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运动预适应降低肥胖人群运动心血管事件风险

王传志^1,*, 王蔚², 张双双¹, 梁志德², 原阳¹

¹青岛大学体育学院，青岛 266071；²青岛大学基础医学院，青岛 266071

摘要

肥胖是诱导心血管疾病的独立危险因素。流行病学研究表明，肥胖诱导产生炎症因子、影响血流动力学、心肌重构，进而导致心脏病理学变化，损伤心功能。运动对心血管系统的积极效应已被广泛证实，但是，运动造成的急性心血管应激不容忽视。相比于普通人群，肥胖人群的心功能异常、心肌病理性重构、对应激的低耐受致使其在运动过程中更易出现心律不齐，运动心血管事件风险更高。研究表明，前置的运动干预可有效避免肥胖人群此类风险事件的发生。运动预适应(exercise preconditioning, EP)是指通过短期的运动使得心肌耗氧量增加，造成心肌的相对或绝对缺血，诱导心肌产生内源性保护效应，减轻后续长时间运动对心肌造成的持续性缺血损伤。本文综述肥胖所造成的心脏病理生理学异常改变、运动中可能存在的心血管事件风险以及EP改善运动心血管事件风险的作用，总结和分析肥胖人群的EP模式、EP预防肥胖人群运动心血管事件的研究进展，以期为EP应用于肥胖人群提供理论基础。

关键词： 运动预适应; 肥胖人群; 预防; 运动心血管事件风险

Exercise preconditioning reduces exercise-induced risks of cardiovascular events in obese population

WANG Chuan-Zhi^1,*, WANG Wei², ZHANG Shuang-Shuang¹, LIANG Zhi-De², YUAN Yang¹

¹School of Sports, Qingdao University, Qingdao 266071, China；²School of Basic Medicine, Qingdao University, Qingdao 266071, China

Abstract

Obesity is an independent risk factor of cardiovascular diseases. Epidemiological studies have shown that obesity induces the production of inflammatory factors and changes in cardiac hemodynamics, remodeling and function, leading to myocardial damage and heart diseases. The positive effect of exercise on the cardiovascular system has been widely confirmed, while the acute cardiovascular stress caused by exercise cannot be ignored. Compared with the general population, obese people were more prone to arrhythmia and have a higher risk of cardiovascular events during exercise, due to their abnormal cardiac function, myocardial pathological remodeling and low tolerance to corresponding stress. Studies have shown that the intervention of exercise preconditioning (EP) can effectively reduce such risks. EP increases myocardial oxygen consumption through short-term exercise, resulting in relative or absolute myocardial ischemia, inducing the intrinsic myocardial protective effect and reducing the continuous ischemia caused by subsequent long-term exercise. This article reviews the obesity-induced abnormal changes of cardiac function and structure, possible exercise- induced risks of cardiovascular events in obese people and the role of EP in reducing exercise-induced risks of cardiovascular events. We summarize the progress on EP models in obese people, EP prevention against adverse cardiovascular events in obese people, with the aim to provide a theoretical basis for the application of EP in obese people.

Key words: exercise preconditioning; obese population; prevention; exercise-induced risks of cardiovascular events

收稿日期：　　录用日期：

通讯作者：王传志　　E-mail: yuanyangoffice@yeah.net

DOI: 10.13294/j.aps.2022.0074

引用本文：

王传志, 王蔚, 张双双, 梁志德, 原阳. 运动预适应降低肥胖人群运动心血管事件风险[J]. 生理学报 2022; 74 (5): 792-804.

WANG Chuan-Zhi, WANG Wei, ZHANG Shuang-Shuang, LIANG Zhi-De, YUAN Yang. Exercise preconditioning reduces exercise-induced risks of cardiovascular events in obese population. Acta Physiol Sin 2022; 74 (5): 792-804 (in Chinese with English abstract).