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The ESC Textbook of Sports Cardiology最新文献

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Evaluation of ischaemia, blood pressure, QT interval, and arrhythmias 评估缺血、血压、QT间期和心律失常
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0011
F. Schnell, F. Carré
{"title":"Evaluation of ischaemia, blood pressure, QT interval, and arrhythmias","authors":"F. Schnell, F. Carré","doi":"10.1093/med/9780198779742.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0011","url":null,"abstract":"Exercise is a major stress for the cardiovascular system, and therefore many adverse cardiac events can occur during intense exercise. Thus it makes sense to perform maximal exercise testing when assessing an athlete presenting with exertional symptoms, with a known cardiac disease, or for pre-participation evaluation. Nevertheless, the limits of exercise testing must be kept in mind. Exercise testing has a high rate of false-positive results for identifying ischaemia in an asymptomatic athlete. The value of exercise testing in the evaluation of arrhythmias is proved, but the constraints of an exercise test in a laboratory do not reflect those induced on the field. It seems more appropriate to analyse the kinetics of blood pressure (BP) responses during exercise testing rather than to check only the maximal systolic BP. Regular intense training may prolong QTc duration; nevertheless, because of the lack of specific studies on athletes, the same interpretation of QT responses to exercise validated in the general population is used for athletes.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115872776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The risk, aetiology, clinical features, management, and prevention of exercise-related sudden cardiac death and acute cardiac events in adult athletes 成年运动员运动相关心源性猝死和急性心脏事件的风险、病因、临床特征、管理和预防
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0035
P. Thompson
{"title":"The risk, aetiology, clinical features, management, and prevention of exercise-related sudden cardiac death and acute cardiac events in adult athletes","authors":"P. Thompson","doi":"10.1093/med/9780198779742.003.0035","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0035","url":null,"abstract":"Regular physical activity reduces atherosclerotic coronary artery disease (CAD) events including acute myocardial infarction (AMI) and sudden cardiac death (SCD). Conversely, vigorous exercise acutely and transiently increases the risk of both these CAD events in adult athletes with known or occult CAD. CAD is the cause of most exercise-related SCDs in adult athletes. Exercise-related AMIs are typically caused by atherosclerotic plaque rupture and acute thrombosis, whereas exercise-related SCD can be caused by both plaque rupture and exercise-induce ischaemia. The management of athletes with CAD requires aggressive risk factor reduction plus an assessment of risk for an acute cardiac event based on exercise testing, ventricular function measurement, and an assessment of electrical stability. Whether or not an athlete should return to competition after a CAD event is a joint decision made by the athlete and the clinician based on the risks and benefits of athletic participation for that athlete.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131904414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physical activity and leisure-time exercise prescription for sedentary/untrained individuals 体力活动和休闲时间运动处方久坐/未经训练的人
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0042
M. Piepoli, M. Dellborg, M. Börjesson
{"title":"Physical activity and leisure-time exercise prescription for sedentary/untrained individuals","authors":"M. Piepoli, M. Dellborg, M. Börjesson","doi":"10.1093/med/9780198779742.003.0042","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0042","url":null,"abstract":"Modern life is associated with limited physical demands. Societal change has made travel, work, and free time physically less demanding. Sedentary/untrained individuals are an increasing group in modern society, and they are also considered to be at higher risk of cardiovascular complications. Thus this group should benefit from an increased level of physical activity (PA) as both primaryand secondary prevention. Advice on lifestyle should include guidance on smoking, eating, and physical activity, each complementary and additive to the other. The prescription of exercise to sedentary individuals is recommended to all, but should include an individual risk–benefit analysis to achieve the maximum potential health benefits at the lowest possible risk. However, there are also some absolute contraindications for PA in sedentary individuals. The final prescription should be followed up, and it should include assessment of the PA level and/or fitness, and must be adjusted when indicated.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130533855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Electrophysiological study 电生理研究
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0014
