Potential mechanisms linking high-volume exercise with coronary artery calcification.
Potential mechanisms linking high-volume exercise with coronary artery calcification.
复制标题
大容量运动与冠状动脉钙化之间的潜在机制。
DOI：
10.1136/heartjnl-2022-321986
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Hsu,JeffreyJ
中科院分区：
文献类型：
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作者：
Zambrano,Angelica;Tintut,Yin;Demer,LindaL;Hsu,JeffreyJ
最近的研究发现，在老年男性耐力运动员中，大量的体力活动与冠状动脉钙化（CAC）水平增加之间存在关联，但潜在的机制在很大程度上仍然难以捉摸。潜在的机制包括更多地暴露于炎性细胞因子、活性氧和氧化的低密度脂蛋白，因为已经发现急性剧烈的体力活动会增强它们的全身释放。其他可能性包括运动后循环甲状旁腺激素升高，这可以改变钙化斑块的数量和形态，以及在剧烈的体力活动期间长期暴露于冠状动脉内的非层流血流，特别是在预先存在动脉粥样硬化的个体中。此外，虽然这种关联仅在男性中被确定，但睾酮在这一过程中的作用仍不清楚。这篇简短的综述讨论了老年男性高容量耐力运动与CAC之间的关联，详细阐述了钙化增加的潜在机制，并为有风险的患者提供了临床意义和建议。
Recent studies have found an association between high volumes of physical activity and increased levels of coronary artery calcification (CAC) among older male endurance athletes, yet the underlying mechanisms have remained largely elusive. Potential mechanisms include greater exposure to inflammatory cytokines, reactive oxygen species and oxidised low-density lipoproteins, as acute strenuous physical activity has been found to enhance their systemic release. Other possibilities include post-exercise elevations in circulating parathyroid hormone, which can modify the amount and morphology of calcific plaque, and long-term exposure to non-laminar blood flow within the coronary arteries during vigorous physical activity, particularly in individuals with pre-existing atherosclerosis. Further, although the association has only been identified in men, the role of testosterone in this process remains unclear. This brief review discusses the association between high-volume endurance exercise and CAC in older men, elaborates on the potential mechanisms underlying the increased calcification, and provides clinical implications and recommendations for those at risk.