Ejercicio físico y fibrilación auricular en atletas y en pacientes con insuficiencia cardíaca: ¿Favorable o perjudicial?

Eduardo Rivas Estany, Nelson A. Campos Vera, Luis O. Domínguez Choy

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Resumen

La fibrilación auricular (FA), epidemia esperada en las próximas décadas, es comúnmente causada por la cardiopatía isquémica y la hipertensión arterial, también se asocia con el sobrepeso y la obesidad. El ejercicio físico (EF) se considera una medida que corrige los factores de riesgo cardiovascular y, por tanto, se recomienda en la prevención de las enfermedades cardiovasculares, y forma parte integral de la rehabilitación cardíaca. Aunque se ha señalado que el EF puede incrementar el riesgo de FA, los beneficios cardiovasculares de la actividad física regular son incuestionables. Se ha comprobado un mejor estado de salud y una mayor expectativa de vida en atletas de resistencia. El EF ligero o moderado protege contra la FA, lo que puede estar asociado a un mejoramiento de las funciones sistólica y diastólica del ventrículo izquierdo, así como a una disminución de la rigidez arterial. La rehabilitación cardíaca con EF, es una indicación aprobada actualmente en pacientes con insuficiencia cardíaca crónica, con FA o sin ella, la cual está demostrado que incrementa la capacidad funcional y la calidad de vida, así como que reduce la mortalidad general y las hospitalizaciones.

Referencias

Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893-962.

Seccia TM, Caroccia B, Muiesan ML, Rossi GP. Atrial fibrillation and arterial hypertension: A common duet with dangerous consequences where the renin angiotensin-aldosterone system plays an important role. Int J Cardiol. 2016;206:71-6.

Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace. 2009;11(9):1156-9.

Pouwels S, Topal B, Knook MT, Celik A, Sundbom M, Ribeiro R, et al. Interaction of obesity and atrial fibrillation: An overview of pathophysiology and clinical management. Expert Rev Cardiovasc Ther. 2019;17(3):209-23.

Rivas-Estany E. Physical exercise in the prevention and rehabilitation of cardiac patients: The Cuban experience in the primary health care system. Primary Health Care [Internet]. 2016 [citado 25 Mar 2020];6(4):1000243. Disponible en: http://doi.org/10.4172/2167-1079.1000243

Rivas-Estany E, Sixto-Fernández S, Barrera-Sarduy JD, Hernández-García S, González-Guerra R, Stusser-Beltranena R. Efectos del entrenamiento físico de larga duración sobre la función y remodelación del ventrículo izquierdo en pacientes con infarto miocárdico de pared anterior. Arch Cardiol Mex. 2013;83(3):167-73.

Rivas Estany E, Campos Vera N, Barrera Sarduy J, Hernández García S, Valdés Martín A, Peña Bofill V, et al. Evaluación funcional de un programa de entrenamiento físico en pacientes infartados con disfunción sistólica severa del ventrículo izquierdo. Rev Colomb Cardiol. 2019;27(4):344-50.

Seccia TM, Calò LA. Is exercise becoming a danger for our health? The complex relationship between exercise and atrial fibrillation. Eur J Prev Cardiol. 2018;25(6):621-3.

Morseth B, Løchen ML, Ariansen I, Myrstad M, Thelle DS. The ambiguity of physical activity, exercise and atrial fibrillation. Eur J Prev Cardiol. 2018;25(6):624-36.

Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993;25(2):237-44.

Morseth B, Graff-Iversen S, Jacobsen BK, Jørgensen L, Nyrnes A, Thelle DS, et al. Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study. Eur Heart J. 2016;37(29):2307-13.

Calvo N, Ramos P, Montserrat S, Guasch E, Coll-Vinent B, Domenech M, et al. Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study. Europace. 2016;18(1):57-63.

Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace. 2009;11(9):1156-9.

Rivas-Estany E. El ejercicio físico en la prevención y la rehabilitación cardiovascular. Rev Esp Cardiol Supl. 2011;11(E):18-22.

Flannery MD, Kalman JM, Sanders P, La Gerche A. State of the Art Review: Atrial Fibrillation in Athletes. Heart Lung Circ. 2017;26(9):983-9.

Sanchis-Gomar F, Perez-Quilis C, Lippi G, Cervellin G, Leischik R, Löllgen H, et al. Atrial fibrillation in highly trained endurance athletes - Description of a syndrome. Int J Cardiol. 2017;226:11-20.

Hew-Butler T, Noakes TD, Soldin SJ, Verbalis JG. Acute changes in endocrine and fluid balance markers during high-intensity, steady-state, and prolonged endurance running: unexpected increases in oxytocin and brain natriuretic peptide during exercise. Eur J Endocrinol. 2008;159(6):729-37.

Bürge J, Knechtle B, Knechtle P, Gnädinger M, Rüst CA, Rosemann T. Maintained serum sodium in male ultra-marathoners--the role of fluid intake, vasopressin, and aldosterone in fluid and electrolyte regulation. Horm Metab Res. 2011;43(9):646-52.

Seccia TM, Caroccia B, Adler GK, Maiolino G, Cesari M, Rossi GP. Arterial hypertension, atrial fibrillation, and hyperaldosteronism: The triple trouble. Hypertension. 2017;69(4):545-50.

Pandey A, Allen NB, Ayers C, Reis JP, Moreira HT, Sidney S, et al. Fitness in young adulthood and long-term cardiac structure and function: The CARDIA Study. JACC Heart Fail. 2017;5(5):347-55.