M. Antz
{"title":"Electrophysiological study","authors":"M. Antz","doi":"10.1093/med/9780198779742.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0014","url":null,"abstract":"An electrophysiological (EP) study is performed for diagnostic reasons, for risk assessment, and for therapy of arrhythmias. It can be useful in athletes with palpitations or documented arrhythmias of unclear origin, in non-sustained ventricular tachycardia, structural heart disease, or electrical abnormalities such as the Brugada syndrome, and for treatment of ectopic beats, supraventricular or ventricular tachycardia, and atrial fibrillation.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124503967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular causes of sudden death in athletes 运动员猝死的心血管原因
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0034
C. Basso, S. Rizzo, G. Thiene
{"title":"Cardiovascular causes of sudden death in athletes","authors":"C. Basso, S. Rizzo, G. Thiene","doi":"10.1093/MED/9780198779742.003.0034","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0034","url":null,"abstract":"Sudden cardiac death (SCD) is usually the result of an interaction between transient acute events (’triggers’) and either structural or non-structural cardiovascular substrates. The structural culprit resides in any of the cardiovascular components, i.e. aorta, coronary arteries, myocardium, valves, conduction system, or ion channels. Epidemiological studies have demonstrated that the occurrence of SCD in athletes is nearly three times than that in non-athletes, so that sport activity adds a significant risk if the athletes are affected by concealed cardiac diseases. Triggers of SCD in young competitive athletes include exercise-related sympathetic stimulation, abrupt haemodynamic changes, and myocardial ischaemia. In this chapter, we will review the various structural diseases, either congenital or acquired, which pose a risk of SCD in athletes. Disparities among published studies emphasizes the need for uniform reporting (source of data, retrospective versus prospective, autopsy versus no autopsy, etc). Identifying causes of SCD in the athletic population is important for guiding preventive measures.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123981785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Overlap ECG patterns in the athlete’s heart and cardiomyopathies 重叠心电图模式在运动员的心脏和心肌病
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0009
H. Dhutia, M. Papadakis
{"title":"Overlap ECG patterns in the athlete’s heart and cardiomyopathies","authors":"H. Dhutia, M. Papadakis","doi":"10.1093/MED/9780198779742.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0009","url":null,"abstract":"Physiological adaptation to exercise manifests on the surface ECG with phenotypes that occasionally overlap with those present in patients with cardiomyopathy, one of the leading causes of exercise-related cardiac death in young athletes. In the era of pre-participation screening, differentiation of physiology from pathology is crucial given the potential consequences of an erroneous diagnosis or false reassurance. This chapter provides a comprehensive overview of the ECG anomalies that may cause diagnostic dilemmas in clinical practice, delineates the size of the ‘ECG grey zones’, and provides practical algorithms for ascertaining which ECG phenotypes require further evaluation.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115116137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular screening of children and adolescent athletes (<14 years) 儿童和青少年运动员(<14岁)心血管筛查
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0040
M. Chessa, W. Budts, Javier Fernández Sarabia
{"title":"Cardiovascular screening of children and adolescent athletes (<14 years)","authors":"M. Chessa, W. Budts, Javier Fernández Sarabia","doi":"10.1093/med/9780198779742.003.0040","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0040","url":null,"abstract":"Sport is not in itself the cause of enhanced mortality. During physical activity physiological changes, such as increased catecholamine levels, acidosis, and dehydration, can trigger cardiac arrest in those young athletes who are affected by underlying cardiovascular disorders. Because sports can prompt adverse events from underlying cardiac disease, pre-participation screening has been advised as strategy in the prevention of sudden cardiac death (SCD) in competitive athletes. SCD is rare in young healthy athletes, but remains a tragic and counter-intuitive event, subject to persistently high public visibility, triggering of emotion, and media attention, with potential legal liability considerations. Pre-participation screening in children and adolescent athletes can be done by an experienced specialist (paediatrician, family doctor, cardiologist, or sports medicine specialist); it includes family and personal history, physical examination (including blood pressure), and resting 12-lead ECG. All these issues are discussed in this chapter.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115149164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac safety at fitness centres 健身中心的心脏安全
