Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom.
Cardiovascular Sciences Research Centre, St George's, University of London, London, United Kingdom.
J Am Coll Cardiol. 2024 Jan 16;83(2):350-370. doi: 10.1016/j.jacc.2023.10.032.
Athletes epitomize the healthiest segment of society. Despite this premise, sudden cardiac death may occur in apparently healthy athletes, attracting significant attention not only in the medical community but also in laypersons and media. The incidence of sudden cardiac death is variably reported, and epidemiological burden differs among cohorts. Athletes appear to be at risk of developing fatal arrhythmias when harboring a quiescent cardiac disorder. Primary cardiomyopathies, ion channelopathies, and coronary artery anomalies are prevalent causes in young individuals. Cardiac assessment of athletes can be challenging because these individuals exhibit a plethora of electrical, structural, and functional physiological changes that overlap with cardiac pathology. A diagnosis of cardiac disease in a young athlete is not necessarily an indication to terminate competition and sports participation. International guidelines, traditionally focused on disqualification of individuals with cardiac disease, have recently adopted a more liberal attitude, based on a careful assessment of the risk and on a shared-decision making approach.
运动员是社会中最健康的群体。尽管如此，看似健康的运动员也可能会发生心源性猝死，这不仅引起了医学界的高度关注，也引起了非专业人士和媒体的关注。心源性猝死的发生率报道不一，不同队列的流行病学负担也不同。当运动员隐匿性心脏疾病时，可能会有发生致命性心律失常的风险。原发性心肌病、离子通道病和冠状动脉异常是年轻人中常见的原因。评估运动员的心脏情况具有一定的挑战性，因为这些个体表现出许多与心脏病理学重叠的电、结构和功能的生理性变化。在年轻运动员中诊断出心脏疾病并不一定意味着必须终止比赛和运动参与。传统上，国际指南侧重于患有心脏病的运动员被取消参赛资格，但最近基于对风险的仔细评估和共同决策方法，采取了更为宽松的态度。
