Cardiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain.
Cardiology Department, Hospital Universitario de Bellvitge, Barcelona, Spain.
Scand J Med Sci Sports. 2018 Apr;28(4):1404-1411. doi: 10.1111/sms.13037. Epub 2018 Jan 8.
Physical activity has benefits on health. However, there is a small risk of effort-related adverse events. The aim of this study is to describe exercise-related severe cardiovascular events and to relate them with the type of sport performed. We performed a ten-year retrospective study in eight Spanish cardiac intensive care units. Adverse cardiac events were defined as acute myocardial infarction, cardiac arrest or syncope related to physical activity. From 117 patients included, 109 were male (93.2%), and mean age was 51.6 ± 12.3 years; 56 presented acute myocardial infarction without cardiac arrest (47.9%), 55 sudden cardiac death (47.0%) and six syncope (5.1%). The sports with higher number of events were cycling (33%-28.2%), marathon or similar running competitions (19%-16.2%), gymnastics (18%-15.3%) and soccer (17%-14.5%). Myocardial infarction was observed more frequently in cyclists compared to other sports (69.7% vs 39.3%, P = .001). The most common cause of sudden cardiac death was myocardial infarction in those >35 years (23%-63.9%) and idiopathic ventricular fibrillation in younger patients (5%-62.5%). Significant coronary artery disease was present in 85 (79.4%). Only one patient with cardiac arrest presented with a non-shockable rhythm (asystole). Eleven patients (9.4%) died during hospitalization; in all cases, they had presented cardiac arrest. All discharged patients were alive at the end of follow-up. Exercise-related severe cardiac events are mainly seen in men. Coronary heart disease is very frequent; about half present acute myocardial infarction and the other half cardiac arrest. In our cohort, prognosis was good in patients without cardiac arrest.
身体活动对健康有益。然而，也存在与努力相关的不良事件的小风险。本研究的目的是描述与运动相关的严重心血管事件，并将其与所进行的运动类型相关联。我们在西班牙的 8 个心脏重症监护病房进行了一项为期十年的回顾性研究。不良心脏事件定义为与体力活动相关的急性心肌梗死、心脏骤停或晕厥。在纳入的 117 名患者中，109 名男性（93.2%），平均年龄为 51.6±12.3 岁；56 名患者出现无心脏骤停的急性心肌梗死（47.9%）、55 名患者出现心脏性猝死（47.0%）和 6 名患者出现晕厥（5.1%）。发生事件较多的运动项目是骑自行车（33%-28.2%）、马拉松或类似的跑步比赛（19%-16.2%）、体操（18%-15.3%）和足球（17%-14.5%）。与其他运动相比，骑自行车的患者中观察到更多的心肌梗死（69.7% vs 39.3%，P=0.001）。>35 岁患者中突发性心脏骤停最常见的原因是心肌梗死（23%-63.9%），年轻患者中最常见的原因是特发性心室颤动（5%-62.5%）。85 名患者（79.4%）存在显著的冠状动脉疾病。仅有 1 名心脏骤停患者出现非除颤性节律（停搏）。11 名患者（9.4%）在住院期间死亡；所有患者均出现心脏骤停。所有出院患者在随访结束时均存活。与运动相关的严重心脏事件主要发生在男性中。冠心病非常常见；约一半的患者出现急性心肌梗死，另一半患者出现心脏骤停。在我们的队列中，没有心脏骤停的患者预后良好。
