The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
J Am Coll Cardiol. 2015 Feb 10;65(5):493-502. doi: 10.1016/j.jacc.2014.10.064.
The overwhelming majority of sports-related sudden deaths occur among those older than 35 years of age. Because increasing numbers of older people are participating in organized endurance and competitive sporting events, the incidence of sports-related sudden death in older adults is expected to rise. Older athletes will approach clinical cardiologists for advice regarding their fitness for participation. It is important to recognize both that strenuous exercise is associated with a transient elevation in risk of sudden cardiac death and that appropriate training substantially reduces this risk. The approach to pre-participation screening for risk of sudden death in the older athlete is a complex issue and at present is largely focused on identifying inducible ischemia due to significant coronary disease. In this brief review, we summarize the current state of knowledge in this area with respect to epidemiology, mechanisms, and approaches to risk stratification, as viewed from the perspective of the consulting clinical cardiologist.
绝大多数与运动相关的猝死发生在 35 岁以上的人群中。由于越来越多的老年人参与有组织的耐力和竞技体育赛事，预计老年人中与运动相关的猝死发生率将会上升。年长的运动员将向临床心脏病专家寻求关于他们适合参与运动的建议。重要的是既要认识到剧烈运动与突发心源性死亡风险的短暂升高有关，也要认识到适当的训练可以大大降低这种风险。年长运动员参与前的猝死风险筛查是一个复杂的问题，目前主要集中在识别因严重冠状动脉疾病导致的可诱导缺血。在这篇简要综述中，我们从咨询临床心脏病专家的角度，总结了这一领域目前在流行病学、机制和风险分层方法方面的知识状况。
