Kardiovaskuläre Risiken körperlicher Extrembelastungen

Zusammenfassung

Regelmäßiger Ausdauersport in mittlerer Intensität reduziert die kardiovaskuläre Ereignisrate und die Gesamtmortalität. Ältere Marathonläufer haben jedoch häufiger eine Koronarsklerose und Myokardfibrosen, als es die durch regelmäßigen Ausdauersport günstig beeinflussten Risikofaktoren erwarten lassen. Das Verhältnis von Dauer und Intensität der Risikofaktorenexposition zur Dauer und Intensität der sportlichen Aktivität ist aber meist schwer bestimmbar. Die Ausprägung der Koronarsklerose ist mit kardiovaskulären Risikofaktoren assoziiert, die Myokardfibrosen zeigen einen Zusammenhang mit der Ausprägung der Koronarsklerose und mit der Häufigkeit der Extrembelastungen. Koronarsklerose und Myokardfibrose haben prognostische Bedeutung. Ob wiederholte Extrembelastungen eine kausale Rolle für diese pathologischen Veränderungen spielen, ist nicht klar. In Zusammenschau mit bevölkerungsbasierten Daten unterstützen unsere Daten die Hypothese, dass körperliche Extrembelastungen eine Überdosis der in mittlerer Dosis äußerst kardioprotektiven Maßnahme sein können.

Abstract

Regular physical activity at intermediate intensity reduces the cardiovascular event rate and all-cause mortality. Master marathon runners have, however, a rate and burden of coronary atherosclerosis and myocardial fibrosis that is unexpectedly high considering the running-related healthy risk factor burden. However, the relationship of duration and intensity of risk factor exposure with duration and intensity of physical activity is usually difficult to determine. The coronary atherosclerosis burden is associated with the cardiovascular risk factor burden, myocardial fibrosis is linked with the coronary atherosclerosis burden and the frequency of strenuous physical exercise. The coronary atherosclerosis burden and presence of myocardial fibrosis have prognostic relevance. Whether repetitive bouts of strenuous physical exercise have a causal role for these pathologies is not clear. Together with epidemiological data, our data support the hypothesis that strenuous physical exercise may be an overdose of a preventive strategy that is highly cardio-protective at intermediate dose.

Schlüsselwörter

kardiovaskuläres Risiko - Koronarkalk - Marathon - Myokardfibrose

Key words

cardiovascular risk - coronary artery calcium - marathon - myocardial fibrosis

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