Empfehlungen für den internistischen Untersuchungsgang in der Sportmedizin

  • Rochus Pokan
  • Harald Gabriel
  • Helmut Hörtnagl
  • Andrea Podolsky
  • Karin Vonbank
  • Manfred Wonisch
Chapter

Zusammenfassung

Der positive Effekt regelmäßig durchgeführter körperlicher Aktivität auf die Gesundheit ist unbestritten und mit hoher wissenschaftlicher Evidenz belegt. Regelmäßige körperliche Aktivität bzw. körperliches Training verringert sowohl in der Primär- als auch in der Sekundärprävention Morbidität und Mortalität und verbessert die Lebensqualität.

Literatur

  1. American Diabetes Association – Position Statement Physical Activity/Exercise and Diabetes (1997) Diabetes Care 27, Suppl: 58–62CrossRefGoogle Scholar
  2. Banzer W, Pfeifer K, Vogt L (2004) Funktionsdiagnostik des Bewegungssystems in der Sportmedizin. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  3. Benzer W, in Zusammenarbeit mit der Arbeitsgruppe für kardiologische Rehabilitation und Sekundärprävention der ÖKG (2008) Guidelines für die ambulante kardiologische Rehabilitation und Prävention in Österreich – Update 2008. Beschluss der Österreichischen Kardiologischen Gesellschaft vom Juni 2008. J Am Coll Cardiol 15 (9–10): 298–309Google Scholar
  4. Bianco M, Bria S, Gianfelici A, Sanna N, Palmieri V, Zeppilli P (2001) Does early repolarization in the athlete have analogies with the Brugada syndrome? Eur Heart J 22: 504–510CrossRefPubMedGoogle Scholar
  5. Bille K, Figueiras D, Schamasch P, Kappenberger L, Brenner JI, Meijboom FJ, Meijboom EJ (2006) Sudden cardiac death in athletes: the Lausanne Recommendations, Eur J Cardiovasc Prev Rehabil 13: 859–875CrossRefPubMedGoogle Scholar
  6. Borer JS, Bonow RO (2003) Contemporary approach to aortic and mitral regurgitation. Circulation 108: 2432–2438CrossRefPubMedGoogle Scholar
  7. Corrado D, Basso C, Schiavon M, Thiene G (1998) Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 339: 364–9CrossRefPubMedGoogle Scholar
  8. Corrado BJ, Basso C, Rizzoli G, Schiavon M, Thiene G (2003) Does Sports Activity Enhance the Risk of Sudden Death in Adolescents and Young Adults? JACC 42(11): 1959–63CrossRefPubMedGoogle Scholar
  9. Corrado D, Pelliccia A, Bjornstad HH, Vanhees L, Biffi A, Borjesson M, Panhuyzen-Goedkoop N, Deligiannis A, Solberg E et al. (2005) Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 26(5): 516–24CrossRefPubMedGoogle Scholar
  10. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G (2006) Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 296: 1593–1601CrossRefPubMedGoogle Scholar
  11. Corrado D, Basso C, Schiavon M, Pelliccia A, Thiene G (2008) Pre-Participation Screening of Young Competitive Athletes for Prevention of Sudden Cardiac Death. J Am Coll Cardiol 52: 1981–1989CrossRefPubMedGoogle Scholar
  12. Crawford MH, Bernstein SJ, Deedwania PC, DiMarco JP, Ferrick KJ, Garson A Jr, Green LA, Greene HL, Silka MJ, Stone PH, Tracy CM, Gibbons RJ, Alpert JS, Eagle KA, Gardner TJ, Gregoratos G, Russell RO, Ryan TJ (1999) Guidelines for ambulatory electrocardiography: executive summary and recommendations. Jr ACC/AHA 100(8): 886–93Google Scholar
  13. De Backer G, Ambrosioni E, Borch-Johnsen K (2003) European guidelines on cardiovascular disease and prevention in clinical practice. Atherosclerosis 171(1): 145–55CrossRefPubMedGoogle Scholar
  14. Diabetes Prevention Program Research Group (2002) Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med 346: 393–403CrossRefPubMedCentralGoogle Scholar
