高运动水平对冠状动脉粥样硬化计算机断层血管造影和结果的影响

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-06-14 DOI:10.1016/j.ajpc.2025.101044

Gudrun M Feuchtner , Elias Ruf , Fabian Barbieri , Thomas Senoner , Johannes Deeg , Yannick Scharll , Gerlig Widmann , Pietro G. Lacaita

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引用次数: 0

摘要

背景：高运动量可能对心血管系统有有害影响，“安全”运动量的上限尚不清楚。目的与传统CVRF相比，评价高运动量对冠心病（CAD）的冠脉CTA、心血管结局的影响。方法802例接受冠状动脉CTA治疗的患者（年龄57.6±10.95岁，女性38.1%）。收集自我报告的运动习惯：类型、量（频率/周、时间/单位）；还有多年的训练。终点为：CTA：冠状动脉狭窄严重程度（CADRADS）；high-risk-plaque(合);冠状动脉钙评分（CAC）和MACE。结果共纳入478名受试者。100名高(H)运动水平（每周3 - 5次，每次1-3小时）的人与124名久坐对照组的倾向评分相匹配。两组CVRF血脂异常（p = 0.393）和年龄相似（p = 0.328），而动脉高血压（p = 0.016）、糖尿病（p = 0.032）和BMI (p <；0.001)，在运动员中较低。CAC （80.5 vs 107.7 AU: p = 0.820, CADRADS: p = 0.394）和mace率无差异。随访3.95±1.0年。在性别匹配后，HRP在h组的频率低1.6倍(17% vs 32.8%；P = 0.231；OR为1.58 (95% CI: 0.787-3.222)，吸烟在对照组更为普遍。在调整所有CVRF后，HRP无差异。MET平均值为8.78±3.5；每周训练量9小时。大多数（78%）报告了5 -10年的训练。结论：高水平运动（高达9小时/周）是安全的，对冠状动脉粥样硬化没有有害影响。

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The influence of high exercise levels on the coronary atherosclerosis profile by computed tomography angiography and outcomes

Background

High exercise volumes may have deleterious effects on the cardiovascular system, and the upper thresholds for "safe" volumes are unclear.

Objective

To evaluate if high-exercise volumes influence the coronary artery disease (CAD) profile by coronary CTA, cardiovascular outcomes, compared with traditional CVRF.

Methods

802 patients (age 57.6 ± 10.95 years;38.1 % women) undergoing coronary CTA were enrolled. Self-reported exercise habits were collected: Type, volume (frequency/week and time/per unit); and years of training. Endpoints were: CTA: coronary stenosis severity (CADRADS); high-risk-plaque (HRP); coronary artery calcium score (CAC), and MACE.

Results

478 subjects were included. 100 with high-(H)-exercise level (>3–5x/week and 1–3 h per unit) were propensity-score matched with 124 sedentary controls. The CVRF dyslipidemia (p = 0.393) and age were similar in both groups (p = 0.328), while arterial hypertension (p = 0.016), diabetes (p = 0.032), and the BMI (p < 0.001) were lower in athletes. CAC (80.5 vs 107.7 AU: p = 0.820, CADRADS: p = 0.394) and MACE-rates were not different. Follow-up was 3.95±1.0 years. After matching for sex, HRP was 1.6-fold less frequent in the H-group (17 % vs 32.8 %; p = 0.231; OR 1.58 (95 % CI: 0.787–3.222) and smoking was more prevalent in controls. There was no difference in HRP after adjusting for all CVRF. MET was mean 8.78 ± 3.5; weekly training volume 9 h. The majority (78 %) reported >5 -10 years of training.