Exercise in Genetic Cardiovascular Conditions

遗传性心血管疾病的锻炼

• 批准号: 9000740
• 负责人: MICHAEL JOHN ACKERMAN
• 金额: $ 122.77万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9000740
• 关键词: American; Arrhythmia; Benefits and Risks; Cardiac; Cardiovascular system; Cessation of life; Clinical; Cohort Studies; Consensus; Coronary Arteriosclerosis; Data; Data Reporting; Decision Making; Emotional; Enrollment; Europe; Exercise; Future; Genetic; Health; Heart Arrest; Hypertrophic Cardiomyopathy; Implantable Defibrillators; Individual; Life; Long QT Syndrome; Longevity; Medical; Methodology; Moderate Exercise; Multicenter Studies; Outcome; Outcome Study; Patient Care; Patient advocacy; Patients; Physicians; Population; Quality of life; Recommendation; Recruitment Activity; Registries; Reporting; Research Infrastructure; Risk; Risk Marker; Safety; Series; Serious Adverse Event; Site; Sports; Strenuous Exercise; Syncope; Ventricular Arrhythmia; advocacy organizations; cohort; high risk; prospective; psychologic; sedentary; sudden cardiac death

 DESCRIPTION (provided by applicant): Exercise is an integral part of life for millions of Americans. The benefits of exercise are well- known-improvement in longevity and quality of life (QOL). However, while data on safety of exercise for patients with genetic cardiovascular conditions, such as the long QT syndrome (LQTS), and hypertrophic cardiomyopathy (HCM,) are sparse, the risk of sudden cardiac death due to vigorous competitive or recreational activities for these patients is thought to be prohibitively high and these patients are restricted from participation in not just competitive, but most recreational sports as well, by current consensus statements in both the US and Europe. However, preliminary data suggest that first, many patients with these conditions are exercising despite the restrictions and second, that the risks may be lower than postulated, and that there may be detrimental effects of exercise restriction in these patients. Whether the risks of exercise outweigh the medical and quality-of-life benefits for patients with these LQTS and HCM has never been evaluated prospectively. This study will prospectively investigate the risks and benefits of exercise for patients with LQTS and HCM in parallel observational cohorts. The study will evaluate the hypothesis that risks of death, cardiac arrest, syncope, or appropriate ICD therapy will not be higher in those exercising moderately or vigorously than the sedentary, and that quality of life will be greater in those exercising. Individuals with HCM and LQT who have chosen to continue to exercise will be identified and enrolled both through traditional recruiting sites, and through partnering with patient-advocacy organizations and less active patients will be enrolled as a comparator group. These subjects will then be followed prospectively for three years. Results of this study will have an immediate and direct impact on patient care. If the hypotheses are correct, many more individuals will enjoy the benefits of exercise. If the hypotheses prove incorrect, those currently exercising need to know, and exploratory aims will investigate what phenotypic, clinical, genotypic, and sports-related factors may moderate the impact of exercise on arrhythmic outcomes, and will identify clinical and psychological variables which may moderate the impact of exercise restriction on quality of life.

 描述（由申请人提供）：运动是数百万美国人生活中不可或缺的一部分。运动的好处是众所周知的--延长寿命和提高生活质量。然而，虽然有关患有遗传性心血管疾病（例如长QT综合征（LQTS）和肥厚性心肌病（HCM））的患者运动安全性的数据很少，但由于这些患者剧烈的竞争或娱乐活动而导致心脏性猝死的风险被认为是过高的，并且这些患者受到限制 从参与不仅是竞争性的，但大多数娱乐体育以及，目前在美国和欧洲的共识声明。然而，初步数据表明，第一，许多患有这些疾病的患者尽管受到限制，但仍在锻炼，第二，风险可能低于假设，并且这些患者的运动限制可能会产生不利影响。对于这些LQTS和HCM患者，运动的风险是否超过医疗和生活质量益处从未进行过前瞻性评估。这项研究将前瞻性地调查运动对LQTS患者的风险和益处 和HCM的平行观察队列。该研究将评估以下假设：中度或剧烈运动的患者死亡、心脏骤停、晕厥或适当ICD治疗的风险不会高于久坐不动的患者，并且运动患者的生活质量会更高。选择继续锻炼的HCM和LQT患者将通过传统招募网站和与患者倡导组织合作进行识别和招募，活动较少的患者将被招募为对照组。这些受试者将接受为期三年的前瞻性随访。这项研究的结果将有 对病人的护理产生直接的影响。如果假设是正确的，更多的人将享受锻炼的好处。如果这些假设被证明是错误的， 运动需要知道，探索性的目的将调查哪些表型，临床，基因型和运动相关因素可能会缓和运动对运动结果的影响，并将确定可能缓和运动限制对生活质量影响的临床和心理变量。