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Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
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2013 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no 47, 3624-3631 p.Article in journal (Refereed) Published
Abstract [en]

AIMS:

We aimed to investigate the association of number of completed races and finishing time with risk of arrhythmias among participants of Vasaloppet, a 90 km cross-country skiing event.

METHODS AND RESULTS:

All the participants without cardiovascular disease who completed Vasaloppet during 1989-98 were followed through national registries until December 2005. Primary outcome was hospitalization for any arrhythmia and secondary outcomes were atrial fibrillation/flutter (AF), bradyarrhythmias, other supraventricular tachycardias (SVT), and ventricular tachycardia/ventricular fibrillation/cardiac arrest (VT/VF/CA). Among 52 755 participants, 919 experienced arrhythmia during follow-up. Adjusting for age, education, and occupational status, those who completed the highest number of races during the period had higher risk of any arrhythmias [hazard ratio (HR)1.30; 95% CI 1.08-1.58; for ≥5 vs. 1 completed race], AF (HR 1.29; 95% CI 1.04-1.61), and bradyarrhythmias (HR 2.10; 95% CI 1.28-3.47). Those who had the fastest relative finishing time also had higher risk of any arrhythmias (HR 1.30; 95% CI 1.04-1.62; for 100-160% vs. >240% of winning time), AF (1.20; 95% CI 0.93-1.55), and bradyarrhythmias (HR 1.85; 95% CI 0.97-3.54). SVT or VT/VF/CA was not associated with finishing time or number of completed races.

CONCLUSIONS:

Among male participants of a 90 km cross-country skiing event, a faster finishing time and a high number of completed races were associated with higher risk of arrhythmias. This was mainly driven by a higher incidence of AF and bradyarrhythmias. No association with SVT or VT/VF/CA was found.

Place, publisher, year, edition, pages
2013. Vol. 34, no 47, 3624-3631 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-205089DOI: 10.1093/eurheartj/eht188ISI: 000329134300012PubMedID: 23756332OAI: oai:DiVA.org:uu-205089DiVA: diva2:640538
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Physical Activity and Cardiovascular Disease
Open this publication in new window or tab >>Physical Activity and Cardiovascular Disease
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim was to investigate associations of fitness and types and levels of physical activity with subsequent risk of cardiovascular disease.

Four large-scale longitudinal cohort studies were used. The exposures were different measures related to physical activity and the outcomes were obtained through linkage to the Swedish In-Patient Register. In a cohort of 466 elderly men without pre-existing cardiovascular disease, we found that skeletal muscle morphology was associated with risk of cardiovascular events. A high amount of type I (slow-twitch, oxidative) skeletal muscle fibres was associated with lower risk of cardiovascular events and high amount of type IIx was associated with higher risk of cardiovascular events. This association was only seen among physically active men. Among 39,805 participants in a fundraising event, higher levels of both total and leisure time physical activity were associated with lower risk of heart failure. The associations were strongest for leisure time physical activity. In a cohort of 53,755 participants in the 90 km skiing event Vasaloppet, a higher number of completed races was associated with higher risk of atrial fibrillation and a higher risk of bradyarrhythmias. Further, better relative performance was associated with a higher risk of bradyarrhythmias. Among 1,26 million Swedish 18-year-old men, exercise capacity and muscle strength were independently associated with lower risk of vascular disease. The associations were seen across a range of major vascular disease events (ischemic heart disease, heart failure, stroke and cardiovascular death). Further, high exercise capacity was associated with higher risk of atrial fibrillation and a U-shaped association with bradyarrhythmias was found. Higher muscle strength was associated with lower risk of bradyarrhythmias and lower risk of ventricular arrhythmias.

These findings suggest a higher rate of atrial fibrillation with higher levels of physical activity. The higher risk of atrial fibrillation does not appear to lead to a higher risk of stroke. In contrast, we found a strong inverse association of higher exercise capacity and muscle strength with vascular disease. Further, high exercise capacity and muscle strength are related to lower risk of cardiovascular death, including arrhythmia deaths. From a population perspective, the total impact of physical activity on cardiovascular disease is positive.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 84 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 972
Keyword
Physical activity, epidemiology, cohort study, heart failure, cardiovascular disease, arrhythmias, atrial fibrillation, bradyarrhythmias, sudden cardiac death, heart failure, stroke, ischemic heart disease, cardiovascular death, maximal exercise capacity, muscle strength, skeletal muscle morphology
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology; Epidemiology
Identifiers
urn:nbn:se:uu:diva-217309 (URN)978-91-554-8871-0 (ISBN)
Public defence
2014-03-21, Enghoffsalen, Akademiska Sjukhuset, Ing 50, Uppsala, 13:15 (Swedish)
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Available from: 2014-02-27 Created: 2014-02-01 Last updated: 2014-04-29

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Andersen, KasperHeld, ClaesLjunghall, SverkerMichaëlsson, KarlSundström, Johan

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