重新认识运动对肥厚型心肌病患者的意义

Rediscovering the value of exercise in patients with hypertrophic cardiomyopathy

以往观点认为肥厚型心肌病是运动员心源性猝死的主要原因,这一观点也被推及普通人群,从而限制了肥厚型心肌病患者进行运动锻炼。但近年研究表明,肥厚型心肌病并非心源性猝死的主要原因,并且适度运动对肥厚型心肌病患者来说是安全有益的。随着越来越多肥厚型心肌病患者运动安全的数据出现,相关指南也从一开始只推荐低强度运动逐渐放开到中高强度运动。这提示我们应重新认识运动对肥厚型心肌病患者的意义。肥厚型心肌病患者可以通过综合评估后制订个体化运动处方,进而受益于运动带来的积极影响。本文总结了肥厚型心肌病患者可以进行运动的证据以及讨论了如何制订运动处方。

It was previously thought that hypertrophic cardiomyopathy is the leadingcause of sudden cardiac death in athletes.This was also extrapolated to the generalpopulation.Thereby,exercise was restrained in patients with hypertrophic cardiomyopathy.However,recent studies have shown that hypertrophic cardiomyopathy is not themain cause of sudden cardiac death,and moderate exercise is not only safe but beneficialfor patients with hypertrophic cardiomyopathy.With the accumulation of evidence,relevant guidelines recommend low-intensity exercise from the beginning,then graduallyrecommend moderate-high intensity exercise for patients with hypertrophic cardiomyopathy.This suggests that we should rediscover the value of exercise in patients withhypertrophic cardiomyopathy.It is now widely accepted that patients with hypertrophiccardiomyopathy can benefit from the positive effects of exercise through an individualizedexercise prescription based on a comprehensive assessment.This review summarizes theevidence showing patients with hypertrophic cardiomyopathy can exercise safely,and themethods to formulate related exercise prescriptions.