Evaluating the cardiovascular tolerance for sex.
Evaluating the cardiovascular tolerance for sex.
复制标题
评估心血管对性的耐受性。
DOI：
10.1016/s0002-9149(00)00894-8
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
DeBusk,RF
中科院分区：
文献类型：
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作者：
DeBusk,RF
心血管对性的耐受力在很大程度上等同于体力活动，但性唤起起着重要作用。运动测试很有用，主要用于评估功能能力，这反映了身体状况的程度以及心绞痛、呼吸困难和疲劳症状所造成的限制。运动测试对于评估久坐患者的功能能力很有用，但对于身体活跃的患者通常是不必要的。运动测试，无论有或没有放射性核素成像，在评估未来心血管事件的风险方面价值有限——这是所有诊断测试（包括冠状动脉造影）所共有的局限性。性交引起的心肌梗塞 (MI) 或死亡的绝对风险极低——健康中年人每小时每百万人中有 2 次机会，缺血性心脏病“高危”患者每小时每百万人有 20 次机会。这分别相当于年风险 1.01% 和 1.2%。性对于急性冠脉事件的诱发因素相对较弱，仅占所有此类事件的 0.5-1.0%。个体对性的心血管耐受力可以用“功能储备”来表征，即心血管对性的反应（通过心率、血压和耗氧量来衡量）侵犯对运动的峰值反应的程度。如果患者在相当于 6 METS 的运动测试中未出现类似症状，则性交过程中的心血管症状很少出现。
The cardiovascular tolerance for sex has largely been equated with physical activity, yet sexual arousal plays a major role. Exercise testing is useful, primarily for evaluating functional capacity, which reflects the extent of physical conditioning and the limitation imposed by symptoms of angina, dyspnea, and fatigue. Exercise testing, which is useful for evaluating functional capacity in sedentary patients, is generally unnecessary in physically active patients. Exercise testing, with or without radionuclide imaging, is of limited value in assessing the risk of future cardiovascular events—a limitation shared by all diagnostic tests, including coronary angiography. The absolute risks of coition-induced myocardial infarction (MI) or death are extremely low—on the order of 2 chances per million per hour in healthy middle-aged individuals or 20 chances per million per hour in “high-risk” patients with ischemic heart disease. This is equivalent to an annual risk of 1.01% and 1.2%, respectively. Sex is a comparatively weak precipitant of acute coronary events, accounting for only 0.5–1.0% of all such events. The cardiovascular tolerance for sex in an individual can be characterized by the “functional reserve,” that is, the extent to which the cardiovascular response to sex—measured by the heart rate, blood pressure, and oxygen consumption—encroaches on the peak response to exercise. Cardiovascular symptoms during sex rarely occur in patients who do not experience similar symptoms during exercise testing at a level equivalent to 6 METS.