Triggering of sudden death from cardiac causes by vigorous exertion
Triggering of sudden death from cardiac causes by vigorous exertion
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DOI：
10.1056/nejm200011093431902
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发表时间：
2000-11-09
影响因子：
158.5
通讯作者：
Manson, JE
中科院分区：
文献类型：
--
作者：
Albert, CM;Mittleman, MA;Manson, JE
背景：回顾性和横断面数据表明，剧烈运动可引发心脏骤停或猝死，而习惯性运动可降低这种风险。然而，体育活动在促进或预防心源性猝死中的作用尚未在大量受试者中进行前瞻性评估。方法：我们在医师健康研究中采用前瞻性、嵌套病例交叉设计，比较剧烈运动期间和剧烈运动后30分钟内猝死的风险与轻度运动或不运动期间的猝死风险。然后，我们评估了习惯性剧烈运动是否能改变与剧烈运动相关的猝死风险。此外，还评估了剧烈运动与冠心病猝死和非猝死的总体风险之间的关系。在12年的随访中，在21,481名男性医生中确认了122例猝死，这些医生最初没有自我报告的心血管疾病，并提供了他们在基线上的习惯性运动水平的信息。剧烈运动期间及运动后30分钟内猝死的相对风险为16.9（95%置信区间，10.5 ~ 27.0;P < 0.001）。然而，在任何剧烈运动期间猝死的绝对风险极低（每151万次运动中有1次猝死）。习惯性剧烈运动降低了与剧烈运动发作相关的猝死的相对风险（趋势P值= 0.006）。运动的基线水平与随后突然死亡的总体风险无关。结论：这些来自美国男性医生研究的前瞻性数据表明，习惯性剧烈运动可以降低剧烈运动期间猝死的风险。[J] .中华医学杂志，2000;33(3):355- 361。(C) 2000年，马萨诸塞州医学协会。
Background Retrospective and cross-sectional data suggest that vigorous exertion can trigger cardiac arrest or sudden death and that habitual exercise may diminish this risk. However, the role of physical activity in precipitating or preventing sudden death from cardiac causes has not been assessed prospectively in a large number of subjects.Methods We used a prospective, nested case crossover design within the Physicians Health Study to compare the risk of sudden death during and up to 30 minutes after an episode of vigorous exertion with that during periods of lighter exertion or none. We then evaluated whether habitual vigorous exercise modified the risk of sudden death that was associated with vigorous exertion. In addition, the relation of vigorous exercise to the overall risk of sudden death and nonsudden death from coronary heart disease was assessed.Results During 12 years of follow-up, 122 sudden deaths were confirmed among the 21,481 male physicians who were initially free of self-reported cardiovascular disease and who provided information on their habitual level of exercise at base line. The relative risk of sudden death during and up to 30 minutes after vigorous exertion was 16.9 (95 percent confidence interval, 10.5 to 27.0; P < 0.001). However, the absolute risk of sudden death during any particular episode of vigorous exertion was extremely low (1 sudden death per 1.51 million episodes of exertion). Habitual vigorous exercise attenuated the relative risk of sudden death that was associated with an episode of vigorous exertion (P value for trend = 0.006). The base-line level of exercise was not associated with the overall risk of subsequent sudden death.Conclusions These prospective data from a study of U.S. male physicians suggest that habitual vigorous exercise diminishes the risk of sudden death during vigorous exertion. (N Engl J Med 2000; 343:1355-61.) (C) 2000, Massachusetts Medical Society.