡更可能由肥厚型心肌病引起（p = 0.0007）；严重动脉粥样硬化发生率无差异（p = 0.4）。不对称性肥厚型心肌病患者的平均年龄低于严重动脉粥样硬化患者（24岁对32岁，p = 0.03）。因此，运动促使患有肥厚型心肌病的年轻个体发生心脏性猝死。
