Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Prog Cardiovasc Dis. 2020 Nov-Dec;63(6):762-774. doi: 10.1016/j.pcad.2020.11.004. Epub 2020 Nov 13.
Higher levels of physical activity (PA) and cardiorespiratory fitness (CRF) are associated with lower risk of incident cardiovascular disease (CVD). However, the relationship of aerobic PA and CRF with risk of atherosclerotic CVD outcomes and heart failure (HF) seem to be distinct. Furthermore, recent studies have raised concerns of potential toxicity associated with extreme levels of aerobic exercise, with higher levels of coronary artery calcium and incident atrial fibrillation noted among individuals with very high PA levels. In contrast, the relationship between PA levels and measures of left ventricular structure and function and risk of HF is more linear. Thus, personalizing exercise levels to optimal doses may be key to achieving beneficial outcomes and preventing adverse CVD events among high risk individuals. In this report, we provide a comprehensive review of the literature on the associations of aerobic PA and CRF levels with risk of adverse CVD outcomes and the preceding subclinical cardiac phenotypes to better characterize the optimal exercise dose needed to favorably modify CVD risk.
更高水平的身体活动（PA）和心肺适能（CRF）与较低的心血管疾病（CVD）发病风险相关。然而，有氧运动 PA 和 CRF 与动脉粥样硬化性 CVD 结局和心力衰竭（HF）风险的关系似乎不同。此外，最近的研究引起了人们对与极高水平有氧运动相关的潜在毒性的关注，在 PA 水平非常高的个体中，注意到更高水平的冠状动脉钙和心房颤动的发生率。相比之下，PA 水平与左心室结构和功能以及 HF 风险之间的关系更为线性。因此，将运动水平个性化到最佳剂量可能是实现高危人群有益结果和预防不良 CVD 事件的关键。在本报告中，我们对有氧运动 PA 和 CRF 水平与不良 CVD 结局风险以及先前的亚临床心脏表型的关联进行了全面综述，以更好地描述需要的最佳运动剂量来有利地改变 CVD 风险。
