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Relación entre el volumen de ejercicio de por vida y la aterosclerosis coronaria en atletas

Vincent L Aengevaeren¹, Arend Mosterd², Thijs L Braber²

¹From Departments of Physiology (V.L.A., T.M.H.E.) and Cardiology (V.L.A.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands (A.M., T.L.B.); Department of Radiology (T.L.B., B.K.V.), Department of Cardiology (P.A.D.), and Julius Center for Health Sciences and Primary Care (D.E.G.), University Medical Center Utrecht, the Netherlands; Department of Radiology, University Medical Center Groningen, the Netherlands (N.H.J.P.); Netherlands Heart Institute, Utrecht, the Netherlands (P.A.D.); Division of Cardiology, Hartford Hospital, CT (P.D.T.); and Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (T.M.H.E.). vincent.aengevaeren@radboudumc.nl thijs.eijsvogels@radboudumc.nl.

|April 29, 2017

Resumen

Los altos volúmenes de ejercicio a lo largo de la vida (> 2000 MET-minutos/semana) están relacionados con una mayor calcificación de las arterias coronarias (CAC) y placas en hombres de mediana edad. Sin embargo, los atletas más activos mostraron una composición de placa más benigna, lo que podría explicar su longevidad.

Área de la Ciencia:

Cardiología
Fisiología del ejercicio
Radiología

Sus antecedentes:

Una mayor actividad física está relacionada con un menor riesgo de enfermedades cardiovasculares.
Existe un debate sobre la dosis-respuesta al ejercicio y la posible aceleración de la aterosclerosis coronaria con altos volúmenes.
La relación entre el ejercicio de por vida y la aterosclerosis coronaria requiere más investigación.

Objetivo del estudio:

Determinar la asociación entre los volúmenes de ejercicio de por vida y la aterosclerosis coronaria en hombres de mediana edad.
Para investigar si el alto volumen de ejercicio acelera la aterosclerosis coronaria.
Explorar las características de las placas ateroscleróticas coronarias en relación con el volumen de ejercicio.

Principales métodos:

284 atletas masculinos de mediana edad se sometieron a tomografías computarizadas (TC) para la calcificación de las arterias coronarias (CAC) y la evaluación de la placa.
El historial de ejercicio a lo largo de toda la vida se registró y cuantificó utilizando el equivalente metabólico de minutos de tarea (MET) por semana.
Los participantes se clasificaron en grupos de volumen de ejercicio: < 1000, 1000-2000, y > 2000 MET-min/semana.

Principales resultados:

Los hombres que ejercitaron > 2000 MET-min/semana mostraron puntuaciones CAC y prevalencia significativamente más altas en comparación con los que ejercitaron < 1000 MET-min/semana.
El ejercicio de intensidad muy intensa (≥9 MET) se asoció con una mayor prevalencia de CAC y placas.
Entre las personas con CAC, las características de la placa no diferían significativamente entre los grupos de volumen de ejercicio.
El grupo más activo (> 2000 MET-min/semana) presentó menos placas mixtas y más placas calcificadas en comparación con el grupo menos activo.

Conclusiones:

Los mayores volúmenes de ejercicio a lo largo de la vida se asocian con una mayor prevalencia de aterosclerosis coronaria (CAC y placas).
A pesar de la mayor prevalencia de placa, los atletas más activos (> 2000 MET-min/semana) demostraron una composición de placa más benigna (menos placa mixta, más placa calcificada).
Estos hallazgos pueden ayudar a explicar la longevidad observada en atletas de resistencia a pesar del aumento de la carga de placa coronaria.

Palabras clave:

la aterosclerosis tomografía computarizada angiografía Los vasos coronarios ejercicio

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