Cuneo A, Oeckinghaus R, Tebbe U
Department I - Cardiology, Angiology, Intensive Care, Klinikum Lippe-Detmold, Detmold, Deutschland.
Herz. 2011 Oct;36(7):637-42. doi: 10.1007/s00059-011-3450-7. Epub 2011 Jun 16.
Leisure sport activity (LSA) is gaining in importance among middle-aged and senior men in the German population. There is a consensus that regular aerobic exercise at moderate intensities and increased physical fitness are associated with a reduced risk of fatal and nonfatal acute cardiac events (ACE) in middle-aged individuals. However, vigorous exercise (VE) can acutely and transiently increase the risk of an ACE in susceptible individuals. There is an ongoing discussion as to whether preparticipation screening may prevent such events. This case study characterizes patients participating in LSA who had not been involved in preparticipation screening prior to their ACE.
In the period between June 2003 and July 2009, all consecutive patients with an ACE presenting at the catheter laboratory were retrospectively screened for VE that had occurred during LSA. All 13 men with previously unknown coronary artery disease (CAD) had exercised regularly. All patients underwent coronary angiography. This study characterized clinical parameters, duration of LSA, coronary diagnostic procedure, as well as therapeutic intervention.
In seven patients, cardiovascular (CV) risk factors comprised arterial hypertension in seven, hyperlipidemia in seven, smoking or former smoking in two, family history of CV disease in four, and previous peripheral atherosclerotic disease in two. The culprit lesion was identified in seven patients in the left anterior descending artery, in four in the right coronary artery, and in two in the circumflex artery. The mean left ventricular ejection fraction was 65% (45-84). The mean complexity of the lesions using the syntax score was 17 (2-36). PCI was performed in 12 patients, while one patient was transferred for coronary artery bypass grafts. All patients survived their ACE.
This case study supports the data indicating that ACE in men with previously unknown CAD is not uncommon during LSA. This patient cohort provides data on a group of patients who might benefit from preparticipation screening.
休闲体育活动（LSA）在德国中年及老年男性中变得越来越重要。人们普遍认为，中年个体进行中等强度的定期有氧运动和提高身体素质与降低致命和非致命急性心脏事件（ACE）的风险相关。然而，剧烈运动（VE）会在易感个体中急性和短暂地增加ACE的风险。关于参与前筛查是否可以预防此类事件的讨论仍在进行中。本案例研究描述了在ACE发生之前未进行参与前筛查的参与LSA的患者。
在2003年6月至2009年7月期间，对所有在导管实验室就诊的连续ACE患者进行回顾性筛查，以确定LSA期间发生的VE。所有13名先前未知冠状动脉疾病（CAD）的男性都有规律地进行运动。所有患者均接受了冠状动脉造影。本研究描述了临床参数、LSA持续时间、冠状动脉诊断程序以及治疗干预。
7例患者的心血管（CV）危险因素包括7例动脉高血压、7例高脂血症、2例吸烟或既往吸烟、4例CV疾病家族史以及2例既往外周动脉粥样硬化疾病。7例患者的罪犯病变位于左前降支动脉，4例位于右冠状动脉，2例位于回旋支动脉。平均左心室射血分数为65%（45-84）。使用句法评分的病变平均复杂性为17（2-36）。12例患者接受了PCI，1例患者转至冠状动脉旁路移植术。所有患者均在ACE中存活。
本案例研究支持的数据表明，在LSA期间，先前未知CAD的男性发生ACE并不罕见。该患者队列提供了一组可能从参与前筛查中受益的患者的数据。
