Haskell W L
Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, CA.
Med Sci Sports Exerc. 1994 Jul;26(7):815-23.
Physical activity performed by patients with coronary heart disease is a two-edged sword. A number of biological changes produced by regular exercise may reduce the risk of future cardiac events, while the increase in cardiac work produced by this same exercise can predispose the patient to sudden cardiac death. Data from observational studies as well as randomized clinical trials demonstrate a lower cardiac mortality rate for men participating in exercise rehabilitation programs vs nonparticipants. Overall, exercise program participants appear to experience a reduction of approximately 25% in cardiac and all-cause mortality, but no single study has provided definitive results. During medically supervised exercise, the risk of cardiac death based on reports of programs in the United States is approximately one event in every 60,000 participant-hours of exercise. At this rate, a typical rehabilitation program that has 95 patients exercising 3 h.wk-1 could expect a sudden cardiac death during an exercise session once every 4 yr. No data have been published on the morbidity or mortality benefits or risks of home-based exercise or for women participants. Also, the contribution of continuous electrocardiographic monitoring to the safety of exercise training of cardiac patients is yet to be defined.
冠心病患者进行体育活动是一把双刃剑。规律运动产生的一些生物学变化可能会降低未来发生心脏事件的风险，而同样的运动所导致的心脏工作负荷增加却可能使患者易发生心源性猝死。观察性研究以及随机临床试验的数据表明，参与运动康复计划的男性与未参与者相比，心脏死亡率更低。总体而言，运动计划参与者的心脏死亡率和全因死亡率似乎降低了约25%，但尚无单一研究给出确切结果。在美国，根据运动项目报告，在医学监督下运动时，心源性死亡风险约为每60000个参与者运动小时数发生1例。按照这个比率，一个有95名患者、每周运动3小时的典型康复计划可能每4年在一次运动课期间出现1例心源性猝死。关于居家运动对发病率或死亡率的益处或风险，以及女性参与者的相关情况，尚无数据发表。此外，连续心电图监测对心脏病患者运动训练安全性的作用尚待明确。