  15. Fletcher GF, Balady G, Blair SN (1996) Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation 4: 857–62CrossRefGoogle Scholar
  16. Galan A, Zoghbi WA, Quinones MA (1991) Determination of severity of valvular aortic stenosis by Doppler echocardiography and relation of findings to clinical outcome and agreement with hemodynamic measurements determined at cardiac catheterization. Am J Cardiol 67: 1007–1012CrossRefPubMedGoogle Scholar
  17. Gavazzi A, De Maria R, Renosto G, Moro A, Borgia M, Caroli A, Castelli G, Ciaccheri M, Pavan D, De Vita C (1993) The spectrum of left ventricular size in dilated cardiomyopathy: Clinical correlates and prognostic implications. Am Heart J 125: 410–422CrossRefPubMedGoogle Scholar
  18. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O’Reilly MG, Winters Jr WL, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Russell RO, Smith Jr FAHA, Committee Members, Task Force Members (2002) ACC/AHA 2002 guideline update for exercise testing: summary article: A report of the American college of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines) J Am Coll Cardiol 40: 1531–40Google Scholar
  19. Gohlke H, Kubler W, Mathes P, Meinertz T, Schuler G, Gysan DB, Sauer G (2005) German Society of Cardiology. Position paper on the primary prevention of cardiovascular diseases. Current position of the 25.3.2003. Statement of the Board of the German Society of Cardiology – heart and circulatory research work commissioned by for the board by Project Group on Prevention: Z Kardiol 94, Suppl 3: III/113–5Google Scholar
  20. Gohlke H, Albus C, Gysan DB, Hahmann HW, Mathes P (2009) Cardiovascular prevention in clinical practice (ESC and German guidelines 2007). Herz 34(1): 4–14CrossRefPubMedGoogle Scholar
  21. Grubb BP (2005) Neurocardiogenic Syncope. N Engl J Med 352: 1004–10CrossRefPubMedGoogle Scholar
  22. Kendall FP, McCreary E, Provance PG (1993) Muscles testing and Function, 4th ed. Williams & WilkinsGoogle Scholar
  23. Kindermann W (2003) Physiologische Anpassungen des Herz-Kreislauf-Systems an körperliche Belastung. In: Kindermann W, Dickhuth HH, Nieß A, Röcker K, Urhausen A (Hrsg). Sportkardiologie. Steinkopf, Darmstadt; 1–18CrossRefGoogle Scholar
  24. Lahav D, Leshno M, Brezis M (2009) Is an exercise tolerance test indicated before beginning regular exercise? A decision analysis. Gen Intern Med 24(8): 934–938CrossRefGoogle Scholar
  25. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellika PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, Sutton MStJ, Stewart W (2006) Recommendations for Chamber quantification. Eur J Echocardiography 7: 79–108CrossRefGoogle Scholar
  26. Lewis JF, Spirito P, Pelliccia A, Maron BJ (1992) Usefulness of Doppler echocardiographic assessment of diastolic filling in distinguishing “athlete’s heart” from hypertrophic cardiomyopathy. Am J Cardiol 68: 296–300Google Scholar
  27. Mancia G, de Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S et al. (2007) Guidelines for the Management of Arterial Hypertension. The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension 25: 1105–1187CrossRefPubMedGoogle Scholar
  28. Maron BJ, Pelliccia A, Spataro A, Granata M (1993) Reduction in left ventricular wall thickness after deconditioning in highly trained Olympic athletes. Br Heart J 69: 125–128CrossRefPubMedPubMedCentralGoogle Scholar
