Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
JACC Clin Electrophysiol. 2018 Jun;4(6):744-753. doi: 10.1016/j.jacep.2018.01.010. Epub 2018 Mar 28.
The goal of this study was to explore the association between exercise duration versus exercise intensity and adverse outcome in patients with arrhythmogenic cardiomyopathy (AC).
Vigorous exercise aggravates and accelerates AC, but there are no data assessing the harmful effects of exercise intensity and duration in these patients.
Exercise habits at time of diagnosis were recorded by standardized interviews in consecutive AC patients. Exercise >6 metabolic equivalents was defined as high intensity, and exercise duration was categorized as long if above median. Life-threatening ventricular arrhythmia (VA) was defined as aborted cardiac arrest, documented sustained ventricular tachycardia, ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy.
We included 173 AC patients (53% probands; 44% female; 41 ± 16 years of age). Median weekly exercise duration was 2.5 h (interquartile range: 2.0 to 5.5 h), and 91 patients (52%) reported high-intensity exercise. VA had occurred in 83 patients (48%) and was more prevalent in patients with high-intensity exercise than low-intensity exercise (74% vs. 20%, p < 0.001), and more prevalent in long-duration than short-duration exercise (65% vs. 31%, p < 0.001). High-intensity exercise was a strong and independent marker of VA, even when adjusted for the interaction with long-duration exercise (odds ratio: 3.8; 95% confidence interval: 1.3 to 11.0, p < 0.001), whereas long-duration exercise was not.
High-intensity exercise was a strong and independent marker of life-threatening VA in AC patients, independent of exercise duration. AC patients could be advised to restrict their exercise intensity.
本研究旨在探讨心律失常性心肌病（AC）患者运动时间与运动强度与不良结局的关系。
剧烈运动可加重和加速 AC，但尚无数据评估这些患者运动强度和时间的有害影响。
通过对连续 AC 患者进行标准化访谈，记录诊断时的运动习惯。运动 >6 代谢当量定义为高强度，运动时间超过中位数为长。危及生命的室性心律失常（VA）定义为心脏骤停、记录到持续性室性心动过速、心室颤动或适当的植入式心脏复律除颤器治疗。
共纳入 173 例 AC 患者（53%为先证者；44%为女性；41 ± 16 岁）。每周运动时间中位数为 2.5 小时（四分位间距：2.0 至 5.5 小时），91 例患者（52%）报告高强度运动。83 例患者（48%）发生 VA，高强度运动患者比低强度运动患者更常见（74%比 20%，p<0.001），长时间运动患者比短时间运动患者更常见（65%比 31%，p<0.001）。高强度运动是 VA 的一个强烈而独立的标志物，即使在调整与长时间运动的相互作用后也是如此（优势比：3.8；95%置信区间：1.3 至 11.0，p<0.001），而长时间运动则不是。
高强度运动是 AC 患者发生危及生命的 VA 的一个强烈且独立的标志物，与运动时间无关。可以建议 AC 患者限制其运动强度。
