University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Lindhofstraße 20, 5020 Salzburg, Austria.
Ludwig Boltzmann Institute for Digital Health and Prevention, Lindhof Street 22, 5020 Salzburg, Austria.
Int J Environ Res Public Health. 2021 Feb 8;18(4):1621. doi: 10.3390/ijerph18041621.
Sudden cardiac death (SCD) still represents an unanticipated and catastrophic event eliciting from cardiac causes. SCD is the leading cause of non-traumatic deaths during downhill skiing and mountain hiking, related to the fact that these sports are very popular among elderly people. Annually, more than 40 million downhill skiers and mountain hikers/climbers visit mountainous regions of the Alps, including an increasing number of individuals with pre-existing chronic diseases. Data sets from two previously published case-control studies have been used to draw comparisons between the SCD risk of skiers and hikers. Data of interest included demographic variables, cardiovascular risk factors, medical history, physical activity, and additional symptoms and circumstances of sudden death for cases. To establish a potential connection between the SCD risk and sport-specific physical strain, data on cardiorespiratory responses to downhill skiing and mountain hiking, assessed in middle-aged men and women, have been included. It was demonstrated that previous myocardial infarction (MI) (odds ratio; 95% CI: 92.8; 22.8-379.1; < 0.001) and systemic hypertension (9.0; 4.0-20.6; < 0.001) were predominant risk factors for SCD in skiers, but previous MI (10.9; 3.8-30.9; < 0.001) and metabolic disorders like hypercholesterolemia (3.4; 2.2-5.2; < 0.001) and diabetes (7.4; 1.6-34.3; < 0.001) in hikers. More weekly high-intensity exercise was protective in skiers (0.17; 0.04-0.74; = 0.02), while larger amounts of mountain sports activities per year were protective in hikers (0.23; 0.1-0.4; <0.001). In conclusion, previous MI history represents the most important risk factor for SCD in recreational skiers and hikers as well, and adaptation to high-intensity exercise is especially important to prevent SCD in skiers. Moreover, the presented differences in risk factor patterns for SCDs and discussed requirements for physical fitness in skiers and hikers will help physicians to provide specifically targeted advice.
心源性猝死（SCD）仍然是一种出乎意料的灾难性事件，由心脏原因引起。SCD 是下坡滑雪和登山等非创伤性死亡的主要原因，这与这些运动在老年人中非常流行有关。每年，超过 4000 万的下坡滑雪者和登山者/攀岩者前往阿尔卑斯山的山区，其中包括越来越多的患有先前存在的慢性疾病的人。两个先前发表的病例对照研究的数据被用来比较滑雪者和徒步旅行者的 SCD 风险。感兴趣的数据包括人口统计学变量、心血管危险因素、病史、身体活动以及案例中突然死亡的其他症状和情况。为了建立 SCD 风险与特定运动身体负荷之间的潜在联系，还包括了对中年男女进行的下坡滑雪和登山运动时心肺反应的数据。结果表明，先前的心肌梗死（MI）（优势比；95%置信区间：92.8；22.8-379.1；<0.001）和全身性高血压（9.0；4.0-20.6；<0.001）是滑雪者 SCD 的主要危险因素，但先前的 MI（10.9；3.8-30.9；<0.001）和代谢紊乱，如高胆固醇血症（3.4；2.2-5.2；<0.001）和糖尿病（7.4；1.6-34.3；<0.001）在徒步旅行者中。滑雪者每周进行更多的高强度运动具有保护作用（0.17；0.04-0.74；=0.02），而登山者每年进行更多的山地运动具有保护作用（0.23；0.1-0.4；<0.001）。总之，先前的 MI 病史也是休闲滑雪者和徒步旅行者发生 SCD 的最重要危险因素，适应高强度运动对于预防滑雪者发生 SCD 尤为重要。此外，SCD 危险因素模式的差异以及对滑雪者和徒步旅行者身体素质的要求将有助于医生提供有针对性的建议。
