Saberi Sara, Day Sharlene M
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan School of Medicine, Frankel Cardiovascular Center, Suite 2364, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5853, USA.
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan School of Medicine, 1150 West Medical Center Drive, 7301 MSRBIII, Ann Arbor, MI 48109-5644, USA.
Cardiol Clin. 2016 Nov;34(4):591-601. doi: 10.1016/j.ccl.2016.06.008. Epub 2016 Aug 28.
Inherited cardiomyopathies have highly variable expression in terms of symptoms, functional limitations, and disease severity. Associated risk of sudden cardiac death is also variable. International guidelines currently recommend restriction of all athletes with cardiomyopathy from participation in competitive sports. While the guidelines are necessarily conservative because predictive risk factors for exercise-triggered SCD have not been clearly identified, the risk is clearly not uniform across all athletes and all sports. The advent of implantable cardioverter defibrillators, automated external defibrillators, and successful implementation of emergency action plans may safely mitigate risk of sudden cardiac death during physical activity. An individualized approach to risk stratification of athletes that recognizes patient autonomy may allow many individuals with cardiomyopathies to safely train and compete.
遗传性心肌病在症状、功能受限程度和疾病严重程度方面具有高度可变的表现。心脏性猝死的相关风险也各不相同。目前国际指南建议限制所有患有心肌病的运动员参加竞技运动。虽然这些指南必然较为保守，因为尚未明确确定运动诱发心脏性猝死的预测风险因素，但风险在所有运动员和所有运动项目中显然并非一致。植入式心脏复律除颤器、自动体外除颤器的出现以及应急行动计划的成功实施，可能会安全地降低体育活动期间心脏性猝死的风险。一种认识到患者自主性的针对运动员风险分层的个体化方法，可能会使许多患有心肌病的个体能够安全地进行训练和比赛。
