Exercise-related resuscitated out-of-hospital cardiac arrest due to presumed myocardial ischemia: Result from coronary angiography and intravascular ultrasound

Kuroki, Nobutaka; Asaoka, Daisuke; Suzuki, Kazuhiro; Mikami, Manabu; Hamabe, Yuichi; Aonuma, Kazutaka; Sato, Akira

doi:10.1016/j.resuscitation.2018.09.023

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Interestingly, the median proportion of exercise-related SCA that received bystander interventions and survived to hospital discharge were consistent with estimates for arrests occurring in densely populated public settings, such as airports, which have high foot traffic, trained responders on-site and a coordinated response to emergencies 46. Similar to the rapid bystander response observed in these settings, a short time delay from collapse to initiation of bystander CPR or application of an AED was noted for exercise-related SCA 3 24 47–54. In general, the average time delay was well under 3 min, which has been suggested as the threshold to allow for neurologically intact survival after SCA in public settings 55 56.…”

Section: Discussionsupporting

confidence: 66%

Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review

Grubic

Hill

Phelan³

et al. 2021

Br J Sports Med

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ObjectiveTo evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA).DesignSystematic review.Data sourcesMEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020.Study eligibility criteriaObservational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained.MethodsAmong all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated.ResultsA total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%–96%), middle-aged (median: 51, IQR: 39–56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%–86%). Bystander CPR was initiated in a median of 71% (IQR: 59%–87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%–42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%–49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA.ConclusionExercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.

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Section: Discussionsupporting

confidence: 66%

Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review

Grubic

Hill

Phelan³

et al. 2021

Br J Sports Med

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“… 29 Alternative mechanistic possibilities include demand ischaemia from obstructive coronary artery stenosis and coronary vasospasm from increased sympathetic activity. 30 Other causes of exercise-related SCD in master athletes include the cardiomyopathies, myocarditis, valvular heart disease, and aortic rupture. 24 …”

Section: Sudden Cardiac Death In Master Athletesmentioning

confidence: 99%

The heart of the ageing endurance athlete: the role of chronic coronary stress

Parry-Williams

Gati

Sharma

2021

European Heart Journal

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Moderate physical exercise is associated with an irrefutable reduction in cardiac morbidity and mortality. The current guidelines recommend at least 150 min of moderate exercise or 75 min of vigorous exercise per week. Endurance athletes perform exercise at a level that is 10- to 20-fold greater than these recommendations. These athletes reveal several structural and functional cardiac adaptations including increased cardiac size, enhanced ventricular filling, and augmentation of stroke volume even at the highest heart rates. The long-term effects of endurance exercise on the heart are unknown. Endurance exercise is associated with a transient increase in serum concentrations of biomarkers of cardiac damage and ventricular dysfunction which improves within 72 h. Over the past decade, there have been emerging studies reporting attenuated mortality benefit amongst individuals who perform the highest volume of exercise. Studies in lifelong male athletes aged above 40 years old show a higher prevalence of high coronary artery calcium scores (>300 Agatston units), a higher coronary plaque burden, and myocardial fibrosis compatible with subclinical myocardial infarction compared with relatively sedentary healthy controls, raising speculation that lifelong intense exercise imposes chronic coronary stress on the heart. This review article will provide a critical analysis of the existing data.

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“…Cardiac arrest is a serious condition resulting from severe coronary artery disease [ 1 ], heart failure [ 2 , 3 ], hemorrhagic shock [ 4 , 5 ], asphyxia [ 6 ], overdose of drugs [ 7 , 8 ], and abnormal potassium [ 9 ]. During cardiac arrest, organs are subjected to severe ischemic insult due to an abrupt loss of the heart’s ability to pump [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Manganese Porphyrin Promotes Post Cardiac Arrest Recovery in Mice and Rats

Wang

Liu

Yan

et al. 2022

Biology

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Introduction Cardiac arrest (CA) and resuscitation induces global cerebral ischemia and reperfusion, causing neurologic deficits or death. Manganese porphyrins, superoxide dismutase mimics, are reportedly able to effectively reduce ischemic injury in brain, kidney, and other tissues. This study evaluates the efficacy of a third generation lipophilic Mn porphyrin, MnTnBuOE-2-PyP5+, Mn(III) ortho meso-tetrakis (N-n-butoxyethylpyridinium-2-yl)porphyrin (MnBuOE, BMX-001), in both mouse and rat models of CA. Methods Forty-eight animals were subjected to 8 min of CA and resuscitated subsequently by chest compression and epinephrine infusion. Vehicle or MnBuOE was given immediately after resuscitation followed by daily subcutaneous injections. Body weight, spontaneous activity, neurologic deficits, rotarod performance, and neuronal death were assessed. Kidney tubular injury was assessed in CA mice. Data were collected by the investigators who were blinded to the treatment groups. Results Vehicle mice had a mortality of 20%, which was reduced by 50% by MnBuOE. All CA mice had body weight loss, spontaneous activity decline, neurologic deficits, and decreased rotarod performance that were significantly improved at three days post MnBuOE daily treatment. MnBuOE treatment reduced cortical neuronal death and kidney tubular injury in mice (p < 0.05) but not hippocampus neuronal death (23% MnBuOE vs. 34% vehicle group, p = 0.49). In rats, they had a better body-weight recovery and increased rotarod latency after MnBuOE treatment when compared to vehicle group (p < 0.01 vs. vehicle). MnBuOE-treated rats had a low percentage of hippocampus neuronal death (39% MnBuOE vs. 49% vehicle group, p = 0.21) and less tubular injury (p < 0.05) relative to vehicle group. Conclusions We demonstrated the ability of MnBuOE to improve post-CA survival, as well as functional outcomes in both mice and rats, which jointly account for the improvement not only of brain function but also of the overall wellbeing of the animals. While MnBuOE bears therapeutic potential for treating CA patients, the females and the animals with comorbidities must be further evaluated before advancing toward clinical trials.

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Exercise-related resuscitated out-of-hospital cardiac arrest due to presumed myocardial ischemia: Result from coronary angiography and intravascular ultrasound

Cited by 4 publications

References 33 publications

Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review

Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review

The heart of the ageing endurance athlete: the role of chronic coronary stress

Manganese Porphyrin Promotes Post Cardiac Arrest Recovery in Mice and Rats

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