Objective: Increased number of runners in Japan has been one reason for increasing the risk of cardiac arrest during marathon races. The purpose of the study was to examine 1) the incidence of cardiac arrest during ma...Objective: Increased number of runners in Japan has been one reason for increasing the risk of cardiac arrest during marathon races. The purpose of the study was to examine 1) the incidence of cardiac arrest during marathon races held in the past in Japan, 2) the characteristics of runners with cardiac arrest, 3) the effectiveness of public access defibrillation (PAD) use for cardiac arrest cases. Methods: We examined the incidence of the cardiac arrest during marathon races in Japan from the medical records of marathon races that Kokushikan University provided in the past five years. Also, we analyzed cardiac arrests occurred in Japan in the past 15 years between 1999 and 2013. Results: The incidence rate of cardiac arrest was 2.18 per 100,000 participants. As shown in Table 1, the incidence rates were 2.00 per 100,000 participants in full marathon and 2.50 per 100,000 participants in half-marathon. A total of 63 cardiac arrests occurred in the past 15 years, and the number of incidents has been increasing every year. Among 63 cardiac arrest cases, the mean age was 45.3 ± 14.9 years old and 93.7% (59/63 cases) were in males. Eighty-three percentage of cardiac arrest cases applied AED (20/24 cases) were the shockable rhythm. In terms of the survival rate, there was a statistically significant difference between the cases where both bystander CPR and PAD were delivered and the cases where the only bystander CPR took place without PAD (95.0% vs. 47.1%;p Conclusions: Performing PAD on the scene during marathon races could be expected to be higher in the survival rate. Creating a medical support system is needed to handle sudden cardiac arrest rapidly in order to perform early bystander CPR and PAD.展开更多
Objectives: Prevention of sudden cardiac death is the number one clinical priority in sports cardiology. While the overall cardiovascular risk of long distance running is acknowledged as low, the frequency of cardiac ...Objectives: Prevention of sudden cardiac death is the number one clinical priority in sports cardiology. While the overall cardiovascular risk of long distance running is acknowledged as low, the frequency of cardiac arrests and sudden death has increased in middle-aged males during marathons since the year 2000. An evidence-based strategy for protecting susceptible runners from these acute cardiac events during races is considered based on identification of the underlying cause. Method: Review of articles in Pub Med on adverse cardiac events during marathons. Findings: Recent epidemiological studies have identified an increasing frequency of cardiac arrest in middle-aged males during marathons since the year 2000 with atherosclerotic heart disease as the main cause of sudden cardiac death. Same-aged asymptomatic middle-aged male physician-runners showed a post-race polymorphonuclear leukocytosis with sequential increases in interleukin-6 and C-reactive protein as a likely consequence of rhabdomyolysis after “hitting the wall”. Increased fibrinogen, von Willebrand factor and D-dimer with in vivo platelet activation indicated a concurrent hemostatic imbalance with pro-coagulant effects. Cardiac troponins I and T and NT-pro-B-type natriuretic peptide were elevated after races as additionally predictive of acute cardiac events in asymptomatic persons. Conclusions: High short-term risk for acute cardiac events in asymptomatic middle-aged male runners is shown by stratification of validated biomarkers, which may render non-obstructive coronary atherosclerotic plaques vulnerable to rupture during marathons. Pre-race aspirin usage is prudent to reduce these events mediated by atherothrombosis based on conclusive evidence for prevention of first acute myocardial infarctions in same-aged healthy male physicians. Prospective studies are needed to determine the efficacy of pre-race low-dose aspirin for curtailing the increasing frequency of race-related cardiac arrest and sudden death in susceptible runners.展开更多
