Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association
Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association
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DOI：
10.1161/cir.0000000000000749
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发表时间：
2020-03-31
期刊：
影响因子：
37.8
通讯作者：
Eijsvogels, Thijs M. H.
中科院分区：
文献类型：
--
作者：
Franklin, Barry A.;Thompson, Paul D.;Eijsvogels, Thijs M. H.
流行病学和生物相容性研究支持增加体力活动或心肺健康水平与减少冠心病事件之间的因果关系。这些数据，再加上运动的抗衰老作用，可能导致越来越多的成年人接受了“更多运动更好”的概念。“因此，自美国心脏协会先前关于运动风险的声明以来，世界范围内参与耐力训练、竞争性长距离耐力赛事和高强度间歇训练的人数显著增加。另一方面，剧烈的体力活动，特别是由不健康的人进行时，会急剧增加易感人群的心源性猝死和急性心肌梗死的风险。最近的研究还表明，大运动量和剧烈运动强度都与潜在的心脏适应不良有关，包括加速冠状动脉钙化，运动诱导的心脏生物标志物释放，心肌纤维化和心房颤动。这些适应不良反应与体力活动之间的关系通常形成U形或倒J形的剂量反应曲线。本科学声明根据目前对相关风险和益处的理解，讨论了中度至剧烈体力活动以及高容量、高强度运动方案对心血管和健康的影响。其目标是为医疗保健专业人员提供最新信息，以建议患者在不同环境和竞争性事件中进行适当的体力活动或体力消耗筛查以及体力活动或体力消耗的益处和风险。
Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart disease events. These data, plus the well-documented anti-aging effects of exercise, have likely contributed to the escalating numbers of adults who have embraced the notion that "more exercise is better." As a result, worldwide participation in endurance training, competitive long distance endurance events, and high-intensity interval training has increased markedly since the previous American Heart Association statement on exercise risk. On the other hand, vigorous physical activity, particularly when performed by unfit individuals, can acutely increase the risk of sudden cardiac death and acute myocardial infarction in susceptible people. Recent studies have also shown that large exercise volumes and vigorous intensities are both associated with potential cardiac maladaptations, including accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, and atrial fibrillation. The relationship between these maladaptive responses and physical activity often forms a U- or reverse J-shaped dose-response curve. This scientific statement discusses the cardiovascular and health implications for moderate to vigorous physical activity, as well as high-volume, high-intensity exercise regimens, based on current understanding of the associated risks and benefits. The goal is to provide healthcare professionals with updated information to advise patients on appropriate preparticipation screening and the benefits and risks of physical activity or physical exertion in varied environments and during competitive events.