Cardiac Risk of Exercise studies

bethdrysdale94's version from 2017-01-21 21:17

Section 1

Question Answer
What is hypertrophic cardiomyopathy?inherited heart muscle disease, ventricle walls are thickened, compromise cardiac function, can lead to cardiac arrythmias, 1/500 UK population
Albert et al (2000) physicians, sudden deaths and exercise study info12 years follow up, 21,000+ male physicians. 122 sudden deaths. deaths in and up to 30 mins of vigorous exercise compared to lighter or no exercise.
Albert et al (2000) study findingsRR of sudden death during and after 30 mins of vigorous exercise = 16.9. RR higher in those who did light or no exercise regularly.
Albert et al (2000) study strengths and weaknesses prospective, case-crossover. reliable, statistically significant. large population, but only physicians
Mittleman et al (1993) interviews post MI study info1228 post MI interviews. looking at MIs due to heavy physical exertion, and how much physical exertion usually undertaken by patients
Mittleman et al (1993) study findingsRR of MI onset decreased with higher frequency of heavy physical exertion
Mittleman et al (1993) study strengths and limitationsself report bias. observational. what classes as "heavy exertion"?
Kim et al (2012) runners and cardiac arrests study info10.9 million runners. looked at cardiac arrest incidences during races. and race type
Kim et al (2012) study findings59 suffered cardiac arrest, 51 were male. incidence was higher in marathons than half marathons. most non-survivors had or were suspected to have HCM
Kim et al (2012) study strengths and limitationsretrospective. may have failed to collect all data, unable to find postmortems on all the deaths in the case.
Thompson et al (2007) reports:habitual activity reduces CHD. vigorous activity transiently decreases risk of sudden death and MI. congenital and hereditary abnormalities account for most of the young incidences. atherosclerosis is biggest risk for adults. Incidence of MI and SD is greatest in habitually least active
Havard Alumni Health Study - Paffenbarger et al (1986) reportsage adjusted risk of death highest in those that do less than 500kcal/week exercise. increases again in those that do up to or more than 3500kcal/week exercise.
Wen et al (2011) reportsall cause mortality reduced when doing daily PA. vigorous exercise provides the biggest reduction in shorter exercise time.
O'Keefe & Lavie (2012) reportsall cause mortality hazard ratio lowest between 0.1-20 miles/week. highest when 0 miles/week. second highest when 25+ miles per week. third highest when 20-24.9 miles/week.
Eijsvogels et al (2016) cardiac troponin study measured cardiac troponin in athletes who ran in the boston marathon. there was an exercise induced increase. suggests cardiac damage.
Bosomworth (2015) review on AF and PA studyreview of observational studies looking at evidence between levels of PA and AF incidence
Bosomworth (2015) findingshigh PA increases risk of AF, but effect is modest and there is no effect on mortality. No firm threshold or guidance that can be drawn from the literature.
Bosomworth (2015) study strengths and weaknessesonly observational studies, no interventional ones available

Section 2

Question Answer
is there a safe upper dose limit of exercise?maybe
chronic intense sustained exercise can cause what that may lead to arrythmias?patchy myocardial fibrosis particularly in the atria, septum and RV which can lead to arrythmias.
chronic intense sustained exercise can cause what to happen to the arteries?coronary artery stiffening, calcification of larger arteries, diastolic dysfunction
what group of people have a 5 fold increase in AF prevalence?veteran endurance athletes
what effect does vigorous exercise have on MI?transiently increases risk but overall risk is low
what types of exercise can lead to longevity/can be detrimental?regular moderate activity/excessive exercise respectively
is there enough data to draw any conclusions about vigorous exercise and MI/AF risk?no, there is insufficient data presently.