Sportcardiologische zorgkaart Nederland

Mediakoppen schrijven:
- "Fanatieke sporters onderschatten gezondheidsrisico’s: ‘Medische richtlijnen volstaan niet’ " (Volkskrant)
- "Te veel sporten na je 35e kan fout gaan: dit moet je weten" (Omroep Gelderland)
- "35-plusser die jaren intensief sport, loopt groter risico op hart- en vaatziekten" (NOS.nl)

Waar zijn deze mediaberichten op gebaseerd?
Recente mediakoppen suggereren dat intensief sporten na het 35e levensjaar gezondheidsrisico’s met zich meebrengt. Deze berichtgeving is grotendeels gebaseerd op een recente internationale Clinical Consensus Statement van onder andere de European Society of Cardiology (ESC) en American College of Cardiology (ACC), gepubliceerd in zowel de European Heart Journal als JACC.

In dit document, met bijdragen van onderzoekers zoals Thijs Eijsvogels en Vincent Aengevaeren, wordt beschreven dat zogeheten “masters athletes” vaker bepaalde cardiovasculaire afwijkingen hebben, zoals atriumfibrilleren, coronairlijden en aortadilatatie. Tegelijkertijd benadrukken de auteurs dat sport in het algemeen juist beschermend is en dat de klinische interpretatie van deze bevindingen complex blijft.

De boodschap is dus genuanceerder dan sommige mediakoppen suggereren: niet stoppen met sporten, maar zorgvuldige beoordeling en individuele benadering bij afwijkingen.

Hierbij de bronnen van het originele artikel:
- https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag040/8586272

Hieronder het abstract:
Exercise training improves cardiovascular health and reduces the risk for future cardiovascular events and mortality. However, emerging evidence suggests that Masters athletes may have a higher prevalence of cardiovascular abnormalities, such as atrial arrhythmias, coronary atherosclerosis, aortic dilatation, and myocardial fibrosis, compared to their less active peers. The clinical management of Masters athletes may be challenging as available guidelines for such conditions are generally based on data derived from symptomatic sedentary patients, limiting their applicability to highly trained individuals. Other unique challenges in the clinical assessment of Masters athletes include differences in symptomatic presentations compared to sedentary individuals, potential resistance to the initiation of pharmacologic treatment, and the increasing availability of consumer wearable health data that may provide relevant information on their cardiovascular health status. The purpose of this joint EAPC/ESC and ACC Clinical Consensus Statement is to provide an in-depth update on the current state of knowledge on abnormal cardiovascular findings in Masters athletes. We present an expert-based approach on the diagnostic assessment, management, and prognosis of (i) atrial fibrillation, (ii) bradyarrhythmias, (iii) ventricular arrhythmias, (iv) coronary atherosclerosis, (v) aortic dilatation, (vi) myocardial fibrosis, and (vii) exercise-induced arrhythmogenic cardiomyopathy. Clinical challenges, areas of ongoing controversy, and uncertainty and the potential underlying mechanisms are discussed. We also present future perspectives and research directives to further refine current best practice strategies. This includes the need for clinical outcome studies, dedicated randomized controlled trials in athletes, and international registries with diverse populations and longitudinal follow-up to evaluate the natural history of cardiac abnormalities and facilitate development of evidence-based approaches in the clinical management of Masters athletes with cardiovascular abnormalities.