分析针灸对长时间运动训练的中长跑运动员(青少年运动员)半程马拉松比赛后淋巴细胞及亚群等的影响。结果显示:赛后4 h CD3+、CD4+、CD8+均比不训练时显著下降,赛后28 h基本恢复至不训练时水平,经针灸干预的CD3+、CD4+、CD8+略有增高,但...分析针灸对长时间运动训练的中长跑运动员(青少年运动员)半程马拉松比赛后淋巴细胞及亚群等的影响。结果显示:赛后4 h CD3+、CD4+、CD8+均比不训练时显著下降,赛后28 h基本恢复至不训练时水平,经针灸干预的CD3+、CD4+、CD8+略有增高,但变化无显著性差异;赛后4 h、28 h NK细胞数量呈逐渐下降,与不训练时无显著性差异,赛后28 h经针灸干预的NK细胞数量下降较未经针灸干预的少得多;赛后4 h、28 hNKT细胞数量与不训练时相比明显减少,差异显著,赛后28 h较赛后4 h少量增加,经针灸干预的增加多,有显著差异。提示:免疫系统在强烈或耐力跑后可出现短暂压抑,针灸在一定程度上可对免疫系统产生明显的调节作用。展开更多
文摘Objective: Increased number of runners in Japan has been one reason for increasing the risk of cardiac arrest during marathon races. The purpose of the study was to examine 1) the incidence of cardiac arrest during marathon races held in the past in Japan, 2) the characteristics of runners with cardiac arrest, 3) the effectiveness of public access defibrillation (PAD) use for cardiac arrest cases. Methods: We examined the incidence of the cardiac arrest during marathon races in Japan from the medical records of marathon races that Kokushikan University provided in the past five years. Also, we analyzed cardiac arrests occurred in Japan in the past 15 years between 1999 and 2013. Results: The incidence rate of cardiac arrest was 2.18 per 100,000 participants. As shown in Table 1, the incidence rates were 2.00 per 100,000 participants in full marathon and 2.50 per 100,000 participants in half-marathon. A total of 63 cardiac arrests occurred in the past 15 years, and the number of incidents has been increasing every year. Among 63 cardiac arrest cases, the mean age was 45.3 ± 14.9 years old and 93.7% (59/63 cases) were in males. Eighty-three percentage of cardiac arrest cases applied AED (20/24 cases) were the shockable rhythm. In terms of the survival rate, there was a statistically significant difference between the cases where both bystander CPR and PAD were delivered and the cases where the only bystander CPR took place without PAD (95.0% vs. 47.1%;p Conclusions: Performing PAD on the scene during marathon races could be expected to be higher in the survival rate. Creating a medical support system is needed to handle sudden cardiac arrest rapidly in order to perform early bystander CPR and PAD.
文摘Objectives: Prevention of sudden cardiac death is the number one clinical priority in sports cardiology. While the overall cardiovascular risk of long distance running is acknowledged as low, the frequency of cardiac arrests and sudden death has increased in middle-aged males during marathons since the year 2000. An evidence-based strategy for protecting susceptible runners from these acute cardiac events during races is considered based on identification of the underlying cause. Method: Review of articles in Pub Med on adverse cardiac events during marathons. Findings: Recent epidemiological studies have identified an increasing frequency of cardiac arrest in middle-aged males during marathons since the year 2000 with atherosclerotic heart disease as the main cause of sudden cardiac death. Same-aged asymptomatic middle-aged male physician-runners showed a post-race polymorphonuclear leukocytosis with sequential increases in interleukin-6 and C-reactive protein as a likely consequence of rhabdomyolysis after “hitting the wall”. Increased fibrinogen, von Willebrand factor and D-dimer with in vivo platelet activation indicated a concurrent hemostatic imbalance with pro-coagulant effects. Cardiac troponins I and T and NT-pro-B-type natriuretic peptide were elevated after races as additionally predictive of acute cardiac events in asymptomatic persons. Conclusions: High short-term risk for acute cardiac events in asymptomatic middle-aged male runners is shown by stratification of validated biomarkers, which may render non-obstructive coronary atherosclerotic plaques vulnerable to rupture during marathons. Pre-race aspirin usage is prudent to reduce these events mediated by atherothrombosis based on conclusive evidence for prevention of first acute myocardial infarctions in same-aged healthy male physicians. Prospective studies are needed to determine the efficacy of pre-race low-dose aspirin for curtailing the increasing frequency of race-related cardiac arrest and sudden death in susceptible runners.
