Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart disease events. These data, plus the well-documented anti-aging effects of exercise, have likely contributed to the escalating numbers of adults who have embraced the notion that "more exercise is better." As a result, worldwide participation in endurance training, competitive long distance endurance events, and high-intensity interval training has increased markedly since the previous American Heart Association statement on exercise risk. On the other hand, vigorous physical activity, particularly when performed by unfit individuals, can acutely increase the risk of sudden cardiac death and acute myocardial infarction in susceptible people. Recent studies have also shown that large exercise volumes and vigorous intensities are both associated with potential cardiac maladaptations, including accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, and atrial fibrillation. The relationship between these maladaptive responses and physical activity often forms a U- or reverse J-shaped dose-response curve. This scientific statement discusses the cardiovascular and health implications for moderate to vigorous physical activity, as well as high-volume, high-intensity exercise regimens, based on current understanding of the associated risks and benefits. The goal is to provide healthcare professionals with updated information to advise patients on appropriate preparticipation screening and the benefits and risks of physical activity or physical exertion in varied environments and during competitive events.

中文翻译：

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长期运动训练后与运动有关的急性心血管事件和潜在的有害适应：将风险纳入视野之中—更新：美国心脏协会的科学声明。

流行病学和生物学的合理性研究支持体育活动或心肺适应水平的提高与冠心病事件减少之间的因果关系。这些数据，加上有据可查的运动抗衰老作用，很可能导致接受“运动越多越好”这一观念的成年人数量不断增加。结果，自从美国心脏病协会先前发表关于运动风险的声明以来，全世界参加耐力训练，竞技长距离耐力赛和高强度间歇训练的参与都显着增加。另一方面，剧烈的体育活动，特别是由不健康的人进行的体育活动，会严重增加易感人群猝死和急性心肌梗塞的风险。最近的研究还表明，大量运动和剧烈运动都与潜在的心脏适应不良有关，包括冠状动脉钙化加速，运动引起的心脏生物标志物释放，心肌纤维化和心房颤动。这些适应不良反应与身体活动之间的关系通常形成U形或反向J形剂量反应曲线。根据当前对相关风险和益处的了解，该科学陈述讨论了中度到剧烈运动以及高容量，高强度运动方案对心血管和健康的影响。