Coronary Heart Disease
Conditions
Keywords
sporting events, stress, myocardial ischemia, ST-segment depression, blood pressure
Brief summary
Major sporting events may have adverse cardiovascular effects in subjects with coronary heart disease. We also hypothesized that the adverse cardiovascular effects of sporting events are a result of psychobiological processes including stress-induced hemodynamic changes, autonomic dysfunction and parasympathetic withdrawal, and inflammatory and prothrombotic responses, all of which may in turn promote myocardial ischemia.
Detailed description
Observational studies suggest that exposure to sporting events may worsen symptoms of angina and trigger acute myocardial infarction. The mechanisms for this association are unknown. To date, there have been no controlled exposures in patients with coronary heart disease: an important population who may be particularly susceptible to the adverse cardiovascular effects of sporting events. In a randomized crossover controlled study, 38 patients with prior myocardial infarction will be exposed to sporting events or not. Myocardial ischemia will be quantified by ST-segment analysis using continuous 12-lead electrocardiography, and blood pressure change will be analyzed using ambulatory blood pressure monitoring. Autonomic function will be assessed by heart rate variability. Ischemic, inflammatory and prothrombotic markers will also be measured.
Interventions
BEHAVIORALExposure to sporting events
Exposure to sporting events
BEHAVIORALNo exposure to sporting events
No exposure to sporting events
Sponsors
China National Center for Cardiovascular Diseases
Chinese Academy of Medical Sciences, Fuwai Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Previous myocardial infarction (\>6 months previously)treated by coronary revascularization * On standard secondary preventative therapy
Exclusion criteria
* Angina pectoris (Canadian Cardiovascular Society grade ≥2) * History of arrhythmia * Uncontrolled hypertension * Unstable coronary disease (acute coronary syndrome or unstable symptoms within 3 months) * Occupational exposure to sporting events * Diabetes * Hepatic or renal failure
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Evidence of definite myocardial ischemia confirmed by Holter monitoring | 2 months |
| Blood pressure measured by ambulatory blood pressure monitoring | 2 months |
| Heart rate variability | 2 months |
Secondary
| Measure | Time frame |
|---|---|
| Episode of neurological events | 3 months |
| Episode of arrhythmia | 3 months |
| Episode of angina | 3 months |
Outcome results
None listed