Flannery M Darragh, Kalman Jonathan M, Sanders Prashanthan, La Gerche André
Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; University of Melbourne, Department of Medicine, Melbourne, Vic, Australia.
University of Melbourne, Department of Medicine, Melbourne, Vic, Australia; Royal Melbourne Hospital, Department of Cardiology, Melbourne, Vic, Australia.
Heart Lung Circ. 2017 Sep;26(9):983-989. doi: 10.1016/j.hlc.2017.05.132. Epub 2017 Jun 3.
Exercise has substantial health benefits with pleomorphic vascular, metabolic, psychological and anti-neoplastic actions resulting in improved quality of life and longevity. Despite these many benefits, numerous studies have shown that endurance athletes are more likely to develop atrial fibrillation (AF) than non-athletes. The type, intensity and amount of sport appears to influence the risk of developing AF. Several endurance sport activities have been shown to increase the risk of developing AF but an excess in AF has not been shown in non-endurance sports. Furthermore, lifetime hours of participation appear to increase the risk of developing AF. Intriguingly, women appear relatively protected and an association between endurance sport and AF has not been clearly demonstrated amongst female endurance athletes. The mechanisms by which endurance sport promotes the development of AF are unclear. There are, however, a number of pathophysiological mechanisms which are known to increase the risk of AF in non-athletes which have correlates in athletes. These include structural remodelling of the left atrium, elevated left atrial pressure, inflammation, myocardial fibrosis, vagal tone, sinus bradycardia and genetic predisposition. In this article, we explore how some of these mechanisms may contribute to the development of AF in endurance athletes.
运动对健康有诸多益处，具有多方面作用，包括血管形态改变、代谢调节、心理影响及抗肿瘤作用，从而提高生活质量和延长寿命。尽管有这些诸多益处，但大量研究表明，耐力运动员比非运动员更易发生心房颤动（AF）。运动的类型、强度和量似乎会影响发生AF的风险。多项耐力运动已被证明会增加发生AF的风险，但非耐力运动中尚未发现AF发生率过高。此外，一生的运动参与时长似乎会增加发生AF的风险。有趣的是，女性似乎相对受到保护，在女性耐力运动员中，耐力运动与AF之间的关联尚未得到明确证实。耐力运动促进AF发生的机制尚不清楚。然而，已知有一些病理生理机制会增加非运动员发生AF的风险，而这些机制在运动员中也有相关表现。这些机制包括左心房结构重塑、左心房压力升高、炎症、心肌纤维化、迷走神经张力、窦性心动过缓和遗传易感性。在本文中，我们探讨其中一些机制可能如何促成耐力运动员发生AF。
