Ruwald Anne-Christine, Marcus Frank, Estes N A Mark, Link Mark, McNitt Scott, Polonsky Bronislava, Calkins Hugh, Towbin Jeffrey A, Moss Arthur J, Zareba Wojciech
Heart Research Follow-up Program, University of Rochester Medical Center, 265 Crittenden Blvd. CU 420653, Rochester, NY 14642, USA Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
University of Arizona Health Science Center, Tucson, AZ, USA.
Eur Heart J. 2015 Jul 14;36(27):1735-43. doi: 10.1093/eurheartj/ehv110. Epub 2015 Apr 20.
It has been proposed that competitive sport increases the risk of ventricular tachyarrhythmias (VTA) and death in patients with arrhythmogenic right-ventricular cardiomyopathy (ARVC). However, it is unknown whether this only applies to competitive sport or if recreational sports activity also increases the risk of VTA/death.
Probands diagnosed with ARVC according to the 2010 task force criteria for ARVC (n = 108) were included in the current analysis. At the time of enrolment, study participants were questioned about exercise level prior to and after ARVC diagnosis, within three categories of sports participation: competitive (n = 41), recreational (n = 48), and inactive (n = 19). Competitive sport was associated with a significantly higher risk of VTA/death when compared with both recreational sport [HR = 1.99 (1.21-3.28), P = 0.007] and inactive patients [HR = 2.05 (1.07-3.91), P = 0.030]. No increased risk of VTA/death was associated with recreational sport when compared with patients who were inactive [HR = 1.03 (0.54-1.97), P = 0.930]. Symptoms developed at an earlier age in patients who participated in competitive sport (30 ± 12 years), when compared with patients who participated in recreational sport (38 ± 17 years) (P = 0.015) and inactive patients (41 ± 11 years) (P = 0.002). No difference in age at first symptom was seen between patients who participated in recreational sport and inactive patients (P = 0.651).
Competitive sport was associated with a two-fold increased risk of VTA/death, and earlier presentation of symptoms, when compared with inactive patients, and to patients who participated in recreational sport. When compared with inactive patients, recreational sport was not associated with earlier onset of symptoms or increased risk of VTA/death. ClinicalTrials.gov Identifier: NCT00024505.
有人提出竞技运动增加了致心律失常性右室心肌病（ARVC）患者室性快速心律失常（VTA）和死亡的风险。然而，尚不清楚这是否仅适用于竞技运动，还是休闲体育活动也会增加VTA/死亡风险。
根据2010年ARVC工作组标准诊断为ARVC的先证者（n = 108）纳入本分析。在入组时，研究参与者被询问ARVC诊断前后的运动水平，分为三类体育参与情况：竞技性（n = 41）、休闲性（n = 48）和不活动（n = 19）。与休闲运动[风险比（HR）= 1.99（1.21 - 3.28），P = 0.007]和不活动患者[HR = 2.05（1.07 - 3.91），P = 0.030]相比，竞技运动与VTA/死亡风险显著更高相关。与不活动患者相比，休闲运动未显示出VTA/死亡风险增加[HR = 1.03（0.54 - 1.97），P = 0.930]。与参加休闲运动的患者（38±17岁）（P = 0.015）和不活动患者（41±11岁）（P = 0.002）相比，参加竞技运动的患者症状出现年龄更早（30±12岁）。参加休闲运动的患者与不活动患者之间首次出现症状的年龄无差异（P = 0.651）。
与不活动患者以及参加休闲运动的患者相比，竞技运动与VTA/死亡风险增加两倍以及症状出现更早相关。与不活动患者相比，休闲运动与症状更早发作或VTA/死亡风险增加无关。临床试验.gov标识符：NCT00024505。
