体育锻炼、心肺功能和动脉粥样硬化性心血管疾病:第 1 部分。

IF 3.8 Q1 PERIPHERAL VASCULAR DISEASE
Pulse Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI:10.1159/000541165
Barry A Franklin, Sae Young Jae
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引用次数: 0

摘要

背景:医学界和他们所服务的患者往往没有充分认识到经常进行中到强度的体育锻炼(PA)、增强心肺功能(CRF)或两者兼而有之对心脏的保护作用和预后意义。在危险因素或冠状动脉钙化(CAC)评分匹配的情况下,CRF 低的人过早死于动脉粥样硬化性心血管疾病(CVD)的几率是体质较好的人的 2 到 3 倍。因此,本综述分两部分,第一部分探讨了这些关系以及潜在的获益机制(如运动预处理)、运动预处理)对动脉粥样硬化性心血管疾病的益处,特别是步态速度和死亡率、作为单独风险因素的 CRF 和 PA、CRF 和/或 PA 对减轻 CAC 评分升高的不利影响的关系,以及可能有利地改变 CAC 形态、对心房颤动事件、全因和心血管死亡率以及心脏性猝死 (SCD) 的影响。第 1 部分通过研究 CRF 和 PA 作为单独风险因素的作用、潜在的获益机制以及它们对步速、死亡率和心房颤动的影响,探讨了 CRF 和 PA 如何降低动脉粥样硬化性心血管疾病导致过早死亡的风险。该综述还探讨了CRF和PA如何减轻CAC评分升高的不利影响、如何改变CAC形态以及如何降低SCD风险:经常进行体育锻炼和高CRF对于降低心血管疾病导致的过早死亡风险和减轻CAC评分升高的负面影响至关重要。此外,它们还能显著预防 SCD 和心房颤动,强调了其广泛的心脏保护作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physical Activity, Cardiorespiratory Fitness and Atherosclerotic Cardiovascular Disease: Part 1.

Background: The cardioprotective benefits and prognostic significance of regular moderate-to-vigorous physical activity (PA), increased cardiorespiratory fitness (CRF), or both are often underappreciated by the medical community and the patients they serve. Individuals with low CRF are two to three times more likely to die prematurely from atherosclerotic cardiovascular disease (CVD), than their fitter counterparts when matched for risk factor profile or coronary artery calcium (CAC) score. Accordingly, part 1 of this 2-part review examines these relations and the potential underlying mechanisms of benefit (e.g., exercise preconditioning) on atherosclerotic CVD, with specific reference to gait speed and mortality, CRF and PA as separate risk factors, and the relation between CRF and/or PA on attenuating the adverse impact of an elevated CAC score, as well as potentially favorably modifying CAC morphology, and on incident atrial fibrillation, all-cause and cardiovascular mortality, and on sudden cardiac death (SCD).

Summary: We explore the underappreciated cardioprotective effects of regular PA and CRF. Part 1 examines how CRF and PA reduce the risk of premature death from atherosclerotic CVD by investigating their roles as separate risk factors, the potential underlying mechanisms of benefit, and their impact on gait speed, mortality, and atrial fibrillation. The review also addresses how CRF and PA may mitigate the adverse impact of an elevated CAC score, potentially modifying CAC morphology, and reduce the risk of SCD.

Key messages: Regular PA and high CRF are essential for reducing the risk of premature death from CVD and mitigating the negative impact of elevated CAC scores. Additionally, they provide significant protection against SCD and atrial fibrillation, emphasizing their broad cardioprotective effects.

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