Is sport niet gezond? - screening voor recreatieve …...2020/02/13  · (such as chess or go),...

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Werner Budts Congenitale en Structurele Cardiologie UZ Leuven Is sport niet gezond? - screening voor recreatieve sporters op hart- en vaatziekten

Transcript of Is sport niet gezond? - screening voor recreatieve …...2020/02/13  · (such as chess or go),...

Page 1: Is sport niet gezond? - screening voor recreatieve …...2020/02/13  · (such as chess or go), predominantly motorized (such as Formula 1 or powerboating), primarily co-ordination

Werner Budts

Congenitale en Structurele Cardiologie

UZ Leuven

Is sport niet gezond? - screening voor recreatieve

sporters op hart- en vaatziekten

Page 2: Is sport niet gezond? - screening voor recreatieve …...2020/02/13  · (such as chess or go), predominantly motorized (such as Formula 1 or powerboating), primarily co-ordination

Werner Budts

Congenitale en Structurele Cardiologie

UZ Leuven

Is sport niet gezond? - screening voor recreatieve

sporters op hart- en vaatziekten

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Is ‘sporten’ wel de juiste term?

“Sport (British English) or sports (American English) includes all forms of

competitive physical activity or games which, through casual or organized

participation, aim to use, maintain or improve physical ability and skills

while providing enjoyment to participants, and in some cases,

entertainment for spectators.”

Definitie

Herkomst

“The word "Sport" comes from the Old French desport meaning "leisure",

with the oldest definition in English from around 1300 being anything

humans find amusing or entertaining.”

SportAccord 2011; Harper and Douglas Etymological Dictionary 2008

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Is ‘sporten’ wel de juiste term?

“Sport can be primarily physical (such as rugby or athletics), primarily mind

(such as chess or go), predominantly motorized (such as Formula 1 or

powerboating), primarily co-ordination (such as billiard sports), or primarily

animal-supported (such as equestrian sport)”.

Fysiek?

Competitief versus niet-competitief of recreatief

Professioneel versus amateur

SportAccord 2011; Harper and Douglas Etymological Dictionary 2008

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Fysieke activiteit is een betere term

Fysieke fitheid ↑↑

“Physical activity refers to any bodily movement produced by skeletal

muscles that increase energy expenditure above a basal level.”

Exercise and physical activity guide for Health promotion 2006. Ministry of Health, Tokyo 2016

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‘Sportdiscipline’ gebonden ‘fysieke activiteit’

Mitchel et al. JACC 2005

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‘Sport discipline’ gebonden ‘fysieke activiteit’

Level of running

=

Level of physical activity

Geindividualiseerd advies?

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Een nieuwere classificiatie…

Niebauer et al. Eur Heart J 2018

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Is ‘sporten’ gezond?

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We worden ouder…

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We worden dikker…

Lancet 2016

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We worden dikker… van jongsaf

Pinto et al. Pediatrics 2007

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Klassieke risicofactoren stijgen…

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Sporten – fysieke activiteit is nodig!!

Lear et al. Lancet 2017

MET = 3,5 ml zuurstof per kg lichaamsgewicht per minuut

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Sporten – fysieke activiteit is nodig!!

Lear et al. Lancet 2017

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Sporten – fysieke activiteit is nodig!!

Lear et al. Lancet 2017

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Sporten – fysieke activiteit is nodig!!

Lear et al. Lancet 2017

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Effect van fysieke activitiet op risicofactoren

Bellisimo et al. Mayo Clin Proc. 2018

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Fysieke activiteit en hartlijden

Fysieke activiteit Hartlijden+

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Keerzijde: incidentie plotse dood!

Asif et al. Curr Opin Cardiol 2013

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Disbributie plotse dood

Marijon et al. Circulation 2011

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Plotse dood: intensiviteitsafhankelijk

Marijon et al. Circulation 2011

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Plotse dood: oorzaak leeftijdafhankelijk

Marijon et al. Circulation 2011

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Plotse dood: sportafhankelijk

Marijon et al. Circulation 2011

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Cardiovasculaire screening!!

Screening is NUTTIG

Vraag:

Hoe het meest practisch?

Het meest evidentie gebaseerd?

Juiste risk benifit verhouding

Kosteneffectiviteit

Logistieke haalbaarheid

Asif et al. Curr Opin Cardiol 2013

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En hoe dan: anamnese, voorgeschiedenis, ekg?

Asif et al. Curr Opin Cardiol 2013

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En hoe dan: anamnese, voorgeschiedenis, ekg?

Asif et al. Curr Opin Cardiol 2013

Asymptomatisch

Syncope

Thoracale pijn

Familiale SD (<50y)

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Optimalizeren EKG evaluatie?

100% negatief predictieve waardeHypertrofische cardiomyopathie

Long QT syndroom

Wolf-Parkinson-White

15-40% vals positieve waarden

Vals negatieve waarden

Coronaire anomalieën

Premature atherosclerose

Aortawortel dilatatie

Asif et al. Curr Opin Cardiol 2013

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Evolutie van EKG evaluatie…

Corrado et al. Eur Heart J 2010

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Nieuwe evolutie van EKG evaluatie

Drezner et al. Br J Sports Med 2013; Sheikh et al. Circulation 2014

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Wat kost het?

Dhutia, H. et al. J Am Coll Cardiol. 2016

$539,888

$453,768

$427,657

N ≈ 5000

Kosten voor verder onderzoek

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Wat kost het om plotse dood te voorkomen?

Asif et al. Curr Opin Cardiol 2013

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Brengt het dan allemaal iets op???

Corrado et al. JAMA 2006

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Brengt het dan allemaal iets op??

Corrado et al. JAMA 2006

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En wat met de vals negatieven?

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Besluit

• Sporten is gezond – het beinvloedt het

cardiovasculair risicoprofiel

• Voldoende fysieke activiteit geeft reeds een voordeel

• Screening vooraleer te sporten is nuttig, vooral bij

competitieve sporten

• Het EKG speelt een belangrijk rol in het screening

proces

• Kosten baten is een blijvende speelbal…

• Een georganiseerde backup helpt de sporter in de

problemen…

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Werner Budts

Congenitale en Structurele Cardiologie

UZ Leuven

Is sport niet gezond? - screening voor recreatieve

sporters op hart- en vaatziekten


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