  29. Maron BJ, Thompson PD, Puffer JC, McGrew CA, Strong WB, Douglas PS, Clark LT, Mitten MJ, Crawford MH, Atkins DL, Driscoll DJ, Epstein AE (1996) Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young). American Heart Association Circulation 94(4): 850–6PubMedGoogle Scholar
  30. Maron BJ, Zipes DP (2005) BETHESDA CONFERENCE REPORT. 36th Bethesda Conference: Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities. JACC 45, 8: 1312–1375Google Scholar
  31. Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, Dimeff R, Douglas PS, Glover DW, Hutter AM et al. (2007) Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update. A Scientific Statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation. Circulation 115: 1643–1655CrossRefPubMedGoogle Scholar
  32. Marti B, Villiger B, Hintermann M, Lerch R (1998) Stellungnahme der Schweizerischen Gesellschaft für Sportmedizin vom 26. Sept 1997: Plötzlicher Herztod beim Sport: sinnvolle Vorsorgeuntersuchungen und Präventivmaßnahmen. Schweizerische Zs f Sportmedizin und Sporttraumatologie 46(2): 83–85Google Scholar
  33. McKenna WJ, Thiene G, Nava A, Fontaliran F, Blomstrom-Lundqvist C, Fontaine G, Camerini F (1994) Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Br Heart J 71: 215–218CrossRefPubMedPubMedCentralGoogle Scholar
  34. Mittleman MA, Maclure M, Tofler GH (1993) Triggering of acute myocardial infarction by heavy physical exertion. New Engl J Med 329: 1677–1683CrossRefPubMedGoogle Scholar
  35. Moinard J, Yquel R, Manier G (2004) Pulmonary gas exchange during exercise in healthy subjects. Rev Mal Respir 21: 950–60CrossRefPubMedGoogle Scholar
  36. Mont L, Elosua R, Brugada J (2009) Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace 11: 11–17CrossRefPubMedGoogle Scholar
  37. O’Connor CM, Whellan DJ, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzmann DW, Blumenthal JA et al. (2009) Efficacy and Safety of Exercise Training in Patients with Chronic Heart Failure. JAMA 301(14): 1439–1450CrossRefPubMedPubMedCentralGoogle Scholar
  38. Pinamonti B, Alberti E, Cigalotto A, Dreas L, Salvi A, Silvestri F, Camerini F (1988) Echocardiographic findings in myocarditis. Am J Cardiol 62: 2285–2291CrossRefGoogle Scholar
  39. Pokan R, Hofmann P, Wonisch M, Hörtnagl H (2004) Funktionsdiagnostik akuter und chronischer Anpassung des Herz-Kreislaufsystems an körperliche Belastungen. In: Pokan R, Förster H, Hofmann P, Hörtnagl H, Ledl-Kurkowski E, Wonisch M (Hrsg). Kompendium der Sportmedizin – Physiologie, Innere Medizin und Pädiatrie. Springer, Wien New York, S 45–83CrossRefGoogle Scholar
  40. Pollock ML, Franklin BA, Balady GJ, Chaitman BL, Fleg JL, Fletcher B, Limacher M, Pina IL, Stein RA, Williams M, Bazzarre T (2000) AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; position paper endorsed by the American College of Sports Medicine. Circulation 101(7): 828–33CrossRefPubMedGoogle Scholar
  41. Prefaut C, Durand F, Mucci P, Caillaud C (2000) Exercise induced arterial hypoxaemia in athelets: a review. Sports Med 30: 47–61CrossRefPubMedGoogle Scholar
  42. Priori SG, Aliot E, Blomstrom-Lundqvist C (2001) Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 22: 1374–1450CrossRefPubMedGoogle Scholar
  43. Rodgers GP, Ayanian JZ, Balady G (2000) American College of Cardiology/American Heart Association. Clinical Competence statement on stress testing: a report of the American College of Cardiology/American Heart Association/American College of Physicians – American Society of Internal Medicine Task Force on Clinical Competence. J Am Coll Cardiol 4: 1441–53Google Scholar
