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运动参与是否会增加长 QT 综合征患者的风险?来自法国大型队列的研究结果。

Does sports participation increase risk in patients with long QT syndrome? Results from a large French cohort.

机构信息

Service de Cardiologie, L'institut du thorax, CHU Nantes, Nantes, France.

Service de Cardiologie, CHU de Bordeaux, Bordeaux, France.

出版信息

Europace. 2022 Oct 13;24(10):1675-1683. doi: 10.1093/europace/euac047.

Abstract

AIMS

Sports practice, especially in competition, is usually restrained in patients diagnosed with long QT syndrome (LQTS). Although data are scarce, a low incidence of cardiac arrhythmic events (CAEs) during sports practice is reported. We aim to evaluate the incidence of CAE during sports practice in LQTS patients.

METHODS AND RESULTS

All consecutive patients above 18 years of age diagnosed with LQTS and prospectively followed at the referral centre for inherited arrhythmia syndrome received a survey to retrospectively assess their sports practice prior to and after the diagnosis of LQTS. Two hundred and forty-six patients were included (57% females). The median age was 43 years, and the median QTc was 457 ms (428; 482). Patients reported a total of 4092 years [1376 (34%) after diagnosis] of sports practice: 2905 (77%) [1138 (39%) after diagnosis] years of leisure practice and 1187 (23%) [238 (20%) after diagnosis] years of competitive practice. One hundred and eighty (73%) patients practiced sport prior to the diagnosis of LQTS and 170 (69%) after. Prior to the diagnosis, four (2%) patients presented a CAE during leisure sports practice and one during competition. After diagnosis, only one patient presented a CAE, appropriately treated by an implantable cardioverter defibrillator discharge, in the context of beta-blocker non-compliance. The CAE event rate was 0.0007 events/year in the 1376 years of total sports practice after the diagnosis of LQTS.

CONCLUSION

After the diagnosis of LQTS, the occurrence of CAE is very low during sports practice, even in competitive practice. There was no CAE in patients properly treated with beta-blocker therapy with good compliance.

摘要

目的

运动,尤其是竞技运动,通常会受到长 QT 综合征(LQTS)患者的限制。尽管数据有限,但有报道称,LQTS 患者在运动期间发生心律失常事件(CAE)的发生率较低。我们旨在评估 LQTS 患者在运动期间发生 CAE 的发生率。

方法和结果

所有年龄在 18 岁以上、在遗传性心律失常综合征转诊中心被诊断为 LQTS 并接受前瞻性随访的连续患者均接受了一项调查,以回顾性评估他们在诊断为 LQTS 前后的运动情况。共纳入 246 名患者(57%为女性)。中位年龄为 43 岁,中位 QTc 为 457ms(428;482)。患者报告的总运动时间为 4092 年[诊断后为 1376 年(34%)]:2905 年(77%)[诊断后为 1138 年(39%)]休闲运动和 1187 年(23%)[诊断后为 238 年(20%)]竞技运动。180 名(73%)患者在诊断为 LQTS 之前进行运动,170 名(69%)患者在诊断之后进行运动。在诊断之前,4 名(2%)患者在休闲运动期间发生了 CAE,1 名患者在竞技运动期间发生了 CAE。在诊断之后,只有 1 名患者因未能遵医嘱服用β受体阻滞剂而发生 CAE,通过植入式心脏复律除颤器放电得到恰当治疗。在诊断为 LQTS 后的 1376 年总运动时间中,CAE 事件发生率为 0.0007 次/年。

结论

在诊断为 LQTS 之后,即使在竞技运动期间,运动期间发生 CAE 的情况也非常低。在接受β受体阻滞剂治疗且依从性良好的患者中,没有发生 CAE。

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