Herzinfarkt und Sport – Individuell angepasste Trainingsprogramme sind notwendig

Die Mehrzahl der Herzinfarkte entsteht auf dem Boden einer koronaren Herzkrankheit (KHK). Wie alle akuten Koronarsyndrome beim Menschen werden sie fast immer durch eine plötzliche Minderdurchblutung eines Herzkranzgefäßes hervorgerufen, die auf eine atherosklerotische Gefäßveränderung mit zusätzlicher Koronarthrombose zurückzuführen ist und von einem Koronarspasmus begleitet werden kann. Auslösende Faktoren für einen Infarkt können z. B. plötzliche Belastungen und Stresssituationen mit starken Blutdruckschwankungen sein. Nach der Diagnosestellung, der akuten und mittelfristigen koronarspezifischen Therapie, stellt sich die Frage nach der Sekundärprävention. Dabei hat man medikamentöse, diätetische, aber auch physikalische Mittel zur Verfügung. Dem Sport wird dabei eine bedeutende Rolle zugeschrieben. Die Frage, ab wann, „wieviel“, also wie häufig und wie intensiv Sport getrieben werden kann, ist keineswegs eine triviale Frage und muss individuell beantwortet werden. Dieser Artikel fasst die aktuellsten Daten zu diesem Thema zusammen.

Physical activity both prevents and helps to treat many established atherosclerotic risk factors, including elevated blood pressure, insulin resistance and glucose intolerance, elevated triglyceride concentrations, low-density lipoprotein cholesterol (LDL-C) concentrations, and obesity. Several meta-analyses have concluded that comprehensive, exercise-based cardiac rehabilitation reduces mortality rates in patients after myocardial infarction. The individually adapted training programs should form the basis of the cardiologic rehabilitation. Overall, available information suggest that physical activity in the range recommended by public health guidelines, has quite an acceptable risk-benefit ratio. For patients with heart disease (in particular after acute coronary syndrome and/or bypass-operation) the participation in outpatient or inpatient rehabilitation programs followed by physical exercise, ideally within „heart groups“, is recommended.

Key words

physical activity - atherosclerosis risk factors - rehabilitation - myocardial infarction

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