  44. Samitz G, Benzer W, Zwahlen M (2009) Wirksamkeit der umfassenden kardiologischen Rehabilitation und Sekundärprävention: klinische und epidemiologische Evidenz: In: Pokan R, Benzer W, Gabriel H, Hofmann P, Kunschitz E, Samitz G, Schindler K, Wonisch M (Hrsg) Kompendium der kardiologischen Prävention und Rehabilitation. Springer, Wien New York, S 17–36CrossRefGoogle Scholar
  45. Sauer G, Andresen D, Cierpka R, Lemke B, Mibach F, Perings C, Vaerst R (2005) Positionspapier zur Durchführung von Qualitätskontrollen bei Ruhe-, Belastungs- und Langzeit-EKG. Z Kardiol 94: 844–857CrossRefPubMedGoogle Scholar
  46. Seto CK, Pendieton ME (2009) Preparticipation Cardiovascular Screening in Young Athletes. Current Guidelines and Dilemmas. Current Sports Medicine Reports 59–64Google Scholar
  47. Sharma S, Maron BJ, Whyte G, Firoozi S, Elliott PM, McKenna WJ (2002) Physiologic Limits of Left Ventricular Hypertrophy. In: Elite Junior Athletes: Relevance to Differential Diagnosis of Athlete’s Heart and Hypertrophic Cardiomyopathy. J ACC 40(8): 1431–1436Google Scholar
  48. Siscovick DS, Weiss NS, Fletcher RH, Lasky T (1984) The incidence of primary cardiac arrest during vigorous exercise. New Engl J Med 311: 874–877CrossRefPubMedGoogle Scholar
  49. Thiene G, Carturan E, Corrado D, Basso C (2010) Prevention of sudden cardiac death in the young and in athletes: dream or reality? Cardiovasc Pathol 19(4): 207–217CrossRefPubMedGoogle Scholar
  50. Tillmanns H, Erdogan A, Sedding D (2009) Treatment of chronic CAD – do the guidelines (ESC, AHA) reflect daily practice? Herz 34(1): 39–54CrossRefPubMedGoogle Scholar
  51. Thompson WR, Gordon NF, Pescadello LS (2009) ACSM’s Guidelines for Exercise Testing and Prescription. Wolters Kluwer/Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  52. Uhrhausen A, Kindermann W (1999) Sports-Specific Adaptations and Differentiation of the Athlete’s Heart. Sports Med 28(4): 237–244CrossRefGoogle Scholar
  53. Vogiatzis I, Zakynthinos S, Boushel R, Athanasopoulos D, Guenette JA, Wagnes H, Roussos C, Wagner PD (2008) The contribution of intrapulmonary shunts to the alveolar-to-arterial oxygen difference during exercise is very small. J Physiol 586: 2381–2391CrossRefPubMedPubMedCentralGoogle Scholar
  54. Wonisch M, Berent R, Klicpera M, Laimer H, Marko C, Pokan R, Schmid P, Schwann H (2008) Praxisleitlinien Ergometrie. J Kardiol 15, Suppl A: 3–17Google Scholar
  55. Wonisch M (2009) Arterielle Hypertonie. In: Pokan R, Benzer W, Gabriel H, Hofmann P, Kunschitz E, Mayr K, Samitz G, Schindler K, Wonisch M (Hrsg) Kompendium der kardiologischen Prävention und Rehabilitation. Springer, Wien New York, S 79–81CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Rochus Pokan
    • 1
  • Harald Gabriel
    • 2
  • Helmut Hörtnagl
    • 6
  • Andrea Podolsky
    • 3
  • Karin Vonbank
    • 4
  • Manfred Wonisch
    • 5
  1. 1.Institut für SportwissenschaftWienÖsterreich
  2. 2.Klinische Abteilung für KardiologieUniversitätsklinik für Innere Medizin IIWienÖsterreich
  3. 3.Klinisches Institut für Präventiv- und Angewandte SportmedizinUniversitätsklinikum Krems Karl Landsteiner Privatuniversität für GesundheitswissenschaftenKremsÖsterreich
  4. 4.MedClinic Innere StadtWienÖsterreich
  5. 5.Facharzt für Innere Medizin und KardiologieSportwissenschafter FranziskusspitalWienÖsterreich
  6. 6.Institut für Sport- und KreislaufmedizinInnsbruckÖsterreich

Personalised recommendations