Jebsen Center of Exercise In Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Circulation. 2012 Sep 18;126(12):1436-40. doi: 10.1161/CIRCULATIONAHA.112.123117. Epub 2012 Aug 9.
Exercise performed at higher relative intensities has been found to elicit a greater increase in aerobic capacity and greater cardioprotective effects than exercise at moderate intensities. An inverse association has also been detected between the relative intensity of physical activity and the risk of developing coronary heart disease, independent of the total volume of physical activity. Despite that higher levels of physical activity are effective in reducing cardiovascular events, it is also advocated that vigorous exercise could acutely and transiently increase the risk of sudden cardiac death and myocardial infarction in susceptible persons. This issue may affect cardiac rehabilitation.
We examined the risk of cardiovascular events during organized high-intensity interval exercise training and moderate-intensity training among 4846 patients with coronary heart disease in 3 Norwegian cardiac rehabilitation centers. In a total of 175 820 exercise training hours during which all patients performed both types of training, we found 1 fatal cardiac arrest during moderate-intensity exercise (129 456 exercise hours) and 2 nonfatal cardiac arrests during high-intensity interval exercise (46 364 exercise hours). There were no myocardial infarctions in the data material. Because the number of high-intensity training hours was 36% of the number of moderate-intensity hours, the rates of complications to the number of patient-exercise hours were 1 per 129 456 hours of moderate-intensity exercise and 1 per 23 182 hours of high-intensity exercise.
The results of the current study indicate that the risk of a cardiovascular event is low after both high-intensity exercise and moderate-intensity exercise in a cardiovascular rehabilitation setting. Considering the significant cardiovascular adaptations associated with high-intensity exercise, such exercise should be considered among patients with coronary heart disease.
相较于中等强度的运动，更高相对强度的运动已被证实可更大程度地提高有氧能力并产生更大的心脏保护作用。此外，体力活动的相对强度与发生冠心病的风险之间也呈反比关系，且与体力活动总量无关。尽管更高水平的体力活动可有效降低心血管事件的发生风险，但也有观点认为剧烈运动可能会使易感人群的心脏性猝死和心肌梗死风险在急性和短暂时间内增加。这一问题可能会对心脏康复产生影响。
我们在挪威的 3 家心脏康复中心中，对 4846 名冠心病患者进行了高强度间歇训练和中等强度训练的心血管事件风险研究。在所有患者均接受这两种类型训练的总共 175820 个运动训练小时中，我们发现 1 例中等强度运动时的致命性心脏骤停（129456 个运动小时）和 2 例高强度间歇运动时的非致命性心脏骤停（46364 个运动小时）。在数据资料中没有心肌梗死的发生。由于高强度训练的时间占中等强度训练时间的 36%，因此按患者运动时间计算并发症发生率为中等强度运动每 129456 小时 1 例，高强度运动每 23182 小时 1 例。
本研究结果表明，在心血管康复环境中，高强度运动和中等强度运动后发生心血管事件的风险均较低。考虑到高强度运动带来的显著心血管适应性，此类运动应在冠心病患者中得到考虑。
