The role of cardiorespiratory fitness on the risk of sudden cardiac death at the population level: A systematic review and meta-analysis of the available evidence

Abstract

Cardiorespiratory fitness (CRF) has been widely studied as a powerful and independent predictor of all-cause and disease-specific mortality. Sudden cardiac death (SCD) is recognized as a significant cause of mortality among the general population, including the general population without previous symptoms of any coronary heart disease (CHD). Consequently, SCD is an important public health problem, which constitutes a clinical challenge. Thus, prevention of SCD by detecting early risk factors could be a useful tool, contributing to the American Heart Association's goal of decreasing the incidence of SCD at the population level. The identification of these risk factors for CVD would facilitate the large-scale screening of those participants at higher risk of SCD. This systematic review collects information about the role of CRF on the risk of SCD at the available evidence, and analyzes the long-term influence of CRF as a risk factor and independent predictor of SCD.

Role of Muscular Strength on the Risk of Sudden Cardiac Death in Men

“…These findings offer new insights into the prevention of SCD through increasing MusS in addition to the previously documented protective benefits of CRF. 1 Moreover, this supports previous research indicating that both MusS and CRF predict all-cause mortality risk. 8 The apparent protective effect of MusS against the risk of SCD might be due to the direct effect of muscle strength, which is considered an index of muscle quality and function that is generally improved by resistance exercise.…”

“…To the Editor: The effect of cardiorespiratory fitness (CRF) on sudden cardiac death (SCD) has been summarized, 1 with the conclusion that the risk of SCD decreases by 14% to 22% per 1-metabolic equivalent task increase in CRF. 1 Recently, Mayo Clinic Proceedings has not only emphasized articles on CRF [2][3][4] but also articles on resistance exercise and muscular strength (MusS). [5][6][7] However, there is no study of the effect of MusS on SCD, even though MusS was inversely and independently associated with all-cause mortality in healthy men.…”

“…For SCD events, the National Death Index was the primary data source for mortality surveillance, augmented with death certificates. 1 Cox proportional hazards regression was used to compute hazard ratios (HRs; 95% CIs) of SCD for tertiles of MusS (models 1-3 in the Table).…”

“…However, the reduction in SCD risk for those with moderate MusS or the combination of both high MusS and CRF was even higher (69% or 72%, respectively) than that previously found for CRF alone (44%-48% risk reduction) in a larger sample of the Aerobics Center Longitudinal Study cohort (n¼59,611). 1 Further studies are needed to assess the combined effects of MusS and CRF on the prevention of SCD.…”

“…To The Editor: Endometriosis is a sex hormone-dependent gynecological disease characterized by the presence and growth of endometrial tissue outside the uterus that affects up to 10% of women of reproductive age. 1 Endometriosis lesions harbor dense vascularization, and angiogenesis has been shown to play a critical role in its establishment and progression. 2 Hence, targeting the vascular endothelial growth factor (VEGF) signaling pathway is considered a promising approach for the treatment of endometriosis.…”