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0046
E. Solberg, Jakob Johansson, A. Biffi
{"title":"Cardiac safety at fitness centres","authors":"E. Solberg, Jakob Johansson, A. Biffi","doi":"10.1093/MED/9780198779742.003.0046","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0046","url":null,"abstract":"Fitness centres are a major location for exercise. There is a lack of data on adverse cardiac events and the structure of cardiovascular safety at such centres. No European recommendation is available. However, sudden cardiac arrest at such centres has a documented higher survival rate. Potentials for prevention of cardiac events thus exist, although the standard of emergency equipment on site, regular training in basic life support for staff members, and emergency plans could be improved.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129759266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arrhythmogenic cardiomyopathy and sudden death in young athletes: causes, pathophysiology, and clinical features 年轻运动员的心律失常性心肌病和猝死:原因、病理生理学和临床特征
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0022
G. Thiene, K. Pilichou, S. Rizzo, C. Basso
{"title":"Arrhythmogenic cardiomyopathy and sudden death in young athletes: causes, pathophysiology, and clinical features","authors":"G. Thiene, K. Pilichou, S. Rizzo, C. Basso","doi":"10.1093/med/9780198779742.003.0022","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0022","url":null,"abstract":"Arrhythmogenic cardiomyopathy (AC) is a rare non-ischaemic cardiomyopathy with a prevalence in of 1:200 to 1:5000. In the 1980s, the disorder was demonstrated to be a major cause of sudden death (SD) in the young and athletes, thus emphasizing the need for early diagnosis for disqualification from sport activity. Pre-participation screening using ECG is effective in detecting ECG abnormalities which raise suspicion of the disease, requiring additional second- and third-level investigations to obtain a definite diagnosis. Cardiac magnetic resonance (CMR), which can detect both morpho-functional and tissue abnormalities, is probably the best tool for assessing doubtful cases. The rarer left ventricular variant (‘non-ischaemic left ventricular scar’) is not detected by ECG at first-level pre-participation screening, which presents a major challenge for SD prevention. Risk stratification consensus criteria recommend use of an implantable cardioverter defibrillator (ICD). Use of pre-participation screening and automated external defibrillators (AEDs), working together should help to prevent SD. Since at least 60% of cases are heredofamilial and usually present desmosome gene mutations, genetic investigation should be carried out in the proband and cascade genetic screening should be offered to first-degree family members for primary prevention. Basic research into the AC pathogenic mechanisms is in progress, and there is clinical and experimental evidence that exercise with right ventricular overload may favour onset and progression of AC, at least in genotype-positive patients. Reduction of sports activity will not only prevent abrupt onset of ventricular arrhythmias with the risk of SD, but may also delay phenotype expression.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129589978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac safety at sports events: the medical action plan 体育赛事中的心脏安全:医疗行动计划
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0045
L. Serratosa, E. Kramer, M. Börjesson
{"title":"Cardiac safety at sports events: the medical action plan","authors":"L. Serratosa, E. Kramer, M. Börjesson","doi":"10.1093/MED/9780198779742.003.0045","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0045","url":null,"abstract":"The cardiac-specific medical services plan, in and around a sports stadium or arena, should be carefully undertaken and individualized, in order to ensure safe, effective, and coordinated management of any sudden cardiac arrest (SCA).\u0000 This is ensured practically by tailoring the designated number and skills of on-duty health-care personnel and by having adequate and appropriate medical equipment, effective communication systems, and the emergency medical service transportation logistics required to initiate cardiopulmonary resuscitation (CPR) and defibrillation within the first 3–5 minutes after SCA, regardless of the size or type of sport environment. The planning should be written down in a medical action plan (MAP) which should be communicated to all relevant and appropriate officials, health-care personnel, and, where relevant, participants and spectators. Relevant contact information regarding activation of the necessary emergency medical services, listing the sport environment health-care personnel, and continuous education and skills training are vital parts of the MAP.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126234772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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