Gómez López N, Rivas Estany E, Crespo FF. Análisis de gases espirados durante la prueba de esfuerzo: Caracterización de resultados en sujetos sin patología cardiovascular. Rev Cuban Cardiol [Internet]. 2014 [citado 25 Mar 2020];20(3):166-75. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/528/644

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics – 2015 update: A report from the American Heart Association. Circulation. 2015;131(4):e29-322.

Santhanakrishnan R, Wang N, Larson MG, Magnani JW, McManus DD, Lubitz SA, et al. Atrial fibrillation begets heart failure and vice versa: Temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133(5):484-92.

Pathak RK, Elliott A, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, et al. Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation: The CARDIO-FIT Study. J Am Coll Cardiol. 2015;66(9):985-96.

Malmo V, Nes BM, Amundsen BH, Tjonna AE, Stoylen A, Rossvoll O, et al. Aerobic interval training reduces the burden of atrial fibrillation in the short term: A randomized trial. Circulation. 2016;133(5):466-73.

Faselis C, Kokkinos P, Tsimploulis A, Pittaras A, Myers J, Lavie CJ, et al. Exercise Capacity and Atrial Fibrillation Risk in Veterans: A Cohort Study. Mayo Clin Proc. 2016;91(5):558-66.

O'Connor CM, Whellan DJ, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301(14):1439-50.

Flynn KE, Piña IL, Whellan DJ, Lin L, Blumenthal JA, Ellis SJ, et al. Effects of exercise training on health status in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301(14):1451-9.

Luo N, Merrill P, Parikh KS, Whellan DJ, Piña IL, Fiuzat M, et al. Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation. J Am Coll Cardiol. 2017;69(13):1683-91.

Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107(23):2920-5.

Rivas Estany E, Gómez López N. Evaluación objetiva de la capacidad funcional: el papel de la prueba de esfuerzo cardiorrespiratoria. CorSalud [Internet]. 2013 [citado 26 Mar 2020];5(3):232-6. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/519/935

Myers J, McAuley P, Lavie CJ, Despres JP, Arena R, Kokkinos P. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status. Prog Cardiovasc Dis. 2015;57(4):306-14.

Osbak PS, Mourier M, Kjaer A, Henriksen JH, Kofoed KF, Jensen GB. A randomized study of the effects of exercise training on patients with atrial fibrillation. Am Heart J. 2011;162(6):1080-7.

Hegbom F, Stavem K, Sire S, Heldal M, Orning OM, Gjesdal K. Effects of short-term exercise training on symptoms and quality of life in patients with chronic atrial fibrillation. Int J Cardiol. 2007;116(1):86-92.

Proietti M, Boriani G, Laroche C, Diemberger I, Popescu MI, Rasmussen LH, et al. Self-reported physical activity and major adverse events in patients with atrial fibrillation: a report from the EURObservational Research Programme Pilot Survey on Atrial Fibrillation (EORP-AF) General Registry. Europace. 2017;19(4):535-43.

Hussain N, Gersh BJ, Gonzalez Carta K, Sydó N, Lopez-Jimenez F, Kopecky SL, et al. Impact of cardiorespiratory fitness on frequency of atrial fibrillation, stroke, and all-cause mortality. Am J Cardiol. 2018;121(1):41-9.

Myrstad M, Malmo V, Ulimoen SR, Tveit A, Loennechen JP. Exercise in individuals with atrial fibrillation. Clin Res Cardiol. 2019;108(4):347-54.

Risom SS, Zwisler AD, Johansen PP, Sibilitz KL, Lindschou J, Gluud C, et al. Exercise-based cardiac rehabilitation for adults with atrial fibrillation. Cochrane Database Syst Rev [Internet]. 2017 [citado 27 Mar 2020];2(2):CD011197. Disponible en: https://doi.org/10.1002/14651858.CD011197.pub2

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-239.

Zhu W, Shen Y, Zhou Q, Xu Z, Huang L, Chen Q, et al. Association of physical fitness with the risk of atrial fibrillation: A systematic review and meta-analysis. Clin Cardiol. 2016;39(7):421-8.

Elliott AD, Linz D, Mishima R, Kadhim K, Gallagher C, Middeldorp ME, et al. Association between physical activity and risk of incident arrhythmias in 402 406 individuals: evidence from the UK Biobank cohort. Eur Heart J. 2020;41(15):1479-86.

Younis A, Shaviv E, Nof E, Israel A, Berkovitch A, Goldenberg I, et al. The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation. Clin Cardiol. 2018;41(9):1170-6.

Piepoli MF, Conraads V, Corrà U, Dickstein K, Francis DP, Jaarsma T, et al. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail. 2011;13(4):347-57.

Farrell SW, Finley CE, Radford NB, Haskell WL. Cardiorespiratory fitness, body mass index, and heart failure mortality in men: Cooper Center Longitudinal Study. Circ Heart Fail. 2013;6(5):898-905.

Vanhees L, Schepers D, Defoor J, Brusselle S, Tchursh N, Fagard R. Exercise performance and training in cardiac patients with atrial fibrillation. J Cardiopulm Rehabil. 2000;20(6):346-52.

Hegbom F, Stavem K, Sire S, Heldal M, Orning OM, Gjesdal K. Effects of short-term exercise training on symptoms and quality of life in patients with chronic atrial fibrillation. Int J Cardiol. 2007;116(1):86-92.

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