Maron B J, Poliac L C, Roberts W O
Cardiovascular Research Division, Minneapolis Heart Institute Foundation, Minnesota 55407, USA.
J Am Coll Cardiol. 1996 Aug;28(2):428-31. doi: 10.1016/0735-1097(96)00137-4.
This analysis was performed to quantitatively assess the relative risks, associated with underlying cardiovascular disease, incurred in the course of intense competitive sports.
Sudden cardiac death during athletic activities is a highly visible event, and controversy persists regarding the true risks associated with participation in sports.
The prevalence of sudden death was assessed in two systematically tabulated groups of endurance runners competing in the annual Marine Corps (1976 to 1994) and Twin Cities (1982 to 1994) marathons, held over a cumulative 30-year period.
A total of 215,413 runners completed the races, and four exercise-related sudden deaths occurred, each due to unsuspected structural cardiovascular disease. Three deaths occurred during the race (after 15 to 24 miles [24 to 38.4 km]) and the other immediately after its completion. The ages were 19 to 58 years (average 37), and three were men. Three of the sudden deaths were due to atherosclerotic coronary artery disease (narrowing of two or three vessels) and one to anomalous origin of the left main coronary artery from the right sinus of Valsalva. None of the four runners had prior documentation of heart disease or experienced prodromal symptoms, and two had previously completed three marathon races each. The overall prevalence of sudden cardiac death during the marathon was only 0.002%, strikingly lower than for several other variables of risk for premature death calculated for the general U.S. population.
Although highly trained athletes such as marathon runners may harbor underlying and potentially lethal cardiovascular disease, the risk for sudden cardiac death associated with such intense physical effort was exceedingly small (1 in 50,000) and as little as 1/100th of the annual overall risk associated with living, either with or without heart disease. The low risk for sudden death identified in long-distance runners from the general population suggests that routine screening for cardiovascular disease in such athletic populations may not be justifiable.
进行此项分析以定量评估在激烈的竞技运动过程中，与潜在心血管疾病相关的相对风险。
体育活动期间的心脏性猝死是一个备受关注的事件，对于参与运动的真正风险仍存在争议。
在两个系统列表的耐力跑者群体中评估猝死发生率，这些跑者参加了在30年期间累计举办的年度海军陆战队马拉松（1976年至1994年）和双城马拉松（1982年至1994年）。
共有215,413名跑者完成了比赛，发生了4例与运动相关的心脏性猝死，每例均归因于未被怀疑的结构性心血管疾病。3例死亡发生在比赛期间（15至24英里[24至38.4公里]之后），另一例在比赛结束后立即发生。年龄为19至58岁（平均37岁），3例为男性。3例心脏性猝死归因于动脉粥样硬化性冠状动脉疾病（两支或三支血管狭窄），1例归因于左主冠状动脉起源于右冠窦的异常。4名跑者均无心脏病既往记录或前驱症状，其中2名此前各自完成过3次马拉松比赛。马拉松期间心脏性猝死的总体发生率仅为0.002%，显著低于为美国普通人群计算的其他几个过早死亡风险变量。
尽管像马拉松跑者这样的高度训练的运动员可能存在潜在的致命性心血管疾病，但与这种高强度体力活动相关的心脏性猝死风险极小（五万分之一），仅为有或无心脏病的人群每年总体生存风险的1/100。从普通人群中长跑者发现的低猝死风险表明，对此类运动员群体进行心血管疾病的常规筛查可能不合理。
